Pain is a fact of life that afflicts millions of North Americans, both young and old, on a daily basis. From strenuous physical activity to injuries, we face pain. As we age, we are less able to deal with the stressors in our lives that cause pain.

Often over-the-counter and prescription medications do not bring a long-term end to pain in a safe and effective manner. Additionally, the use of many of the nonsteroidal anti-inflammatory drugs (NSAIDs) can lead to serious complications and side effects. Dr. Prithvi Raj, Professor of Anaesthesia at Texas Tech University, has written that “medical models of chronic pain management have failed to produce a reliable, effective treatment.”

The good news is that today we can offer patients a comprehensive, multidisciplinary team and a multicomponent nutritional protocol that will result in effective and safe relief of chronic pain. The use of chiropractors, acupuncturists, massage therapists, psychologists, and nutritionists are as important as the primary care physician in addressing chronic pain. Phytoanalgesic botanicals and nutraceuticals contribute to an effective, safe, long-term treatment plan. Many of these natural agents also work on a related factor of chronic pain - inflammation.

Pain, the Brain, and the Immune System

Pain perception is hardwired in our nervous systems via neurotransmitters and other chemical messengers. Our immune system produces chemical messengers that can either transmit pain signals to the brain or cause inflammation. The immune system plays a dual role; it can be both helpful and destructive. When it comes to pain, we know that those with chronic pain have elevated levels of destructive inflammatory messengers. If not suppressed, these messengers set up a chronic pain feedback loop with the brain. An interaction between the brain and the immune system causes pain signals to remain permanently turned on, resulting in further chronic pain. Therefore, interrupting these pain signals becomes paramount from both a medical and nutritional point of view.

Prostaglandins and leukotrienes are compounds that are produced via the metabolism of fats in our diets. Both of these compounds can be simplistically categorized as either “good” or “bad.” The good prostaglandins and leukotrienes are beneficial to the body, while the bad ones are very destructive, playing a role in increasing our chances for cancer, heart disease, and inflammation. The consumption of high amounts of saturated fat gives rise to the production of the bad prostaglandins and leukotrienes. It is therefore recommended that we decrease animal fat in our diet and increase consumption of the unsaturated fats that come from fish.

The enzymes involved in the production of the destructive prostaglandins and leukotrienes (known as COX-2 and LOX) are the target of both medical and nutritional intervention. We can offer patients dietary supplements that work in the same manner as drugs, but are safer and just as effective over the long run.

The Nutritional Approach

Natural treatment of chronic pain is comprehensive and addresses nutrients that

• inhibit the immune system’s inflammatory cytokines, which are elevated in chronic pain conditions
• inhibit the “bad” prostaglandins and leukotrienes, which cause inflammation 
•  increase endorphins, the natural pain-relieving substances in our brain
• involve the repair of tissue once it is damaged from inflammation
• provide antioxidant support, since inflammation that damages tissues gives rise to increased free radicals
• assist with relieving the stress and anxiety associated with chronic pain conditions.

Specifically, the following nutritional agents may be incorporated in a variety of pain conditions, such as headaches and arthritis, as part of a comprehensive nutritional protocol.

Practitioners in Pain Management

Just as there is no single drug or nutrient that can be singularly effective, neither is there one single health-care modality. While the primary care physician is at the centre of the patient’s care, the pain sufferer can also utilize chiropractors, acupuncturists, massage therapists, nutritionists, and psychologists as integral members of the health care team.

If your physician shrugs off these other important practitioners, then it’s time to get another physician. Each of these disciplines deserves equal attention as they may impart significant benefits above and beyond the drug standard of care.

How well we recover from chronic pain depends upon how well we educate ourselves. Nature’s painkillers can provide us with the resources we need to take charge of pain and improve the quality of our lives.

Nutrients Useful as LOX Inhibitors

• taxifolin (a plant flavonoid)
• standardized turmeric (Curcuma longa)
• standardized boswellia (Boswellia serrata)
• perilla seed extract (Perilla Frutescens)
• omega-3 fatty acids
• pine-bark extract (Pinus maritime)

Nutrients Useful as COX-2 Inhibitiors

• CAPE (caffeic acid phenethyl ester)
• standardized resveratrol (found in the skins of red grapes)
• standardized stinging nettle (Urtica dioica)
• standardized willow bark (Salix)
• standardized turmeric
• omega-3 fatty acids

Nutrients that Help to Repair Tissue

• NAC (n-acetyl cysteine)
• glucosamine 
• chondroitin sulfate
• SAMe (s-adenosyl-methionine)
• niacinamide

Nutrients that Help Reduce Inflammatory Cytokines

• SOD/Gliadin, the first orally effective vegetarian form of superoxide dismutase
• standardized stinging nettle 
• vitamin D
• omega-3 fatty acids
• vitamin E
• standardized turmeric
• pine-bark extract
• quercitin (a bioflavonoid)

Carl Germano, RD, CNS, CDN, is a registered and certified nutritionist. He is the author of Nature’s Pain Killers (Kensington Pub. Corp., 1999).

Source: alive #262, August 2004