A detailed guide to Chronic Fatigue Syndrome (CFS), including its symptoms, causes, and effective treatment strategies to improve energy and well-being.
If you’re experiencing chronic pain, a doctor may recommend that you have a nerve block, a temporary or permanent procedure that disrupts specific nerve activity. It can help diagnose or treat certain types of neuropathic pain, or pain caused by nerve dysfunction or damage. Nerve blocks may be performed by injecting chemicals or anesthetics to the area or by deliberately cutting or damaging certain parts of the nerve.
Many people receive nerve blocks without even knowing it. For example, dentists commonly use nerve-blocking agents such as novocaine to numb the mouth during potentially painful procedures.
If your doctor is trying to diagnose a chronic pain condition caused by nerve dysfunction, he may use a nerve block to pinpoint the exact problem area. In addition to a nerve block, he may also perform an electromyography (EMG) and/or a nerve conduction velocity (NCV) test to narrow down the exact cause of your chronic nerve pain.
Nerve blocks can also treat chronic neuropathic pain, such as pain caused by nerve damage or compression. They are regularly used to treat back and neck pain caused by herniated discs or spinal stenosis. Nerve blocks may be used to control pain temporarily or permanently, depending on the procedure used.
A local nerve block is performed by injecting or applying local anesthetics, such as lidocaine, to a certain area.
An epidural is a local nerve block that involves injecting steroids or analgesics into the area that surrounds the spinal cord. Though common during childbirth, an epidural may be also be used to treat chronic neck or back pain caused by a compressed spinal nerve. Local nerve blocks are usually temporary, although some may be repeated over time.
A neurolytic block uses alcohol, phenol, or thermal agents, such as cryogenic freezing, to treat chronic nerve pain. These procedures actually cause damage to certain areas of the nerve pathway. This means a neurolytic block is usually appropriate only in severe chronic pain cases, such as cancer pain or complex regional pain syndrome (CRPS).
A surgical nerve block is performed by a neurosurgeon and involves surgically removing or selectively damaging certain areas of the nerve. Like a neurolytic block, a surgical nerve block is usually reserved for severe pain cases, such as cancer pain or trigeminal neuralgia. Most surgical nerve blocks are permanent.
Even a temporary nerve block such as an epidural carries a risk of permanent nerve damage. Because nerves are extremely sensitive and regenerate slowly, even a tiny error in calculation can cause devastating side effects. These include muscle paralysis, weakness, or lasting numbness. In some rare cases, nerve blocks may actually irritate the nerve further, causing an increase in pain.
Fortunately, skilled and licensed health practitioners, such as dentists, surgeons, and anesthesiologists, perform these delicate procedures.
While there is always a risk of nerve damage during these procedures, most nerve blocks successfully reduce chronic nerve pain.
You may feel temporarily numb or sore after your nerve block, and you may notice some redness or irritation to the area. This is usually not permanent and should fade with time. If you have had a surgical block, you may be asked to rest for a certain period of time after your procedure. Depending on the complexity of the surgery, you may have to spend a few days recovering in the hospital.
Some pain may persist after your nerve block, but that doesn’t mean the procedure wasn’t effective.
Additionally, some nerve blocks may cause swelling, which compresses the nerve and requires time to subside. If you find the side effects of your nerve block are lasting longer than expected, contact your doctor.
The symptoms can be frustrating, ranging from numbness to outright pain in the affected areas.
When you go to your doctor for treatment, they’re likely to prescribe pain medications, pat you on the back and tell you to continue with your day-to-day activities.
But not only are pain medications expensive – but they also come with side effects that can be even more severe than your initial sciatica.
An alternative to taking the meds is doing yoga specifically designed to treat sciatica. And while that’s certainly a viable option for those who can afford classes, not everyone can perform the most helpful posts.
Turmeric’s active ingredient, curcumin, can be used as a tonic to reduce the inflammation that occurs as a result of sciatica.
One way you can administer sciatica is by consuming it as tea. Dr. Weil’s recipe requires you to bring four cups of water to a boil, add one teaspoon of ground turmeric, simmer it for 10 minutes, strain and then add honey to taste.
If the tea is a bit too strong for your liking (turmeric does have a very distinctive taste), you can also, as per Home Remedies For Life’s instructions, sprinkle a quarter of a teaspoon of it on scrambled eggs or into soup, sauce or salad dressing. You should gradually increase the amount of turmeric you use until you make it to 1 teaspoon.
If you’re looking to skip tasting the turmeric altogether, you can also turn it into a paste that you apply on the area that is hurting.
To do this, boil half a cup of water and stir it into a quarter cup of turmeric. Reduce the heat and let it simmer for 7 minutes while you stir constantly.
The mixture will turn into a paste – once it does, take it off the heat and let it cool. If it’s too dry, add a few drops of water and leave it in your refrigerator in a tightly sealed container.
When you’re ready to use it, apply the paste to the sore areas of your skin and leave it on for 15 minutes. Then, have a shower and wash it off.
Turmeric works by lowering levels of inflammation-fueling enzymes. It’s been used as a painkiller for centuries due to its proven effectiveness. It was confirmed by Malaysian scientists in 2010 to get rid of nerve pain, but it was used all over Asia long before then.
How much turmeric is most effective? The suggested dose per adult for the purpose of reducing pain is 300mg taken 3 times a day.
Despite the claims of some government agencies, research has shown that the overwhelming majority of addictions do not start with a prescription, and most opioid prescriptions do not cause addiction.
When 58-year-old Zyp Czyk* had a serious mountain biking accident in June, she refused to go to the emergency room even though her injuries knocked her out cold and her husband pleaded for her to seek help.
Instead, Czyk slept for two days—contrary to the conventional wisdom of what you’re supposed to do after sustaining a head injury. Only then did she finally agree to go to an urgent care center, where she discovered she had broken her collarbone and some ribs and needed surgery. Czyk isn’t afraid of doctors, hospitals, or pain medication, and she’s not opposed to Western medicine. In fact, she’s been taking Oxycontin for chronic pain for nearly two decades. And that’s the problem: She feared that if she went to the hospital she might be labeled a drug-seeker, which could lead to her doctor cutting off her opioid prescription, leaving her without the treatment that makes her life bearable.
Czyk is just one of the more than 100 million Americans with chronic pain caught in the latest drug war crossfire. These patients and their doctors are often targeted by federal agencies like the Centers for Disease Control (CDC) and the Drug Enforcement Agency (DEA) in an intensifying crackdown on painkillers that fall in the same class of drugs—opioids—as heroin. But these efforts are as misguided as most “supply-side” drug war initiatives, and the collateral damage tends to be excruciating.
Last week, the CDC released a report showing that the rate of heroin overdose deaths in America quadrupled between 2002 and 2013. In a press briefing, CDC director Thomas Friedman said that the rising use of medical opioids “primed” Americans for heroin addiction and called for “an all-of-society response,” including a reduction in prescriptions and better law enforcement. Likewise, in its 2015 assessment of the threat from heroin, the DEA reported, “Increased demand for, and use of, heroin is being driven by both increasing availability of heroin in the US market and by some controlled prescription drug (CPD) abusers using heroin.”
You’d never know it from the official government line, but while the “opioid epidemic” is linked to increased use of pain medications, the overwhelming majority of addictions do not start with a prescription—and most opioid prescriptions do not cause addiction.
All of which is to say that chronic pain patients are bearing the brunt of yet another drug war blunder.
Like Czyk, those who genuinely need painkilling drugs are now subject to policies like random reports to the doctor’s office for pill counts, prescription limits, extra refill appointments, urine testing, and other restrictions that can become expensive and onerous. Worse, they are often made to stop taking drugs that help them. While she knew she risked her health by postponing care after her crash, Czyk tells me that she felt waiting offered less risk than being falsely labeled an “addict” and was “not as dangerous as losing my pain medications.”
Opioid addiction usually begins in the same place that all other addictions start: in the childhoods, traumas, mental illnesses, and genes of those affected.
Her fears are far from unrealistic given reports of pain doctors being arrested and charged with crimes resulting from so-called overprescribing, leaving their patients to seek emergency care. Chronic pain support groups are filled with horror stories about pharmacists refusing to fill prescriptions and physicians simply dropping patients or deciding that they no longer want to risk treating pain with opioids. But according to a new study in the journal Addictive Behaviors, the greatest predictor of whether a person misuses opioids is not poor health—instead, it’s having used illegal drugs in the past year.
Drug warriors don’t like to tell this story. In the stereotypical account, addiction starts with an evil doctor—probably high on Big Pharma propaganda—hooking innocent patients. For example, when Massachusetts Governor Charlie Baker was inaugurated this January, he incorrectly described the experience of the parents of a young man who died of an overdose.
“After a routine medical procedure their 19-year-old son, Evan was prescribed opiates for pain,” Baker said. “Slowly and unknowingly, he became addicted to them. When the prescription ended, he turned to heroin,”
In fact, Evan started taking drugs with his friends, who introduced him to pills the same way they did marijuana—no doctors were involved. It’s not clear what put him in the 10 to 20 percent of drug users who become addicted, but it definitely wasn’t pain treatment.
And Evan’s route to opioid addiction is by far the most common. Since the Substance Abuse and Mental Health Service Administration (SAMHSA) started collecting this data, it has always been found that over 75 percent of people who misuse painkillers get them from friends, relatives, dealers, or other illicit sources—not physicians.
Data on people who start pain treatment yields the same conclusion: The vast majority don’t misuse their drugs.
Even among the most frequent users, less than a third see doctors get their drugs.
And there’s more research supporting the idea that the vast majority of opioid addiction starts on the street. In 2014, a national study of nearly 136,000 emergency room patients admitted for overdoses containing opioids found that just under 13 percent had a chronic pain diagnosis. And a 2008 study, this one from an addiction-ravaged region in West Virginia, found that 78 percent of victims had a history of substance misuse and nearly two-thirds possessed prescription drugs that were not prescribed to them.
Looking at people treated for Oxycontin addiction alone, a study in the American Journal of Psychiatry found that the vast majority—78 percent—never had a legitimate prescription and a similar number reported cocaine use and previous treatment for substance abuse.
Unless you’re ready to believe that doctors can turn pain patients into coke fiends, the simpler explanation is that painkiller addiction hits people who are already abusing other drugs. These people know where to buy stuff like coke and heroin, unlike pain patients—a.k.a. your parents and grandparents—who tend to be unfamiliar with how street drug markets operate.
Data on people who start pain treatment yields the same conclusion: The vast majority don’t misuse their drugs. Here, Czyk’s case is typical. Formerly a computer systems administrator, she had suffered inexplicable pain since childhood. Eventually, she was diagnosed by specialists at Stanford with Ehlers Danlos Syndrome, a painful connective tissue disorder that often manifests in visible bruises. She says she has never misused her drugs, and even initially refused to take enough of them to effectively treat her pain.
In 1995, Czyk’s doctor suggested that she try a newly-introduced drug called Oxycontin. “I took it as prescribed,” she tells me. “I took as little I could as get away with.” She adds that her doctor finally sat her down and said she’d get more relief if she “took enough that it would actually work.”
Although opioids can make people sleepy, Czyk had the opposite experience. “I was able to work,” she says, “When I took the pills, my energy went up because the pain [had been] so tiring.” Ever since she says she’s used it judiciously. While chronic pain patients may suffer withdrawal symptoms if they stop using a drug abruptly, this is the not same thing as addiction, which is defined by experts as compulsively using a drug in the face of negative consequences.
Clinical studies of pain patients without a history of heavy drug use find that less than 1 percent become addicted during treatment—as summarized by a stringent review by the respected Cochrane Collaboration. (In actual pain practice, researchers find addiction rates of up to 33 percent, but this is more likely due to poor screening for addiction history and to drug-seekers faking pain than to new cases, given the rest of the data out there.)
Dee Dee Stout, an addictions consultant, and expert counselor has been taking opioids for fibromyalgia and pain from a car accident for ten years. Recently, she was refused a refill due to complex regulations that neither doctor nor patient had been warned about. Consequently, she had to spend a weekend enduring pain and withdrawal symptoms like diarrhea and restlessness until her doctor was back in the game on Monday.
“I can’t begin to tell you how stressful it’s been,” she tells me, echoing the voices of other chronic pain patients who are often ignored in media coverage of the opioid “crisis” but appear in the comments en masse under most such articles.
If we really want to deal with opioid addiction, we have to face facts. Most cases don’t start at doctors’ offices. Instead, kids get drugs the way they always have: through friends and family. To do better, we need to stop tightening the screws on chronic pain patients and start looking at why so many young people are turning to the most dangerous class of drugs.
Mistreating patients doesn’t stop addiction; that requires compassionate care.
Sometimes prescription drugs are warranted in acute conditions and can save lives. But more often than not, prescription drugs for chronic health conditions can actually deteriorate your health in the long run, and many people are overprescribed drugs that cover up the underlying health issue found in their lifestyle or diet choices.
There are some major downfalls of relying on pills for a chronic condition. Western medicine tends to focus on managing and suppressing individual symptoms one at a time, rather than carefully identifying the root cause underneath and working to improve it in a holistic way. Unfortunately, in many cases, there is also the risk of addiction to prescription drugs; abuse of medications has been increasing steadily in the United States for years. Currently, opioid addictions are more widespread than cocaine overdoses.
Not to mention, the majority of prescription drugs for chronic conditions are associated with nutrient deficiencies and a number of side effects that become another health battle of their own. Soon, patients are stuck in a cycle of prescription after prescription; trying to manage the symptoms caused by the medication that came before it. In fact, the CDC states that 48.9% of people are currently taking at least one prescription and 23.1% of people are taking three or more! The most frequently prescribed therapeutic drugs are antidepressants, painkillers, and antihyperlipidemic agents (such as cholesterol medications).
You have a higher risk of dying from a preventable adverse drug reaction than you do of dying from cardiovascular disease, lung cancer, breast cancer, or diabetes. And that’s cause for concern. While the following list compromises some of the most popularly prescribed medications with the worst side effects and risks, it by no means approaches a comprehensive list of prescriptions to be careful of. The bottom line is to do your research on every prescription your doctor recommends and talks openly with him or her about your concerns with potential side effects and reactions with your body.
Otherwise known as PPIs, proton pump inhibitors are commonly prescribed for acid reflux. You may be familiar with their brand names Nexium, Prevacid, and Prilosec. However, they have been associated with higher risks of dementia, kidney disease, and heart attacks. Furthermore, PPIs can cause chronic constipation, low magnesium levels, and increase the risk of bone fractures.
If you’ve been prescribed PPIs for heartburn, talk to your doctor or an integrative healthcare practitioner about finding natural treatments instead. Your focus should be on finding the underlying cause of your acid reflux (either an element of your diet, lifestyle, or a side effect of H.pylori bacteria). Oftentimes, the root cause of acid reflux is low stomach acid, not excess acid. Therefore taking PPIs can inadvertently make digestion and overall health worse, as stomach acid is crucial for digestion of protein, absorption of minerals, and protecting against pathogens in contaminated food and water.
Prednisone is a multi-tasking steroid often prescribed for autoimmune conditions such as rheumatoid arthritis, lupus, and ulcerative colitis. It works by suppressing the immune response that causes the body to attack itself, but at the same time, it is literally compromising your immune system and making you more susceptible to infections, both mild and serious. Long-term use has been associated with bruising, changes in body fat in certain locations (face, neck, back, and waist), low libido, acne, and complicated menstruation. Potential side effects also include insomnia, mood problems, headaches, dizziness, bloating, and nausea.
Talk to your doctor about alternatives to combat inflammation (such as in rheumatoid arthritis) using natural solutions.
Long-term use of statins has been linked to a deficit of coenzyme Q10 and vitamin K2 increases your risk of breast cancer and diabetes and can raise the risk of Parkinson’s disease.
If you have been diagnosed with high levels of LDL cholesterol, talk to your doctor about what you can change at home to help manage your levels naturally.
1 in 10 Americans over the age of 12 take antidepressants, according to the CDC. One in ten! And 60% of those people have been taking antidepressants for more than two years in a row. Unfortunately, their side effects are plentiful; they include weight gain, low libido, nausea, problems sleeping, constipation, irritability, and anxiety. But for adolescents and children taking antidepressants, there’s also a heightened risk of suicide.
It’s crucial to note that antidepressants do work well for some people, but for many people, they simply aren’t an effective treatment. Pay special attention to your body and your wellbeing overall and work with your practitioner to find strategies that help you manage depression. Natural options to consider are exercise, minimizing processed foods and eating a nutrient-dense diet, and natural supplementation such as St. John’s Wort, magnesium, and valerian root. Note: do not take yourself off prescription medication without the guidance of your practitioner, and keep in mind that some natural treatments such as St. John’s Wort are contraindicated with SSRIs.
If you or someone close to you is showing signs of needing help, don’t ignore the red flags. The Suicide Prevention Lifeline can be reached at any time at 1-800-273-8255
While most doctors agree with the appropriate prescription of opioid painkillers for acute pain, opioids are not an appropriate solution for chronicconditions. Moreover, because of their highly addictive nature, even people who have prescribed opioids for a brief time (such as for post-operation recovery) can very easily become addicted and begin abusing their prescriptions. For this reason, there is a growing movement to avoid prescribing opioid painkillers altogether to reduce the risk. (Not to mention short-term side effects such as nausea and constipation).
If you’re preparing for major surgery, talk to your doctor or surgeon about your recovery options and express your concerns about steering clear of potentially addictive substances. Likewise, if you struggle with chronic pain, it’s important to turn to as many natural solutions as possible to avoid dependence on drugs.
You should never remove yourself from a prescription without speaking to your medical care provider about it. You can work with your family doctor or a naturopathic doctor to determine a plan to safely wean yourself off of a prescription and replace it with a natural and safer alternative that works for your lifestyle and your body.
Remember that there are many ways to keep your body healthy, and the first thing your doctor suggests is not always the best option for you. Holistic Nutritionist, Alina Islam summarizes it perfectly:
“REMEMBER, JUST BECAUSE A PARTICULAR SPICE, HERB OR FOOD DOES NOT HAVE CORPORATE-BACKED RESEARCH WORTH MILLIONS OF DOLLARS, IT DOES NOT MEAN THERE IS NO SCIENTIFIC EXPLANATION BEHIND ITS BENEFITS. IT MEANS THERE IS LACK OF INTEREST IN PURSUING THE RESEARCH.”
People around the world are becoming increasingly aware of natural remedies and alternative medicine.
However, this does not change the attitude of Big Pharma to enforce their drugs on an open-mouthed public despite their numerous and well-documented, harsh side-effects.
The almighty health benefits of cannabis are becoming increasingly accepted in mainstream society and are being bolstered by numerous recent studies.
The Foria Relief Company has even invented a vaginal suppository, based on aromatic cocoa butter, which is a perfect substitution for Vicodin, Midol, and Ibuprofen. It effectively treats menstrual cramps by relaxing the muscles. Additionally, it does not lead to psychotropic properties.
It is produced from pesticide and additive-free cannabis. Therefore, their active ingredients are used in a process without microbials and are combined with exact doses; 60 mg of tetrahydrocannabinol (THC) and 10 mg of cannabidiol (CBD).
The pain is blocked by the THC, which inhabits the pleasure areas of the brain’s cannabinoid system. CBD relaxes the muscles, treats the spasms, and has a favorable effect on inflammatory mechanisms within the body.
According to a woman who tried the vaginal suppository, it relaxed her clenched and cramped muscles and soothed the pain in her midriff. She explained that she felt the area below the waist to the thighs “as if floating in some other galaxy”.
Yet, this amazing remedy is only sold in California and is still not approved by the FDA. However, if you decide to use it, make sure you consult your doctor beforehand, even though there have been no complaints from people who have tried it.
A license to treat chronic pain with medicinal cannabis has been granted here for the first time, it has emerged. A 3-month agreement was given the green light by the Department of Health to use Tetrahydrocannabinol (THC) people in constant agony.
THC is the principal psychoactive constituent of cannabis. It is currently illegal to use medicinal cannabis here – but medical consultants can apply for the license on a case by case basis. A three-month license can be granted on foot of an application made directly to the Minister for Health under section 14 of the Misuse of Drugs Act.
Under guidelines from Chronic Pain Ireland, the THC would NOT be consumed via smoking. A patient would ideally take it by vaping or in their tea. Under the strict terms, a medical professional would administer a starting dose, monitor the patient, and adjust the dose accordingly, they say. Patients will be placed under constant medical supervision.
Last February, Health Minister Simon Harris announced that he would implement a Health Products Regulatory Authority recommendation that cannabis–based products be made available to some patients with multiple sclerosis and epilepsy, and those suffering nausea in chemotherapy.
However, chronic pain was not included in Mr. Harris’ plan. It was on this basis that Chronic Pain Ireland applied to the minister for a license, for one of their members, along with their medical consultant.
There were no formal application guidelines from the Department of Health, so Mr. McLoughlin created one from scratch. This is now available on Chronic Pain Ireland’s website.
The application included how THC would be administered, details of the patient’s medical consultant, and what dosage they would potentially start on.
The patient can take the medicinal cannabis either through tea or by vaping.
“Some people are desperate due to chronic pain,” said Mr. McLoughlin. “I personally know of people who use cannabis for chronic pain. Some say it works, some say it doesn’t. But you must always go to your doctor.”
Professor of pharmacology and therapeutics David Finn, who is also the co-director of the Centre for Pain Research at NUI Galway, said the granting of the license was an “important development”.
“This is a very interesting and important development which demonstrates a recognition by Irish medical professionals and the minister for health of the potential therapeutic value of medicinal cannabis for the treatment of chronic pain,” said Prof Finn.
“Chronic pain is the most researched indication for cannabinoids, and the majority of clinical studies, meta-analyses, and systematic reviews conclude that cannabis or cannabinoids can be effective in alleviating certain types of chronic pain.
“Approximately 20% of the Irish population suffers from chronic pain, and up to 40% of patients report that the management of their pain is inadequate, either due to the limited efficacy of existing treatments or unacceptably high levels of side-effects.”
Solidarity-People Before Profit Alliance TD Gino Kelly has been a longtime campaigner for legalizing cannabis for medicinal purposes and brought forward an opposition bill towards this end.
The Cannabis for Medicinal Use Regulation Bill 2016, is now entering its third stage of debate and will go before the Oireachtas health committee early next year. “The tide has now turned. It is a significant day for people with chronic pain in Ireland,” said Mr. Kelly.
It started as a dull ache right above the base of my spine.
There was no injury, no clear cause — just pain that seemed to come out of nowhere. At the time, I thought it would go away in a few weeks. I didn’t know it would turn into a four-and-a-half-year-and-counting odyssey of experimentation to battle lower back pain that simply refused to retreat.
I tried everything. I dove into twice-a-week physical therapy, daily exercises, regular walking breaks, and meditation. I bought a sit-stand desk. Nothing worked. After several months, if anything, my pain was worse.
This health problem, coincidentally, arose just as a career shift made improving US health policy my focus. After working as a consultant for hospital systems and insurance companies, I accepted a position at the federal agency that runs Medicare and Medicaid. My work focused on designing new ways to pay health care providers to reduce waste and provide higher-quality care.
Through my work, I realized just how massive the chronic pain problem is in the US. Defined as any pain lasting longer than three months, chronic pain afflicts more than 50 million Americans each year and has a net economic impact of around $600 billion. Lower back pain alone is the most common cause of disability for Americans under 45.
It struck me that policy and business leaders tackling the problem-focused almost entirely on what not to do: avoid excessive imaging studies, avoid invasive treatments and surgeries. Especially avoid opioid painkillers.
Given how common my problem was, I was surprised at how little research and policy was focused on what could be done to fix my pain.
It is certainly true that US clinicians went overboard on opioid prescribing, with horrifying repercussions. I am not going to argue here that opioids are a good treatment option — they appear not to be in most cases — or minimize the devastating effects of opioid addiction.
However, a full response to the opioid epidemic must go beyond reducing opioid use: We need to find ways to reduce pain through better treatment. Policymakers need to put more focus and public dollars toward understanding pain, and patients need to be supported in their pursuit of pain treatments that work.
Every day at work, I was learning about innovative programs to improve health outcomes for populations with chronic illnesses such as diabetes and hypertension. There was nothing similar for pain management. Chronic pain seems to be something that few doctors, let alone administrators and policymakers, really understand and know how to treat.
My own journey to find relief made the problem deeply personal. In the absence of clear knowledge and robust treatment options, patients like me are forced to spend a lot of time, energy, and money experimenting with different remedies.
I received an MRI to figure out the source of my back pain — it showed nothing. I am one of the 85 percent of low back pain patients whose pain is “nonspecific”: Doctors cannot pinpoint a cause. Of the many treatments that exist, there is not a definite winner. I tried various medications, several physical therapy regimens, and creams and injections of all sorts. I tried a small patch that sends high-frequency electrical pulses to suppress nerve activity, a treatment that actually helped a bit.
Desperate to exert control in the absence of effective treatments, I funneled my energies into remaking my office workstation. I was lucky to be able to work from home often, a privilege many lacks, so I had complete control over my environment. With the help of a specialized vendor, I fashioned a workstation that allowed me to either walk on a treadmill or lie on my side while working on two large side-by-side monitors.
My closet was full of the flotsam of tried-and-failed ergonomic cushions, massaging implements, and foam rollers. I rarely invited people over, dreading I would have to explain my bizarre apartment setup.
Eventually, I took a short trial of opioid painkillers. The pills were moderately effective but made me very tired. That, coupled with a fear of building tolerance, caused me to stop taking them after a few weeks. Fortunately for me, my pain is relatively low-intensity. The trade-off is different than for someone experiencing more pain. The crucial point is that — for me, anyway — painkillers were simply another treatment with a unique set of risks and benefits. My issue was, and remains, managing pain, not managing opioids.
Throughout my adventure of trial and error, coverage decisions from my insurance companies often seem random. Many treatments — for instance, massage or prolotherapy injections, in which a sugar solution is used to stimulate tissue repair — have been denied, on the grounds that the evidence of effectiveness is weak.
Yet other treatments with similarly weak evidence behind them, like steroid injections, are covered. I understand the reluctance to pay for a treatment that is unlikely to be effective, but this process of experimentation is all I have. I’m lucky to have the means to spend tens of thousands over the years out of my own pocket. Others don’t have that option.
On my quest to figure out why there seem to be so few good solutions to chronic pain, I discovered that less than 1 percent of National Institutes of Health research funding is dedicated to pain research.
Dr. Edward Michna, a pain specialist who works with the American Pain Society, ties this to the stigma around chronic pain. (The American Pain Society previously received funding from pharmaceutical companies that sold opioid painkillers.) “Even before opioid use became an epidemic, funders and politicians equated pain management with addiction treatment, and they ran away from funding it,” he said.
He pointed to a pervasive belief that these patients were exaggerating their pain to receive disability benefits and, in modern times, to get high on painkillers. “With some notable exceptions, it simply wasn’t an issue they wanted to get involved with.” It would be easy to dismiss his views as biased in favor of big pharmaceutical companies, but as someone who is in pain and wants help, his words resonated with me.
Pain is often a symptom of an underlying condition, which means that research into those conditions will ultimately alleviate pain. Cancer-related pain will probably improve if we find better treatments for cancer in general. But for tens of millions of Americans like me, our pain cannot currently be explained by a separate disease. We need more than just 1 percent of government funding devoted to pain research specifically.
Some researchers are beginning to embrace the theory that pain itself is a type of independent disease. They speak of “central sensitization” — the idea that in some people, for reasons yet unknown, the central nervous system changes over time to experience heightened pain. This isn’t New Age hand waving: It’s real science that demands further study.
Another important question for both researchers and health care providers in improving how we match patients to treatments. Often, when treatment ends up working, it remains unclear why it worked for a given patient and not for another, similar patient. When we say a treatment like prolotherapy injections has limited scientific evidence, that usually means that in trials, few saw benefits above placebo. If we could figure out what is different about those few who did see real benefits and identify them, the same treatment becomes more useful.
The opioid crisis — as grave as it is — threatens to overshadow these important issues. Right now, states and governing bodies are focused almost exclusively on reducing opioid prescriptions rather than finding alternatives. The National Committee for Quality Assurance, which sets quality standards for health plans, has a new measure that effectively penalizes providers who prescribe patients opioids over a certain dosage amount. Some states, like Maine, put in place caps on opioid doses.
It’s too early to tell how many patients who legitimately need opioids are having trouble accessing them as a result of these policies. But anecdotes from patients and clinicians suggest some people are suffering. Two small-business owners in Maine are suing the state over rules that require long-term opioid users to lower their dosages.
That policy was an understandable reaction to the fact that 313 people in Maine died from opioid overdoses last year. Yet we have to acknowledge the lack of good options for treating chronic pain. We should also recognize that while evidence behind opioids is weak and they are highly risky, some patients have been well-served by them.
Improving how we apply existing treatments also requires workforce training. A 2011 study found that US medical schools allotted an average of nine teaching hours to painmanagement. (The average for Canada was 19.5 hours.) Clinicians across all specialties should receive better training.
Cannabis-infused sports creams claim to offer muscle relief. We spoke to experts to see if they’re worth a shot.
Chances are you’re no stranger tomuscle aches. Well, what if we told you that cannabis creams might help provide relief?
Yes, there’s a new type of topical ointment on the market, and it’s infused with cannabidiol (CBD) from marijuana. Manufacturers claim it can help alleviate acute pain and muscle soreness. CBD is similar to THC, except it’s non-psychoactive, meaning some researchers view it as the golden child of medicinal use.
Science has confirmed that cannabis is an effective pain reliever, reinforced in a massive new report from the National Academies of Sciences, Engineering, and Medicine. But there’s a big difference between ingesting cannabis or its individual chemicals orally and absorbing it through your skin. Here, the lowdown on this new crop (no pun intended) of pain relievers.
The ointment is made from infusing high-quality cannabis flowers in some kind of quality oil—coconut or olive typically—which extracts the active compounds, either CBD, THC, or both depending on the type of hemp used. This oil is then blended with other therapeutic herbs, like arnica or lemongrass essential oils, which are well-known pain relievers.
If you read the ingredient list, often everything in the jar is straight from mother earth. As long as that’s indeed the case with the cream you have your eye on, the formula is immensely safe, chemically, says Gregory Gerdeman, Ph.D., neurophysiologist who researches cannabinoid biology and pharmacology at Eckerd College in Saint Petersburg, FL. And since they’re formulated to be topical—absorbing into the top layer of skin—and not transdermal—which would pass through the skin and into your bloodstream—there’s no risk of getting high.
“When it comes to cannabis-based topicals for muscle soreness or other pain relief, there’s absolutely no reason why it should be a big deal to try,” he says.
They may be safe, but there’s one massive problem: There’s practically no scientific data to support the idea that a CBD-infused topical cream is any more effective than other topical pain relievers, like Tiger Balm, BenGay, or Icy Hot. Michelle Sexton, a San Diego-based naturopathic doctor and medical research director of the Center for the Study of Cannabis and Social Policy says that her patients do seem to have a great interest in CBD ointments, and roughly 40 percent of them have indeed tried one. However, these people are in her office now because the topicals didn’t work for them. “As a medical professional, my opinion is there’s little evidence to back up the claims being made—it’s all marketing for now,” she says.
There is an argument to be made for the simple fact that science hasn’t caught up to the trend (and laws) of 2017 yet. And there are doubtlessly researchers testing the efficacy of CBD–infused creams for pain relief as we speak.
The theoretical logic is there, Gerdeman says. What exactly is that thinking? Well, there are a few different ways CBD could help regulate pain—by increasing your natural endocannabinoids, decreasing your inflammatory response, and desensitizing your pain receptors (although it’s still unclear whether this stands when absorbed topically compared to orally).
Let’s start simple: Endocannabinoids are natural signals in your body that help maintain homeostasis by detecting and regulating hunger, pain, mood, and memory. CBD helps elevate your natural levels of pain-relieving endocannabinoids by blocking metabolism as they’re moving around your body.
The second method of pain relief centers around the damage you do when you work out. When you strength train, you create micro-tears in your muscles, which is why you feel sore as you heal. Once your immune cells detect damage, they release inflammatory mediators in order to repair the tissue. CBD, though has the ability to limit the release of some proinflammatory signals, thereby helping with pain without thwarting the healing entirely, Gerdeman explains.
Finally, you have receptors called TrpV1 that detect and regulate your body temperature. When activated, they put out heat, soothing your pain receptors. Using this channel, CBD makes these pain receptors hyperactive for a period of time, causing them to get hot, desensitizing them, and downregulating those pain–sensing nerve endings.
Phew—enough of that biology lesson. The real problem here is that all of this has yet to be proven in scientific studies on humans.
A study analysis in the Journal of Pain Research confirms that topical use of certain cannabinoid topicals can reduce pain in animals with inflammation or neuropathic pain. And science has found topical creams with THC and CBD help relieve pain for conditions like multiple sclerosis. But for the vast majority of chronic pain—and most certainly for acute pain like post-workout—the scientific jury is 100 percent still out. “There’s a little bit of data in support of CBD for pain relief, but to go from animal to human is a giant leap,” Sexton says.
“The pain and stiffness that comes post-workout or from overexertion certainly has a pro-inflammatory component to it, so it’s reasonable to think CBD or other cannabinoids might have benefits, but we have no research to support this yet,” Gerdeman adds.
The other issue? Topical creams will treat anatomical structures within 1 centimeter of the skin—and the muscle where your actual soreness is located is going to be deeper than that, explains Ricardo Colberg, M.D., a physician at Andrews Sports Medicine and Orthopaedic Center in Birmingham, AL.
The fatty tissue can only hold so much oil, so, theoretically, if you apply enough of a CBD–infused topical cream to your skin it might leak down into your skeletal muscle just out of diffusion, Sexton adds. But there’s no study to show this, and that means you’re going to be rubbing on a whole lot of the stuff.
This takes us to the next problem: There is no regulation around how much active CBD or THC is in each cream or how much of the compound is needed to see relief. Read: “If you have three products that say 1 percent CBD infused in coconut oil, one could be great and the other two could be crap—that’s the reality of cannabis medicine right now,” Gerdeman says.
That’s not to say CBD–infused creams definitely won’t reduce your acute pain or muscle soreness. That’s because pretty much all of these creams on the market right now have other scientifically-proven analgesic compounds, like menthol, camphor, and capsaicin which are also found in other, non-CBD topical pain relievers.
“Any cream with a heating or cooling sensation desensitizes the nerves to pain by distracting them with stimuli on top,” Dr. Colberg explains. Plus you’re often massaging the area as you apply, which improves circulation and reduces muscle spasms, he adds.
So do you need CBD? All our experts agree that until we have more peer-reviewed research, all claims are marketing hype and not evidence-based.
But there is an argument to be made for simply believing the CBD adds that special something. “Scientific literature says there’s a 33 percent chance of the placebo effect helping people, so for some, just using a cream they believe can help will provide some relief,” Dr. Colberg adds.
The short of it: Science hasn’t confirmed creams with CBD will have any greater benefit than those without, but there’s little-to-no risk in trying it out (other than wasting your money, of course). And if you believe in the power of CBD–infused creams, that may be enough to score some relief.
If your state has legalized both compounds, look for a cream with 1:1 CBD to THC as well as another cannabinoid BCP (beta-caryophyllene) if possible, which manufacturers have seen better results with, Gerdeman suggests. Try Apothecanna’s Extra Strength Relieving Creme ($20; apothecanna.com) or Whoopi & Maya’s Medical Cannabis Rub (yes, that’s Whoopi Goldberg’s line), which was designed specifically for menstrual aches and pains (whoopiandmaya.com).
If you don’t live in a legalized state, you can typically still get CBD–infused creams. Since there’s no regulation or standardized testing, your best bet is to find trustworthy brands that use creams free of toxins but with additional pain relievers like menthol, capsaicin, lemongrass, or camphor. Try Mary’s Nutritionals Muscle Freeze ($70; marysnutritionals.com) or Elixinol’s CBD Rescue Balm ($40; elixinol.com).
Your body is constantly working. It does a long list of amazing things without you even thinking about it consciously. You breathe efficiently even while you’re sound asleep. When your nose itches, you automatically reach up to scratch the itch. Blood flows through your veins effortlessly.
You process food through your body, discard waste, and mount a defense against viruses and other unhealthy intruders. You burp, pass gas, cough, sneeze, and hiccup effortlessly. Your body even maintains body temperature automatically.
Imagine if your body started to malfunction with some of those automatic processes. This is what happens to an estimated 70 million people around the world when they develop Dysautonomia syndrome.
This may look like a long medical term that is difficult to understand, but it’s simply a group of medical conditions that impact the Autonomic Nervous System (ANS).
The ANS allows your body to complete all of those amazing tasks automatically. It’s the reason you’re alive because it controls your blood pressure, breathing rate, and many other functions that you need to regulate in order to live.
It also controls automatic movements that allow you to remain mobile and fully functional in daily life. When parts of this system start to break down or are damaged, you can face serious medical conditions known as Dysautonomias.
It’s common for fibromyalgia sufferers to experience at least one form of Dysautonomia syndrome. We know that with fibromyalgia, there is a dysfunction in the ANS. For many with fibromyalgia, it appears as a delayed and inflated response to stressful situations. The fibromyalgia sufferer may go through a stressful situation without releasing the stress hormones that are typically produced automatically.
Once the stressful encounter is over and the sufferer is able to relax, the release of those stress hormones is triggered. The sufferer is flooded with stress hormones and experiences the anxiety and energy that others felt during the stressful situation, only the sufferer experiences it to an extreme degree long after the stress has subsided. This delayed reaction may make it appear that there is no cause for the sudden onset of severe alarm and discomfort.
There are other ways that fibromyalgia patients can suffer from Dysautonomia syndrome. Just as fibromyalgia can produce different symptoms in different people, the forms of Dysautonomia can vary from one person to another.
There are many other possible symptoms that could go on this list, depending on the parts of the autonomic system impacted by the Dysautonomia. For instance, Postural Orthostatic Tachycardia Syndrome (POTS) can lead to dizziness, nausea, and even fainting when you try to stand up. It’s caused by dysfunction in the regulation of the heart rate when you go from sitting to standing position, and it’s a common form of Dysautonomia for fibromyalgia sufferers.
In some cases, problems with the autonomic system can lead to death. This may occur when the condition interferes with those essential automatic processes that you need to live, including your heart rhythm. If you think that you may suffer from any form of Dysautonomia, it’s important to seek medical help immediately.
Those of us with MCS also can have a greater propensity to this kind of syndrome in the CNS because of the effect of environmental toxins on the body and the effect on various systems of the body including the immune, endocrine, and nervous systems.
You may have seen some conflicting information regarding fibromyalgia and autoimmune diseases. Some people will tell you it is considered to be an autoimmune disease, others will tell you it’s not. However, you must know that physicians do not consider fibromyalgia to be an autoimmune disease.
The cause of this debilitating disease is not known and individuals who have other diseases could be much more likely to be affected by it. Diseases that make an individual more susceptible to fibromyalgia are ankylosing spondylitis, lupus, and rheumatoid arthritis. Typically, the symptoms of fibromyalgia are the same as those in some of these autoimmune diseases, which makes diagnosing much more difficult.
At this point in time, fibromyalgia is not considered to be an autoimmune disease. Further research could change this, but that doesn’t seem likely right now. Though some cases of fibromyalgia do involve a dysregulation of the immune system itself, this is much different than the dysregulation caused by an autoimmune disease. Right now, researchers have been unable to totally understand the nature of the dysregulation caused by fibromyalgia.
As mentioned before, autoimmune diseases include ankylosing spondylitis, lupus, rheumatoid arthritis, and others. Nowhere in this list will you find fibromyalgia autoimmune disease. So, though fibromyalgia does exhibit the symptoms of an autoimmune disease/disorder, it is not considered to be one.
There are many symptoms of autoimmune disease– many of which are the same or almost the same in those who have fibromyalgia. Following are some of the symptoms that occur with autoimmune diseases that could also point to fibromyalgia.
Joint and Muscle Pain- this can be a range of pain, from general pain, to burning, to aching, general soreness in the muscles and aches/pains in the joints.
Muscle Weakness- weak feeling in the muscles, as well as loss of hand/arm or leg/thigh strength.
Swollen Glands- especially those in the throat, under the arms, and the tops of the legs around the groin.
Greater Susceptibility to Infections– frequent bladder infections, colds, ear infections, yeast infections, sore throat, and sinus problems are very common among both fibromyalgia patients and those patients with autoimmune disorders. Additionally, you will experience a much slower recovery time if you have an autoimmune disorder.
Changes in Blood Pressure- you may have very high or very low blood pressure, in combination with feelings of vertigo or dizziness, palpitations/fluctuations in heart rate, and/or fainting.
Memory Problems- this often manifests as what is called “brain fog” where you can only vaguely remember things.
Thyroid Problems- typically, the problem is hypothyroidism, though sometimes can be hyperthyroidism, and typically does not show up on a thyroid test. This can manifest itself as excessive hair loss and a lowered body temperature.
– Fatigue– feeling completely drained of energy (can be one of the most debilitating of the symptoms).
– Difficulty Sleeping– this includes both falling and staying asleep. You will not be getting adequate sleep, so you feel quite deprived of sleep upon getting up.
– Brain Fog– problems with focusing/concentrating on things, retaining information recently learned, etc.
– Stiffness Upon Waking in the Mornings- muscles feel sorer in the early mornings and individuals feel stiffer than they usually are. Typically, gently stretching your muscles and taking a warm shower/bath helps to loosen them up.
– Digestive Disorders- abdominal pain, bloating, constipation, nausea, diarrhea, gas, IBS, and more are very common with fibromyalgia. Also, slow digestion and acid reflux are common.
– Migraines/Headaches- these are typically present at least twice per week and are rated as severe pain- usually with a migraine component. The pain is partially due to trigger points located in the head, neck, and shoulders.
Though some of the symptoms are quite similar- and even exactly the same in some cases- the research into fibromyalgia has not found a link to autoimmunity. There have been no inflammatory markers that have been elevated consistently, there have been no antibodies discovered, and researchers have not observed the damage that is typical of autoimmune activity within the body.
However, there has been a significant overlap that has been observed between specific autoimmune conditions and fibromyalgia that shows the possibility that those who have autoimmunity are susceptible to developing fibromyalgia. These are:
The fact that people misunderstand the meaning of ‘autoimmunity’ greatly contributes to the misunderstanding between the two. Additionally, it could be to the similarities between the two.
For example, both fibromyalgia and autoimmune disorders have fatigue, pain, and several other very common symptoms; both fibromyalgia and autoimmune disorders can be quite difficult to diagnose and can take a long time to sort out; a common poor understanding of the two- even those in the medical community don’t always understand fibromyalgia and autoimmune disorders, so they lump them all together because, on the surface, they appear the same.
However, you must understand the difference between the two because though they appear to be the same, the treatments are very different. You don’t want to be treated for one if you have the other- the treatment would not be successful.
