Nutrition and Functional Medicine for Chronic Pain
How We Currently Treat Pain
An Overuse of drugs
In the United Kingdom half of women and 43% of men are on prescriptive drugs. This of course does not include over the counter medication. The world’s supply of drugs is in the midst of an over-prescribing epidemic. Anti-inflammatories, muscle relaxants and opioids may have a place for certain types of pain and can assist in the beginning phases of recovery. The model to follow regarding the prescribing of drugs should be “the lowest dose, for the shortest duration and combined with natural, integrative strategies to support physical and emotional healing.” Long-term administration of drugs is not a solution for chronic pain. Painkillers are often abused, create dependence and can be addictive. The public has a right to safe and natural means for healing pain that do not have side-effects or cause harm.
Imaging Abnormalities Poorly Correlate with Pain
An abnormal reading on an imaging study does not necessarily reveal the root cause of your pain. Instead, it may lead to expensive and unnecessary procedures that won’t result in better healing then less invasive approaches. Medical tests are useful to rule out disease or when there is an acute trauma. However, chronic pain is rarely something that can be viewed on an image. Many abnormalities detected with advanced imaging are so common in healthy, uninjured people that they could be viewed as normal signs of aging. Bones and joints show many abnormalities but this does not mean you are damaged. In a cross-sectional study in the Journal of Bone & Joint Surgery 40% of healthy participates aged sixty or older showed degenerative changes in their spine but reported no pain! Each day we are discovering similar findings for all joints of the body, including the neck, shoulder, hip and knee. The concept of “wear and tear” can be replaced with movement is medicine. Bones and joints can with stand the sands of time just fine.
Surgery Is Not a Cure for Chronic Pain
Did you know that pain can persist even after a surgery such as a total knee replacement? The brain is still paying attention to the area even though the knee is “new.” Over imaging may lead one down the promise road of surgery as a quick fix. Many surgeries for chronic conditions such as spinal pain are no more effective (or less effective) than intervention like physical theory and pain education. Surgery only addresses the structural component and may be necessary in certain cases. Pain is multifactorial. The structure and function of a joint is but only one component of effective pain care.
How We Should Treat Pain
Pain is an experience, not a sensation. The definition of chronic pain is an “unpleasant sensory and emotional experience associated with actual or potential tissue damage.” When pain persists beyond the usual healing time of three months it is considered chronic. In fact, pain can persistent even if there was no injury at all. A broad framework is required to understand both the biological and behavioral responses that occur when someone experiences pain. Chronic pain is a complex disease with the involvement of many systems in the body including the gastrointestinal, muscular, endocrine, immune and nervous systems. Furthermore, the pain experience is influenced by psychosocial factors that may create further “threat” to the nervous system and turn on pain as a harm alarm. The complexity of chronic pain requires an integrated approach for healing, not a single treatment. This integrated system is where I combine Functional Medicine, Physiotherapy and Nutrition.
What is Functional Medicine
Functional Medicine is an evolution in the practice of medicine that better addresses the healthcare needs of the 21st century.
By shifting the traditional disease-centered focus of medical practice to a more patient-centered approach, functional medicine addresses the whole person, not just an isolated set of symptoms. Functional Medicine practitioners spend time with their patients, listening to their histories and looking at the interactions among genetic, environmental, and lifestyle factors that can influence long-term health and complex, chronic disease. In this way, Functional Medicine supports the unique expression of health and vitality for each individual.
Why do we need Functional Medicine?
- Our society is experiencing a sharp increase in the number of people who suffer from complex, chronic diseases, such as diabetes, heart disease, cancer, mental illness, and autoimmune disorders like rheumatoid arthritis.
- The system of medicine practiced by most physicians is oriented toward acute care, the diagnosis and treatment of trauma or illness that is of short duration and in need of urgent care, such as appendicitis or a broken leg.
- Unfortunately, the acute-care approach to medicine lacks the proper methodology and tools for preventing and treating complex, chronic disease.
- There’s a huge gap between research and the way doctors practice. The gap between emerging research in basic sciences and integration into medical practice is enormous—as long as 50 years—particularly in the area of complex, chronic illness.
- Most physicians are not adequately trained to assess the underlying causes of complex, chronic disease and to apply strategies such as nutrition, diet, and exercise to both treat and prevent these illnesses in their patients.
How is Functional Medicine Different?
Functional Medicine involves understanding the origins, prevention, and treatment of complex, chronic disease. Hallmarks of a Functional Medicine approach include:
- Patient-centered care. The focus of functional medicine is on patient-centered care, promoting health as a positive vitality, beyond just the absence of disease.
- An integrative, science-based healthcare approach. Functional Medicine practitioners look “upstream” to consider the complex web of interactions in the patient’s history, physiology, and lifestyle that can lead to illness. The unique genetic makeup of each patient is considered, along with both internal (mind, body and spirit) and external (physical and social environment) factors that affect total functioning.
- Integrating best medical practices. Functional Medicine integrates traditional Western medical practices with what are sometimes considered “alternative” or “integrative” medicine, creating a focus on prevention through nutrition, diet, and exercise; use of the latest laboratory testing and other diagnostic techniques; and prescribed combinations of drugs and/or botanical medicines, supplements, therapeutic diets, detoxification programs, or stress-management techniques.
How I treat through the 5-R Program
This is the general approach I use, when investigating the underlying causes and contributing factors to someone’s health issues and working towards health-goals. Instead of focusing on the diagnosis or the symptoms as the end point, I consider them the starting point of the thought process. Most symptoms are used as diagnosis I.e. Atypical Facial Pain. This is basically pain of unknown origin. It tells you nothing about where it comes from or a pathway that happened to lead to this diagnosis. Using the 5-R approach I can use investigative means to find the root cause of your symptoms.
Here I are looking for anything that is present in the body, environment or lifestyle that is causing biochemical perturbations or contributing to the symptoms or health issues. They may include such things as;
- Parasites, bacteria or viruses.
- Environmental Toxins such as pesticides or mercury.
- Foods that are creating inflammatory reactions in the body.
This refers to anything missing from the body or life, that is required for health. Here we investigate such things as:
- Vitamin and minerals levels in the body.
- Components of the diet, such as vegetables, antioxidants or fats.
- Physical activity.
- Sleep health.
- Emotional Health.
Repairing tissues in the body that have been damaged by inflammation or injury is a critical part of the healing process. This can include important barriers in the body, such as the blood-brain barrier, the gut lining and the skin.
I cannot over-emphasize the importance of the microbial colony in the gut to regaining and maintaining the health of the body and the brain. This critical step focuses on the foods and possibly supplements that will nourish and nurture the intricate ecosystems that we have in our gut.
The final piece of the puzzle looks at the whole person and their life to make sure that all the pieces required for a healthy and happy life have been accounted for. This whole picture includes stress, family and other important relationships, physical activity, sleep, hydration, nutrition, genes as well as other pertinent lifestyle and physical factors.