Non-drug methods for treating chronic pain

I am frequently asked if I can suggest non-drug therapies for the treatment of chronic pain. There is actually significant research on drug-free ways to address pain. Please note that as a general rule one should read all Internet or health column medical advice with a sense of caution, particularly if you have a health condition or are on medication, you should discuss any health advice with your health provider before making changes.

Why should one even consider not taking drugs for pain, particularly as they seem to work? The problem is that all medications come with side effects and some of those are serious.

A very common class of drugs, which include Motrin and Advil, are known as (NSAIDs) or non-steroidal anti-inflammatory drugs. They are great for treating pain but do have the potential for severe side effects and despite the name “anti-inflammatory,” they do not actually work to heal whatever process is causing the pain in the first place. In other words, they do treat pain for the time they are working but they do not make your arthritis or muscle strain any better and there are even some studies which show they may hinder the healing process.

The most feared side effects include the possibility of severe bleeding from the stomach and they may also harm your heart and your kidneys. A recent study even showed worsening kidney function in ultra marathoners who were taking these drugs to help them decrease the pain of the marathons.

Other drugs which are used to treat pain are the opiates. These are narcotics like Vicodin and the even stronger Oxycontin. The really serious problem with opiates is that they are highly addictive and withdrawal from them may make pain worse and the body often requires increasing amounts of the drugs to control pain. As the amount of opiate medication increases, the possibility of overdose and even death dramatically increases.

The country is in the middle of an opiate epidemic partially due to the over-prescribing of opiates for chronic pain. Alarmingly, there were over 50,000 deaths from opiate overdoses in 2016 alone.

So if drugs are not necessarily a great answer, what else works? There are some non-drug substances that seem to actually decrease inflammation at the site of your pain. These substances usually do not decrease pain as quickly as drugs such as Motrin and Vicodin but unlike those drugs they may actually work to heal the areas that have pain and they usually will decrease the chronic pain from inflammation over time.

1. Turmeric: One substance supported by a surprising amount of research and increasing popularity is the spice, turmeric, which contains the active ingredient curcumen. It is the yellow/orange spice found in Indian curries. Early research on turmeric was originally initiated after it was noted that people from India seemed to suffer from very little arthritis. One can take turmeric as a spice in foods or in greater amounts in capsule form. If you buy capsules, look for the brands that also have pepper in the capsule as pepper helps curcumen or turmeric to work.

2. Astaxanthin is a substance found in the red coloring of salmon, shrimp and lobsters. It is also a very powerful anti-inflammatory and numerous studies have shown its ability to decrease inflammation. Recent studies have even linked it with increases in longevity. There are two major categories of this substance in capsule form. There are natural forms. One of the most popular of these is BioAstin Hawaiian which is produced in Hawaii from microalgae. There is also a synthetic form which is also produced by a Hawaii-based company. The synthetic type, Zanthosyn, is the type used in recent studies by the University of Hawaii. The studies appeared to show that taking astaxanthin increased the expression of a gene associated with living longer. (As a disclaimer, I was so impressed with the research on astaxanthin that I bought stock in one of the Hawaii companies years ago).

3. Omega 3 fats: There are several types of fat in our normal diet. These include omega 6 fats, which actually increase inflammation, and omega 3 fats, which decrease inflammation. Omega 3 fats are found in fish such as salmon and sardines, nuts such as walnuts, and in leafy green vegetables. Omega 6 fats are high in processed foods and in vegetable oils. One can increase omega 3 intake by eating more omega 3 containing foods and also by taking omega 3 in capsule form. You can decrease omega 6 by eating less processed foods and cooking with coconut, avocado and olive oils rather than vegetable oils.

4. Diet: It turns out that diet alone can make a big difference in chronic pain. Sugar in the diet increases inflammation. A very good rule of thumb is to try to get rid of almost all the simple sugars in your diet. This usually means dramatically decreasing most processed foods, as they are almost all filled with sugars including high fructose corn syrup. It also means cutting out soda and replacing drinking fruit juices with eating the whole fruits.

5. Exercise: Regular exercise can play a big role in decreasing chronic pain. We are designed to move and not moving may help pain in the short term but in the long term not moving enough is almost always a really bad idea and tends to increase pain and mobility limitations.

Chronic pain can greatly decrease the enjoyment of life. If you suffer from chronic pain, I would consider discussing non-drug treatments with your health care provider.

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Lee Evslin, MD is a retired primary care physician. He was former CEO of Kauai Medical Group and Wilcox Hospital. His columns cover recent research on health issues. The information presented here should not be taken as medical advice but only as a sharing of information.

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