Overcoming Chronic Pain
Everybody experiences pain at some point in life. Pain sensations can be intense, but are usually brief. However, according to research by Pfizer Australia, for 29% of the Australian population, pain doesn’t subside and they are living with it chronically. This means nearly 1 in 10 Australians are experiencing chronic pain at any given time. Chronic pain can be described as a pain that extends beyond the expected healing time, or pain that is persistent, lasting longer than 6 months. The pain can range from a mild discomfort to excruciating; episodic or continuous; general or localized.
Pain can originate from a wide range of causes including physical injury; musculoskeletal problems such as arthritis, back pain and fibromyalgia; migraines and headaches; sciatica; hormonal issues like dysmenorrhea; cancer; emotional pain; neuropathic pain and even pain of an unknown or undetected source. These causes of pain often stem from imbalances that have become deeply set into one’s physiology over many years.
Whatever the cause or presentation, chronic pain affects people on many different levels. Chronic pain may lead to prolonged physical suffering or disability; family and marital problems; loss of employment; financial issues; excessive use of drugs and alcohol; fatigue; sleep disturbances; weakened immunity; withdrawal from usual daily activities and friends; emotional issues such as hopelessness, fear, irritability, stress, anxiety and depression - it affects people’s enjoyment and enthusiasm for life.
Common modern medical treatment:
Treatment of chronic pain is a major challenge for modern medical health-care providers because of its unclear definition, complex causes and the generally poor response to therapy. Most of the modern medical treatment relies on the use of medication to match the symptoms - anti-inflammatory’s, analgesics and anti-depressants.
Most pain has inflammation as its base, so the most widely prescribed medical intervention for chronic pain is non-selective NSAIDs (Non-Steroidal Anti-Inflammatory Drugs), which include aspirin, ibuprofen, acetaminophen, advil and the new COX-2-inhibiotry class of drugs (including Vioxx and Celebrex). NSAID’s make up 70 million prescriptions and 30 million over the counter sales each year in the US. (Wolf, Lichenstien, Singh, 1999)
While NSAIDs may offer benefits when using them on occasion, regular use is a serious concern for health. Most of the research around the damaging effects of NSAIDs revolves around the digestive system as the drugs promote gastric irritation, increase intestinal impermeability and cause injury to the liver and kidneys. In one study, small intestine and bowel erosions were noticed in 62% of the NSAID users compared to 5% of non-users (Ackerman, Blower, 1987). It is also estimated that 16,5000 NSAID related deaths occur just in patients with osteoarthritis or rheumatoid arthritis every year (a similar number to those who die from acquired immunodeficiency) (Wolf, Lichenstien, Singh, 1999). Also a minimum of 10-20% and a maximum of 50% of patients who take NSAIDs have dyspepsia (reflux, heart burn and other stomach discomfort)(Wolf, Lichenstien, Singh, 1999).
Not only can the drug be damaging to health but NSAIDs at best only offer symptomatic relief and do not address the underlying issues of the conditions.
Ayurvedic view on Chronic Pain:
According to Ayurveda, chronic pain is caused by doshic (energy) imbalances and is influenced by many factors like diet, digestion, toxin accumulation, stress, exercise levels and other lifestyle factors.
Poor diet, weak digestion and elimination, coupled with the accumulation of stress and the disruption of homeostasis and natural bodily rhythms by poor lifestyle choices all lead to the formation and build up of toxins in tissues (Called Ama in Ayurveda). This Ama in the tissues is what activates the pain response. Consuming certain foods over a long period of time that are not compatible with your body constitution also aggravate the nerves that increase pain, and this toxic build up blocks cellular nutrition, depresses the body’s natural healing ability, and slows the recovery from the experience of chronic pain – leaving the pain sensation in the nervous system for longer.
Ayurvedic treatment for chronic pain:
Here are some natural Ayurvedic treatments that are effective at relieving chronic pain without negative side effects:
Removing the toxic build up and impurities using the deep purification and rejuvenation methods of Panchakarma are the best way to address the root causes of the chronic pain. The combined treatments in Panchakarma of the herbalised oil massage, specific diet and cleansing methods help loosen impurities that are deeply embedded in the tissues and help liquefy them so they can be easily absorbed into the circulation and released, as well as focusing on balancing the nervous system to eliminate the pain. Regular daily massage during Panchakarma helps reduce pain because it pacifies excessive Vata, alleviates joint and muscle stiffness, increases circulation, mobilises toxins, and relaxes the mind and body.
The diet on Panchakarma is based around supporting the digestive system with easily digestible meals, while being satisfying and nourishing to restore balance to the specific bodily functions whose malfunctioning is causing the chronic pain.
According to Ayurveda, the Vata dosha (wind energy) that governs the nervous system is the underlying cause of pain in the body. Vata imbalance can be reversed by diet, oil treatments, herbs, cleansing methods, and yoga asanas, but the most profound remedies are meditation and yogic breathing exercises.
The emotional toll of chronic pain can also make the pain worse in a self-perpetuating cycle. Stress, worry, anxiety, depression, anger and even fatigue interact in complex ways and decrease the body’s production of natural painkillers. Also, these negative feelings may increase the level of substances that amplify sensations of pain. These emotions also compromise systems of the body, especially the immune system. So working on reducing these emotions is a key in treatment and meditation is effective with this.
There is quite a bit of research that show the benefits of meditation in chronic pain. New research shows that meditation can ease your pain after just 80 minutes of instruction and practice (Zeidan, 2011). Side effects of this may include better sleep, reduction in feelings of depression, increase in self-esteem and willingness to let go! In this same study by Fadel Zeidan, Ph.D, published in the Journal of Neuroscience, participants who learned to meditate took less pain medication and reported higher self-esteem and a more positive outlook. 15 months later most continued to mediate, even though they didn’t need to for the study, and maintained most of these improvements. Dr. Zeidon noted that meditators reported 40% less pain when meditating. They also reported 57% less discomfort from the pain. People on pain medication such as morphine reported 25% pain reduction. Areas of the brain that show pain in brain scans become less active for a person who meditates.
‘The incredible thing about proper meditation is that the more you do it, the more it becomes a part of you. There were prior studies on monks who had incredible amounts of meditation training, and they didn’t even have to meditate to reduce pain. It had become automatic’ - Dr. Zeidan.
Because chronic pain is a mind-body phenomenon, Yoga has a lot to offer. Yoga integrates physical movement, which works on addressing the underlying physiological imbalances in the body by stretching, strengthening and bringing circulation to the ligaments, tendons and connective tissue, with mindful practices that address the cognitive and emotional components.
A study that focused on yoga for chronic pain in the lower-back found that participation in once-weekly yoga classes was associated with significant and sustained reductions in pain intensity, functional disability and pain medication (Williams et al. 2005). Specifically, 88% of participants assigned to a 16-week yoga intervention reported decreasing or stopping pain medication by the end of the program, compared with only 35% in a control group that received lectures and handouts on self-care for chronic pain in the lower-back.
Anti-inflammatory medicines such as aspirin, ibuprofen, and naproxen work well because they block the enzymes that trigger both swelling and pain. There are natural alternatives to NSAIDs that have a similar mechanism but without the negative side effects. They include turmeric, green tea, ginger, rosemary, cat's claw, devil's claw, boswellia and willow bark.
Out of all the herbs, turmeric is showing the most promising research for natural pain relief. The beautiful, vibrant turmeric has been used in Ayurveda for thousands of years to ease the pain of many conditions including sprains, joint inflammation, swelling and bruising. The anti-inflammatory and analgesic qualities of turmeric come from the compound that gives it its wonderful bright yellow colour. This phytochemical is called Curcumin. Curcumin lowers the enzymes in the body that cause inflammation and therefore pain. Curcumin has demonstrated anti-inflammatory activity, in a number of experimental models around arthritis (Chainani, Altern, 2003). Clinical trials have shown Turmeric or curcumin/curcuminoids to be beneficial in a number of inflammatory conditions including rheumatoid arthritis, postoperative inflammation, osteoarthritis, uveitis and inflammatory orbital pseudotumours (Deodhar et al, 1980).
Please see your health care practitioner for recommendation of supplements and herbal medicine for pain, but as an effective home remedy you can also add this wonder spice into your diet. Use the fresh root or the dried powder in cooking or juices. You can take ¼ tsp of the dried powder with a pinch of black pepper daily on an empty stomach for pain relief.
Pain is seen as a multi-layered message to us, and Ayurveda welcomes and acknowledges pain, even while trying to relive it. Pain is nature’s way of saying ‘stop what you are doing’ or ‘stop using that body part’, and invites an opportunity to look deeper into our lives to see what we are doing that is creating this discomfort. If viewed with this outlook, chronic pain can become a catalyst for positive change.
If you or someone you know is suffering from chronic pain then natural medicine has a lot to offer. Treatment begins with identifying then removing or addressing the root cause so the pain can subside and true healing can occur. Gaining true relief from chronic pain is possible but will require a multifaceted approach that encompasses mind, body and spirit.
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Author: Tegan Wallis
Tegan is an Naturopath, Ayurveda Health Consultant and Yoga Teacher at Griffith Consulting's sister company, Veda Wellness.
Tegan is one of Griffith Consulting's key program facilitators and specialises in workplace health & wellness.
For more information about Tegan or her services, please go to: www.vedawellness.com.au