Safer Pain Management

The sensation of pain is difficult to ignore. It evokes a stress response and affects mood and concentration. Our natural inclination is to medicate in hopes of relieving the pain. In some cases, an aspirin or two might be all we need to move on with our lives. In other cases, more is needed to achieve sufficient pain relief.

The Habit of Pain

As many as 20% of adult Americans experience chronic pain. This leaves them vulnerable to dependency on pain medication, a challenge that has reached devastating proportions. A quarter of patients prescribed opiate pain medication become addicted during their course of treatment.

Is it all in our head?

Our experience of pain suggests that it resides in our body at the point of some trauma. The truth is a bit more complicated. While we do receive stimulus from nerves located in injured tissue, we do not experience it as pain until our brain interprets the nerve impulses. Our current mood and awareness around the severity of the injury can also exacerbate the pain.

The primary function of pain is to encourage an action that might reduce the further chance of injury. If we succeed in removing ourselves from the source of trauma, pain signaling becomes largely redundant. Within minutes of injury, our natural pain-killing chemicals (endorphins and enkephalins) are released to block pain signaling. These natural pain blockers can be remarkably effective; however, they do not persist indefinitely. Enzymes present in the nervous system eventually break them down.

There are several types of pain and several supplements that may be helpful in managing them. The two primary types are nociceptive and neuropathic. Nociceptive pain is the most common and results from soft tissue injury. Neuropathic pain is a result of damage to the nerves themselves.

Conventional Pain Medications

Especially painful conditions often call for narcotics which can be quite effective at reproducing our natural pain response. However, they may cause side effects, and the aforementioned dependency is an ever-present threat.

Compounded Medications

Because patients vary in size, symptoms and pain tolerance, commercially available medications sometimes may not provide the appropriate dosage strength for an individual patient. Through compounding, a physician and pharmacist can customize the dosage to the exact amount the patient requires, and find a dosage form that best suits the patient’s needs. Pharmacy compounding may help improve a patient’s quality of life by providing relief with potentially fewer side effects and less overall medication.

Alternative Dosage Forms

Topical gels, creams, or sprays offer an alternative to capsules or tablets. Alternative options to oral medications include nasal sprays, suppositories, or custom-flavored troches that dissolve under the tongue.

Combination Therapy

When placed on multiple medications, you need multiple prescriptions and swallow multiple pills. Compounding can make it possible to get all medications in a single preparation.

Strength Variations

Patients vary in size, symptoms, and pain tolerance. Mass-produced commercial medications may not provide the appropriate dosage strength for an individual. Compounding allows customizing medication to a patient’s needs.

Natural Strategies

DLPA: A Versatile Amino Acid

DLPA contains L-phenylalanine, an essential amino acid that affects mood, energy, and pain perception. It blocks the action of enzymes that break down our native painkillers, effectively increasing their useful lifespan. It also encourages the production of those endorphins and enkephalins to maintain a steady supply. Daily doses of 1,000 mg to 5,000 mg have been recommended for chronic pain.

PEA: A Useful Fatty Acid

Palmitoylethanolamide (PEA) is a native lipid that helps to regulate pain and inflammation through its influence on our endocannabinoid system. PEA has shown benefits for chronic pain, especially in cases of nerve damage. A typical dose for pain management is 600 mg twice per day.

Inflammation and Pain: Necessary Evils

When tissue injury occurs, the resulting inflammatory response can promote pain signals which alert us to danger. However, if inflammation persists, chronic pain can result. Managing inflammation is an important step to tissue recovery and improved quality of life. Let’s examine several interventions that can accelerate recovery.

Omega-3 Fatty Acids: Essential Lipid Precursor

These long-chain fatty acids, typically obtained from fatty fish and other animals, serve structural as well as chemical purposes. They are used in the creation of anti-inflammatory hormones. Without this influence, we are much more vulnerable to chronic inflammation. Typical therapeutic doses may be as high as 4 to 6 grams per day.

Turmeric: Ancient Spice with Remarkable Potential

For millennia, turmeric has been a central aspect of food and medicine in the Indian subcontinent. Turmeric is anti-inflammatory, antioxidant, liver regenerative, and has preventative potential in cases of conditions stemming from chronic inflammation. A well-absorbed extract standardized to 95% curcuminoids will provide the best results.

CBD: New Kid on the Block

Hemp-derived cannabidiol (CBD) is a cannabinoid with great potential for regulating pain and inflammation. Unlike other interventions, it can be applied topically to quickly improve muscle and joint symptoms. Ingestible forms of CBD also have their place, however much like the other supplements mentioned earlier, the benefits are cumulative and may not reach their maximum potential for several weeks of continual use.

Additional Reading

About the Author

Joel Hall

Coastal Pharmacy & Wellness Staff

At Coastal, Joel is our go-to guy for anything related to supplementation and the complex role nutrients play in every bodily function. Although he may be reserved, helping people find their way to optimal health drives what he does. If you see him staring intently at his computer screen, he’s most likely researching something that most of us can only partly understand. He loves sharing his accumulated knowledge and spends as much time as necessary to explain things in a way to help you make good health decisions. He's been working in the wellness arena since the early 2000's and has been in the pursuit of nutritional knowledge since way before that. You can find him behind the wellness desk Tuesdays through Saturdays. For more information read our profile on Joel.


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