Statistics:
1 in 5 Australians aged 45 and over are living with persistent ongoing pain,
The estimated cost to the community was $139 billion in 2018, mainly due to reduced quality of life and productivity losses.
If left unattended inflammation causes a key role in disease development (1)
What is chronic pain?
Chronic pain is pain that lasts longer than normal pain after an injury or illness.
Chronic pain can result from injury, surgery, musculoskeletal conditions such as arthritis, or from other medical conditions such as endometriosis and migraines.
Diet and lifestyle strategies combined with therapeutic doses of herbal medicine and nutritional supplements can all play a key role in pain reduction.
Food as medicine
The Traditional Mediterranean diet is the most researched diet. It focuses on anti-inflammatory foods while excluding or limiting inflammatory foods.
The diet is generally defined by the daily consumption of fruits, vegetables, whole grains, nuts/ seeds and healthy fats, especially monounsaturated fatty acids (MUFAs) from virgin olive oil. The diet also limits the intake of red meat and dairy, whilst focusing on fish, poultry, beans and eggs as the preferred source of protein. It is high in antioxidants and phenols which are naturally protective
Therapeutic dosing.
This is the amount needed to treat a condition.
Many people don’t take the recommended dose of a supplement or for the recommended time to see a result. I encourage you to seek professional advice when taking a supplement and find the best bioavailable one for you. Otherwise, you may be wasting your money and not getting the results that you should. I personally recommend a minimum of 3 months of a supplement at the therapeutic dose especially when treating pain and inflammation.
Herbal Medicine
Curcumin
Whilst curcumin is derived from turmeric, it is not the same as turmeric. Curcumin, represents about 2-8% of turmeric, giving its distinct colour and flavour.
Curcumin’s many benefits include anti-inflammatory, a potent antioxidant, anti-cancer, has shown to improve mood and may also affect gut function. Curcumin was first isolated from Turmeric in 1915, Since this time thousands of clinical trials have revealed the therapeutic effect of curcumin.
As curcumin is poorly absorbed into the bloodstream, it’s important to choose a more bioavailable form that has been researched. Most research has looked at doses of 500-1000mg p/day.
Rheumatoid arthritis (RA) and Osteoarthritis (OA)
In a recent randomised, double-blind, three-arm parallel-group trial, curcumin administration (250 or 500mg twice daily) for 90 days produced significant improvements in clinical symptoms in patients with active RA and was well tolerated. Curcumin demonstrated significant anti-inflammatory effects with a reduction in inflammatory markers in both curcumin treatment groups.
A meta-analysis of seven clinical trials, using curcumin daily and ranging from four to 16 weeks demonstrated that curcumin supplementation significantly reduced knee pain and improved quality of life in patients with knee OA.
Boswellia
Bosweliia serrata, has long been used for fighting inflammation in traditional medicine.
Non steroidal anti-inflammatory drugs (NSAIDs), can have serious side effects when used long term. NSAIDs prevent inflammation by inhibiting an enzyme called COX-2 (cyclooxygenase-2). The problem is that in the process, it also blocks COX-1, which is needed to maintain a healthy stomach lining. Thus long-term use of NSAIDs can affect digestion and gut health
Improvements in osteoarthritis pain.
In a randomised controlled trial in patients with knee OA, who were given Boswellia showed a reduction in pain and improved function when compared to placebo.
It’s important that as with any herbal medicine that you check with your health care professional if you are taking any prescription medicine.
Nutritional supplements
Palmitoylethanolamide (PEA)
PEA is produced in the lipid layer of our cells when we are in pain. PEA is an important anti-inflammatory supplement with pain-relieving properties, mainly involved in the downregulation of mast cell activity. PEA also activates different enzymes that reduce the expression of enzymes involved in inflammation.
Knee Osteoarthritis
In a double-blind, placebo-controlled trial, 111 patients with mild to moderate osteoarthritis were randomised to a daily dose of 300mg PEA, 600mg PEA, or placebo for 8 weeks in two separate doses with meals. Pain, stiffness and function improved in both PEA groups compared to placebo within 8 weeks. The pain score in the 600mg was reduced by 49.5% at 8 weeks.
Endometriosis
PEA has been shown to be beneficial in the reduction of chronic pelvic pain in Women with endometriosis. The therapeutic dose recommend was 600mg twice per day for 3 months. It is a safe supplement as we produce it ourselves but require a lot more.
Movement as medicine
Exercise can make chronic pain more manageable, helping with symptoms by improving muscle tone and strength, as well as increasing energy. Exercise releases endorphins, the brain’s feel-good chemicals or “happy hormones” that help to improve mood and sleep, whilst reducing stress and blocking pain signals from reaching the brain.
It can be challenging to exercise when you suffer from chronic pain. Your condition may limit the type, amount and intensity of exercise and exertion you can manage. Look for movements that don’t trigger more pain - it’s imperative not to overdo it. Start slowly, and monitor your symptoms.
If you would like to know more about any of the treatments mentioned above, please get in touch.
Have a great day.
Jules x
Casuarina Holistic Health is conveniently located on the Tweed Coast. Naturopathic consultations can either be in clinic or online.
Bibliography
1. AIHW (2020). Chronic pain in Australia, Summary. [online] Australian Institute of Health and Welfare. Available at: https://www.aihw.gov.au/reports/chronic-disease/chronic-pain-in-australia/summary.
2. Amalraj, A., Varma, K., Jacob, J., Divya, C., Kunnumakkara, A.B., Stohs, S.J. and Gopi, S. (2017). A Novel Highly Bioavailable Curcumin Formulation Improves Symptoms and Diagnostic Indicators in Rheumatoid Arthritis Patients: A Randomized, Double-Blind, Placebo-Controlled, Two-Dose, Three-Arm, and Parallel-Group Study. Journal of medicinal food, [online] 20(10), pp.1022–1030. doi:https://doi.org/10.1089/jmf.2017.3930.
3. Kaushik, A.S., Strath, L.J. and Sorge, R.E. (2020). Dietary Interventions for Treatment of Chronic Pain: Oxidative Stress and Inflammation. Pain and Therapy, 9(2), pp.487–498. doi:https://doi.org/10.1007/s40122-020-00200-5.
4. Stochino-Loi, E., Pontis, A., Cofelice, V., Pirarba, S., Fais, M.F., Daniilidis, A., Melis, I., Paoletti, A.M. and Angioni, S. (2019). Effect of ultramicronized-palmitoylethanolamide and co-micronized palmitoylethanolamide/polydatin on chronic pelvic pain and quality of life in endometriosis patients: An open-label pilot study. International Journal of Women’s Health, Volume 11, pp.443–449. doi:https://doi.org/10.2147/ijwh.s204275.
5. www.lifeextension.com. (n.d.). Boswellia, An Effective Pain Relief - Life Extension. [online] Available at: https://www.lifeextension.com/magazine/2014/12/boswellia-new-studies-show-effective-pain-relief .