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To enjoy good health, to bring true happiness to one's family, to bring peace to all, one must first discipline and control one's own mind. If a man can control his mind he can find the way to Enlightenment, and all wisdom and virtue will naturally come to him.

It make me nervous when anyone tells me they are regularly using oral non-steroidal anti-inflammatory pain medications (NSAIDS), such as Aspirin, Motrin, Advil, Ibuprofen, Naprosyn, and the further complete list which you can find at THE BOTTOM OF THIS NEWSLETTER. In my opinion these are only to be used temporarily, and are always to be taken with a meal, NEVER on an empty stomach. Yet because they are so readily available OTC, it is understandable one would think  they are safe to use long term  at full dose. Consumer beware.

 

Several times in my medical career I have had patients who were doing wonderfully well, then suffered some mild-moderate musculoskeletal injury eventuating in pain. On their own, they started taking the NSAIDs for the pain.  They were not careful to take the meds with a full meal & they stayed on it too long. Anyway, they ended up with significant gastrointestinal bleeds, hospitalization, transfusions, and prolonged recovery periods.

 

 The prevalence of upper GI ulcers  in those taking low dose aspirin is 10-40%, depending upon the study.  Aspirin increases the risk of GI bleeding by 2 times. Those using non aspirin NSAIDS have a 20% prevalence of upper GI ulcers and a 4-6 times increased risk of GI bleeding.  So use these products judiciously and consider the many alternatives that are available.

 

This newsletter will present a variety of other approaches for stopping the kind of pain for which one might want to use regular aspirin or NSAIDS.  I have no issue with sporadic use of these drugs. Also, I am not addressing the kind of severe intractable pain of some cancers or other pains which require a pain management specialist.  Though some of the techniques I mention would be useful adjuncts to the management of severe pain as well. 

 

 This newsletter is meant to encourage you to look for the best alternative for you and to let you know what some of them are. It is by no means an exhaustive exploration of the subject, but an introduction to some of what is available. I will not discuss each method in depth but will direct you to more information. This will mean following several links and looking into the suggestions to see what "clicks" for you to use when you or someone you care about has pain.

 

WHAT ARE SOME OF THOSE ALTERNATIVES?

 

 

If the pain is localized to not too large an area, a topical product is excellent. There are many on the market, but I like Stop Pain spray or roll-on from CVS pharmacy for quick relief. Aspercreme, aspirin topical can be useful with inflammatory pain. Various arnica based homeopathic products can help , such as Arnica Gel  and Traumeel Gel  .Ibuprofen Cream can be purchased OTC.  There are also topical NSAIDS available by prescription, usually from  compounding pharmacies. You can then bypass the stomach and also avoid some other systemic side effects, up to a point, as long as you do not use the topical on too large an area at once. 

 

Another useful approach to minimize symptoms and duration of injury is to apply DMSOright after the injury occurs (as long as your skin is not too sensitive to it) which you will only know after trying. After 1-2 minutes it may develop a burning sensation which lasts  about 5-10 minutes. This is normal, and you can fan it to stop the discomfort. If you develop a rash, then your skin is too sensitive and do not use DMSO. If you handle this, use it 1-2 times a day until a musculoskeletal injury has resolved.  It will minimize the impact of the injury, will speed up the healing time and minimize discomfort.

 

I have personally used DMSO over the last many years of my life whenever there is a sprain, strain, etc and I am careful to take it along when traveling. I became a believer in 1980 when I was thrown from a horse and landed flat on my back on hard packed dirt. Immediately my entire back began to swell in a frightening manner. The horse trainer had some DMSO ( it is used in race horse injuries) and applied it to my swelling back. Then I rested in his office  awhile, dreading what I thought would be a prolonged recovery. To my amazement, the swelling began to subside almost as quickly as it had arisen. By the next day, I was completely recovered, with no residual from the fall.  It was then I became a believer. Since my skin handles the DMSO well, I use it with any slight musculoskeletal strain  which starts to cause pain.  First I spray on the DMSO, then follow it with the Stop Pain spray which is cold, and for me, masks the brief burning of the DMSO. You can experiment with the topical spray, cream, or patch to find what works best for you.

 

 

There is always the good old fashioned ice and/or heat, but I prefer infrared heat which I find far more effective, again as long as the pain is in a fairly localized area. I recommend the Thermotex Infrared Heating Pad. These heating pads are expensive, but worth it if you have pain issues. Because it is infrared it does not get too hot so you can even sleep with the sore part of your body on it. Though they recommend you don't, I and others have with no problem.

 

Another appliance I like is the Light Relief  which uses infrared light to penetrate the tissues, increase circulation & relieve pain. There was a time when I had the residuals of a thigh injury & carried this everywhere I went, including a European River Cruise where I blew it out by having the wrong plug adaptor. It was sorely missed & I ordered a new one upon my return home. Fortunately there are no current injuries, aches or pains. so the devices and ointments are packed away.

 

 

Emotional Freedom Technique (EFT) is a new form of therapy for many physical and emotional issues. Basically it consists of tapping on certain acupressure points while reciting specific phrases.  If practiced faithfully and correctly, it can help you to accomplish many goals, including that of pain relief. This technique may look silly and seem like hocus pocus, but I have to tell you I have seen it work on numerous symptoms and problems, including pain!

 

 There are many EFT practitioners to guide you and there are numerous web sites with demonstrations. I took a 3 day EFT workshop  with Lindsay Kenny and I think she is  excellent in both teaching and applying this technique. You can see Lindsay discussing and explaining EFT. If there is no good EFT practitioner in your area, she will work with you by phone. If you look at a variety of EFT videos, you will find some differece in the points used for tapping, but I prefer Lyndsay's approach of  using all 14 meridians.

 

If you want to learn for yourself and proceed on your own, you may want to order the DVD The Tapping Solution. While there click on  the trailer for the movie what it is about. You may also want to sign up for the free tapping ebook they provide.

 

A Tapping Insiders Club has just started which allows you to tap along on video with many different experts for different kinds of problems for a very reasonable monthly or yearly membership fee. This is much less than private sessions & exposes you to many of the top therapist in the field.  You may want to view the discussion of this to see if you would find it helpful.

 

 

There are also some new pain relief techniques which require you to seek the expert services of those rendering the treatment, but have great promise. One is called the Pain Neutralization Technique developed by chiropractor, Dr Stephen Kaufman who tells you about it in this you-tube video.     Here is the explanation of the technique from a chiropractor who uses is successfully in his practice.  Southern Ca practitioner of this technique .

 

The individual applying this technique must be skilled in knowing which areas the press on to create what seems to be a reciprocal inhibition of the pain. The correct stimulation from non pain nerve fibers will shut out the transmission of pain through pain fibers.

 

 

The FDA approved LLLT for use on chronic pain in 2002. It is a safe treatment with essentially no side effects. The terms cold laser and  low level laser treatment (LLLT)are interchangeable.  This has been used in Europe for many years for some types of pain. It is primarily used by chiropractors to help relieve many types of musculoskeletal pain, to help with sinusitis, tinnitus, and lymphedema.

 

The LLLT device delivers energy units called photons to damaged body cells. This stimulates metabolic activity & promotes the health of the cells. The photons:  increase production of the cells which promote wound healing, reduce inflammation by inhibiting the body's production of inflammatory chemicals, improves blood flow to the impaired area, & enhances immune activity in the area being treated. Numerous studies have demonstrated the effectiveness of LLLT. A 2009 study published in The Lancet analyzed 16 randomized controlled studies of LLLT for neck pain. The conclusion was that those receiving this treatment were about 70% more likely to experience reduced pain compared to those given a placebo treatment.

 

 

Another new alternative pain management technique is prolotherapy or an adaptation of this called Prolozone. Prolotherapy is non surgical ligament reconstruction. This is based on the theory that some musculoskeletal problems are caused by lax loose ligaments &/or tendons. Ligaments attach bones to bones, and tendons attach muscles to bones. Pain can arise if the ligaments & tendons are not functioning properly to maintain stable structure. Treatment involves injections of collagen stimulating substances in to the affected area in an attempt to cause localized inflammation which then increases blood supply and helps with tissue repair.

 

 A variant of this is prolozone therapy. This involves adding ozone gas  to the injection, and claims more success. Ozone is a gas which is 99% oxygen and 1% ozone.  The oxygen is believed to provide instant energy to the cells around the pain.  These cells are believed to be oxygen deprived from the swelling and inflammation related to the pain. The ozone stimulates chemical mediators of tissue repair, regeneration, and modulation of the inflammation.  Here is a listing of Prolozone Therapists.

Obviously this approach is slightly invasive.  You may only want to resort to it  if other methods have not worked. This is certainly less invasive than surgery, where surgery can be avoided.

 

This is perhaps one of the most dramatic newer methods of pain control and is predominantly used for craniofacial pain such as TMJ, migraines,  other headaches, and  neck pain. It has also been used to help with movement disorders, tics, and tremors. I have a couple of patients now who are receiving this treatment for neck pain and TMJ, with benefit.  Click the link to see dramatic views of some of the benefits.  When there, be sure to also click on the "Additional Video" section, as well. Hopefully you will have the time to look through some of these improvements in case you know someone who can be helped by this technique. This is highly specialized and requires a dentist skilled in this technique.

 

 

Rolfing has been available for quite a while and again is only as effective as the skills of the rolfer. But in the right hands it is a remarkable tool for relief of chronic body pain. It is a deep form of hands on body work which reorganizes the connective tissues of the body to release, realign, and rebalance the entire body. The theory is that an imbalance or old injury, or carrying of tension anywhere in the body throws off the alignment of all other parts of the body. This is one reason why chiropractic treatments may not "hold". Because, though the adjustment is made and the person temporarily feels better, the general mal-alignment of the body will again pull the neck, back, or whatever out of proper position.

 

 Rolfing generally consists of ten weekly sessions which move through  the entire body in a particular sequence to release  and restructure the deep tissue.

 

 I suffered a whiplash in the 70's followed by persistent neck pain and decided to undergo rolfing. I worked with Jim Asher until he moved away, and then with Joe Heller , who was a rolfer then, but who subsequently developed Hellerwork which is an adapted gentler form of rolfing.  This eliminated my chronic neck pain. I have to tell you I absolutely loved rolfing and though no longer need it would continue just for  pleasure if there were a good rolfer in my area. I  have tried a few other rolfers along the way, but it was not the same.  Rolfing is an art as well as a science and requires experienced sensitive hands , so if you choose this method be sure to find the right healing hands for you.

 

 

I did not pay too much attention to the subject of "Medical Marijuana" until one of my best friends, who is a physician, became a medical consultant evaluating which patients qualified to receive permission to use marijuana for their various illnesses.  When she started telling me about some of the horrendous chronic pain cases years post terrible accident or botched surgeries who responded to the marijuana with pain relief, I began paying attention.  Many of them did not get adequate relief from the codeines and morphines of the world and were so "doped" they had no quality of life.  The marijuana enabled them to decrease or stop the opiates, to have less or no pain and improved quality of life with minimal or no side effects.  It's hard for me to argue with those results.

 

Many studies have supported that cannabinoids help decrease pain & affect many symptoms and bodily functions.  

 

In 2005 Health Canada approved  an oromucosal/sublingual cannabinoid spray called Sativex.  They are continuing to study its effects. In a double-blind placebo controlled study of 100 multiple sclerosis patients Sativex significantly reduced spasticity and associated pain. 

 

Sativex is being studied in large randomized trials in the U.S. for use as an  adjunct in intractable cancer pain.  It may work together with the opioids to increase their effectiveness and to decrease the development of tolerance.

 

Marinol, as ingested oral form of cannabinoid is available in the U.S. It has been used to treat glaucoma, for control of nausea with chemotherapy, and in AIDS patients.  Those who do not feel it is as effective as the herbal form argue it only has 1 cannabinoid, THC, while the herbal forms have the full range of natural cannabinoids.

 

The route of administration of cannabinoids is an issue.  Those who use the oral form report is does not work as predictably and as well as inhaled forms.  Dosage is also easier to adjust with an inhaled form.  An August 2010 Canadian study found that 3 puffs of cannabis daily helped people with chronic nerve pain from injury or surgery--to feel less pain and to sleep better.

 

The argument against inhaled forms has been the respiratory irritation, though smoking devices such as vaporizers are available to minimize that aspect.  Those with nausea prefer inhalation because they can't tolerate oral doses.

 

Another argument is that herbal cannabis as offered in dispensaries in those states where it is legal is neither standardized, nor monitored for quality and may contain pesticides.  The operators of these facilities receive feedback on the effectiveness of their products from the consumers.  Many growers are only growing organic produce and I would recommend only using that which is organically grown.  There are different form of marijuana for different uses.  The medical dispensaries have them labeled and classified.  The Indica form is best for most problem except nausea, which responds best to Sativa.

 

Hopefully this article has stimulated you to look for alternatives in pain management.

 

Please see the below table of NSAIDs available by prescription or over the counter. This is by no means an exhaustive list, so please consult a pharmacist for concerns about specific drugs.