Safe Ways to Address Chronic Pain
By Tom Cowan, M.D. |
| Soon after I moved to California, almost 15 years ago, I received a notice saying that all physicians in California needed to take and pass a course on pain management to renew their license. The motivation behind this initiative, we were told, was that pain syndromes were left unrecognized and inadequately treated in the U.S. to an alarming degree. We were told that because of new drugs, physicians now could see to it that no person was left to suffer with chronic pain.  About a month ago, I took a follow-up class largely devoted to the state of pain management in 2018. We learned that as a result of the initiatives to effectively treat patients with pain, mostly with newer opiate medicines, at least tens of thousands of people died. Countless other people have had their lives devastated as a result of chronic opiate use, benzodiazepine use (medicines such as Valium, Librium, Xanax, etc.), or the deadly combination of opiates and “benzos.† Physicians, encouraged by pharmaceutical companies, created what many call an epidemic of tragic proportions, not only for the individuals whose health was undermined through chronic medication use, but also for their families and communities.  We even heard that a new study indicated that the chronic use of prescription sleeping pills, which an extraordinary percentage of older Americans uses, dramatically increases the all-cause mortality rate. The course was designed to alert us to the dangers these drugs cause and to teach us how to “safely†and “legally†prescribe them.  Most of the doctors in the room were older practitioners, most in solo or small-group practices; in other words, part of the dying breed. The sense of despair and futility in the room was palpable, as these men and women were aware that, given the constraints of their practices, they have no effective way to comply with the regulations concerning opiate prescriptions. Perhaps more important, most have no clue what to tell their patients who are in pain, as they have no other tools in their toolbox besides pharmaceutical medicines.  All they know is how to prescribe drugs, and yet it is crystal clear that these substances are literally killing people. This is clearly a horrible situation for these doctors and the patients who rely on them for their care.  This entire situation was brought home to me last year when I watched an interview with the Golden State Warriors basketball head coach, Steve Kerr. Kerr had to quit work for weeks because of chronic pain from leakage of spinal fluid during back surgery. When describing what he was going through, he made two clear points: That if he had it to do over again, he would not have had the back surgery, and that he was not willing to take opiates, having seen the devastation this had caused to friends and colleagues.  Given the intense nature and physical traumas that professional athletes routinely experience, I can only imagine the extent of the use of opiates and other pharmaceuticals. Anti-inflammatory drugs, which have been linked to chronic kidney disease and heart disease, are also not the solution. For someone like Steve Kerr to go public with his distrust of the strategies offered to him by top doctors underscores how widespread this problem is.  I don’t have the answer to the treatment of chronic pain, but I can offer suggestions that have helped many of my patients. First, pain is not the diagnosis. Even if you receive the diagnosis “chronic regional pain syndrome,†pain is a symptom, or a way your body is communicating that something is wrong. The answer to what is wrong varies; it could be an acute injury, such as a fracture, or it could be a chronic condition, such as migraine headaches. In either case, the place to start is to have a thorough evaluation to see whether the source can be identified.  Once the evaluation has been done, and in many cases, no actual diagnosis can be found, a number of pain-relief strategies can be tried. None work as quickly or as profoundly as opiates at getting rid of pain, but they lack opiates’ dangerous effects.  As always, the place to start is with diet and movement. Many people’s pain is a result of arthritis, inflamed soft tissues (tendonitis, bursitis, etc.) or simply weakness of the muscular-skeletal system. A “Nourishing Traditionsâ€-type diet and a combination of strength training, stretching, and either walking or swimming will help most people live healthier, more pain-free lives. If you are not used to exercising, finding a personal trainer to guide you can be a wise investment.The next modality I employ with many people with chronic pain, especially muscular-skeletal in origin, is the bio-photon or light therapy we use in the office. The theory and practice of bio-photon therapy is simple. A heat-sensing camera finds spots of congestion and inflammation, and different wavelengths of light, including far-infrared, are directed to these areas. The light exposure increases blood flow and improves cellular function and detoxification. The pain is not just blocked; the areas treated actually get healthier. Many of our patients report significant improvement after about six sessions of 15 minutes each, two to three times a week. Nothing is injected, and no side effects of any sort occur.  The treatment of pain almost always involves improving blood flow and detoxification.  Oral medicines that help include liposomal vitamin C and glutathione, both of which improve detoxification; siliplant, an organic silica preparation for improving the strength and elasticity of the joints and muscles; and the anti-inflammatory herbs boswellia (in photo above) and turmeric. The liposomal preparations, particularly those made by an innovative company called Quicksilver Scientific, means they put the desired substances in a tiny fat bubble (made from non-GMO sunflower oil), which ferries the nutrient into the blood stream. Using this type of preparation, we are able to obtain blood levels of glutathione (sometimes called the master detoxifier) and vitamin C that were previously obtainable only through IV use. Another useful liposomal preparation from Quicksilver is high-potency hemp oil. Hemp oil is rich in non-psychoactive cannabidiols, which often provide effective pain relief. Other helpful interventions include massage therapy, osteopathy and acupuncture.  We do have safe options for the treatment of chronic pain. Except in rare cases, and then only acutely or for end-stage cancer pain, the current pharmaceutical approach should be our last resort. |
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