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Natural Interventions for Pain

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Generally speaking, as we age, our level of inflammation increases. Whether it is from wear and tear injuries to muscles and ligaments, or a chronic disease such as arthritis, those over 40 are at much higher risk for pain and inflammatory damage. Unfortunately, the adverse effects of non-steroidal anti-inflammatory drugs (NSAIDs) like ibuprofen, naproxen sodium, aspirin and celecoxib are also more likely to be serious, even life threatening, as we age. Did you know that side effects of NSAIDs include gastric ulcers and bleeding, decreased kidney function, and a two- and three-fold increased risk of heart attack and stroke? Conservative estimates indicate that more than 100,000 hospitalizations and over 16,500 deaths each year occur due to this class of drugs.

Therefore, it becomes even more important to find effective natural products that reduce pain and inflammation without the risks of NSAID use.

However, inflammation is not always the enemy. Inflammation is a necessary process for repair and recovery after an injury.

Acute inflammation can take many forms—heat, redness, swelling, and of course—pain. Pain is most often is an indicator of a more complex underlying issue. Under normal circumstances, our body will deal with the inflammation quickly so the rest of the healing process can occur and thus the pain disappears. However, our diet, lifestyle and genetics can play a significant role in how efficiently our bodies can respond to inflammation.

If we are already overwhelmed by toxins and deprived of necessary nutrients, we can enter a chronic inflammatory state. Chronic inflammation is often referred to as “silent” because it may not have many outward symptoms. However, both acute and chronic inflammation can contribute to pain. Without addressing the inflammation, there is little chance that pain will subside on its own.

Alleviating pain with natural substances focuses on modifying inflammatory pathways, improving mood, and restoring balance in the body. Prescription medications can only target one inflammatory pathway, whereas natural substances have the unique ability to modulate many pathways simultaneously. Natural pain relievers like curcumin, boswe-llia and hemp hold great promise for the pain epidemic in the United States.

Curcumin

Curcumin (from turmeric) is one of the most widely researched medicinal substances—natural or pharmaceutical—in the world. With almost 11,000 peer-reviewed studies, curcumin has been investigated for health conditions such as diabetes, arthritis, Alzheimer’s disease, cancer and pain.

Joint pain is a major cause of chronic pain, with arthritis affecting more than 50 million Americans. In a clinical study on rheumatoid arthritis, participants were split into three groups. The first group received an enhanced absorption curcumin blended with turmeric essential oils called BCM-95 Curcumin, the second group was given the prescription drug diclofenac sodium, and the last group received a combination of curcumin and diclofenac sodium. At the end of the study, all the groups improved, but the greatest improvement was seen in the curcumin group. Additionally, 14 percent of the participants in the drug group had to drop out due to adverse effects. Another clinical study demonstrated that an enhanced absorption phytosome curcumin (Meriva) could alleviate pain as well as the over-the-counter drug acetaminophen.

Boswellia

Curcumin is highly effective on its own, but it also has synergistic properties when combined with other natural ingredients, such as boswellia. In a study on knee osteoarthritis, patients were given either a combination of enhanced absorption curcumin and a uniquely standardized boswellia (BosPure) combination, or the number one prescription drug for osteoarthritis of the knee—celecoxib (one brand name is Celebrex). At the end of the 12-week study, the patients in the herbal group experienced greater reductions in joint pain and tenderness, and an increased ability to walk 1,000 meters (roughly two-thirds of a mile) compared to the drug group. Plus, 64 percent of the herbal group (vs. only 29 percent of the drug group) experienced such significant improvements at the end of the study that they were downgraded from “moderate to severe arthritis” to “mild to moderate arthritis.”

Aside from directly affecting pain, both curcumin and boswellia have also been shown to help improve mood. In many instances, pain and mood disorders co-occur, so finding compounds that can work on the mind and body are incredibly valuable. Curcumin has been shown in multiple clinical trials to be a potent antidepressant for major depressive disorder (MDD) and atypical depression. Boswellia has also been shown to balance cortisol levels, which can become disturbed during chronic pain.

Hemp Oil

Another exciting natural compound that is gaining steam with regard to pain is hemp. Hemp oil from the stalk of the plant contains many beneficial compounds, including a full spectrum of cannabinoids. These cannabinoids interact with our endocannabinoid. The endocannabinoid system has receptors spanning the whole body, and its discovery 30 years ago could be one of the most important medical breakthroughs of our time.

Hemp and marijuana are often both referred to as cannabis, but hemp differs from its cousin marijuana in terms of delta-9-tetrahydrocannabinol (THC) content. THC is responsible for the psychoactive properties of marijuana. By definition, hemp must contain <0.3 percent of THC, whereas the THC content of marijuana can vary significantly. In terms of hemp, there are more than 100 different types of phytocannabinoids that interact in a very complex way, although cannabidiol (CBD) tends to receive much of the attention. Many researchers isolate one or two compounds to evaluate their benefits; however, it seems like whole hemp extracts may be superior. Whole hemp extracts contain compounds like CBD, cannabigerol (CBG), cannabinol (CBN) and many others. Hemp also contains terpenoids like beta-caryophyllene and myrcene. Many of the compounds in hemp have been identified as anti-inflammatory and pain relieving.

One scientific study demonstrated that a whole plant extract was more effective at reducing pain and inflammation than CBD extract alone. Cannabis has also been explored for its positive effects on difficult to treat pain, like neuropathic pain and intractable cancer pain. Research has also found that deficiencies in our ECS can manifest as headaches (including migraines), fibromyalgia, muscle spasms and even irritable bowel syndrome. There are numer-ous clinical trials underway for osteoarthritis, chronic pain, multiple sclerosis, neurological pain and spin-al cord injury pain. Considering the fact we’ve been studying the other systems of our body for thousands of years—cardiovascular, urinary, reproductive, digestive, etc., we have so much to learn about the ECS and its applications to health and wellness.

With upwards of 650,000 opioid prescriptions every day, we clearly are in need of better and safer pain alleviating options. In addition to improvements in diet and lifestyle, natural ingredients that have been scientifically validated like curcumin, boswellia and hemp can make a significant difference in pain and quality of life. Their safety profile is far superior to prescription medications, and instead of side effects, one receives side benefits.

Remember, pain is a signal that needs to be medically evaluated. Pain is our check engine light. Don’t ignore pain, especially if it is sudden and severe—make sure you know what is causing it. Only then can you decide how to best treat that pain. VR

Resources:

Barbour KE, Boring M, Helmick CG, Murphy LB, Qin J. Prevalence of Severe Joint Pain Among Adults with Doctor-Diagnosed Arthritis – United States, 2002 – 2014. MMWR Morb Mortal Wkly Rep. 2016 Oct 7;65(39):1052-1056.

Chandran B, Goel A. A randomized, pilot study to assess the efficacy and safety of curcumin in patients with active rheumatoid arthritis. Phytother Res. 2012 Nov;26(11):1719-25.

Cho JY, Chang HJ, Lee SK, Kim HJ, Hwang JK, Chun HS. Amelioration of dextran sulfate sodium-induced colitis in mice by oral administration of beta-caryophyllene, a sesquiterpene. Life Sci. 2007 Feb 13;80(10):932-939.

Di Pierro F, Rapacioli G, Di Maio EA, Appendino G, Franceschi F, Togni S. Comparative evaluation of the pain-relieving properties of a lecithinized formulation of curcumin (Meriva), nimesulide, and acetaminophen. J Pain Res. 2013;6:201-205.

Dowell D, Haegerich TM, Chou R. CDC guideline for prescribing opioids for chronic pain—United States, 2016. JAMA. 2016;315(15):1624-1645.

Durso GR, Luttrell A, Way BM. Over-the-Counter Relief From Pains and Pleasures Alike: Acetaminophen Blunts Evaluation Sensitivity to Both Negative and Positive Stimuli. Psychol Sci. 2015 Jun;26(6):750-758.

Gallily R, Yekhtin Z, Hanus LO. Overcoming the Bell-Shaped Dose-Response of Cannabidiol by Using Cannabis Extract Enriched in Cannabidiol. Pharmacology & Pharmacy. 2015;6(2):75-85.

Hewlings SJ, Kalman DS. Curcumin: A Review of Its’ Effects on Human Health. Foods. 2017 Oct 22;6(10).

Kizhakedath R, Antony B, Benny M, Kuruvilla BT. Clinical evaluation of a herbal product (Rhulief) in the management of knee osteoarthritis. Abstract 316. Osteoarthritis Cartilage. 2011;19(S1):S145-S146.

Moussaieff A, Gross M, Nesher E, Tikhonov T, Yadid G, Pinhasov A. Incensole acetate reduces depressive-like behavior and modulates hippocampal BDNF and CRF expression of submissive animals. J Psychopharmacol. 2012 Dec;26(12):1584-1593.

Russo EB. Cannabinoids in the management of difficult to treat pain. Ther Clin Risk Manag. 2008 Feb;4(1):245-259.

Sanmukhani J, Satodia V, Trivedi J, Patel T, Tiwari D, Panchal B, Goel A, Tripathi CB. Efficacy and safety of curcumin in major depressive disorder: a randomized controlled trial. Phytother Res. 2013;28(4):579-85.

Singh G. Recent considerations in nonsteroidal anti-inflammatory drug gastropathy. Am J Med. 1998 July 27;(1B):31S-38S.

Smith SC, Wagner MS. Clinical endocannabinoid deficiency (CECD) revisited: can this concept explain the therapeutic benefits of cannabis in migraine, fibromyalgia, irritable bowel syndrome and other treatment-resistance conditions? Neuro Endocrinol Lett. 2014;35(3):198-201.

Wade DT, Robson P, House H, Makela P, Aram J. A preliminary controlled study to determine whether whole-plant cannabis extracts can improve intractable neurogenic symptoms. Clin Rehabil. 2003 Feb;17(1):21-29. Woods SC. The endocannabinoid system: mechanisms behind metabolic homeostasis and imbalance. Am J Med. 2007 Feb;120(2 Suppl 1):S9-S17.

Bio-box:

Cheryl Myers is an integrative health nurse, author, and an expert on natural medicine. She is a nationally recognized speaker who has been interviewed by the New York Times, Wall Street Journal and Prevention magazine. Her many articles have been published in such diverse journals as Aesthetic Surgery Journal and Nutrition in Complementary Care, and her research on botanicals has been presented at the American College of Obstetrics and Gynecology and the North American Menopause Society. Myers is the head of Scientific Affairs and Education for EuroPharma, Inc.

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