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The
Herbal Approach to Curing Chronic Pain
"Doc, what can
I take to speed up the healing process?" "Should I stay
on my same supplements while I get Prolotherapy?" "Do
you have any recommendations on supplements to take?" "Is
anything I am doing interfering with the healing process?" This
is just a sampling of the myriad of questions that are asked by
patients receiving Prolotherapy. The herbal approach to curing
chronic pain will be discussed in this chapter, with an emphasis
on the products that we use at Caring Medical and Rehabilitation
Services in Oak Park, Illinois. Top
Connective Tissue
Deficiency
To understand the role of herbal nutriceuticals in the healing
process, it is necessary to for you to look at the condition
as a connective tissue
deficiency problem; or, as we like to call it, The Hauser Syndrome. This
disorder is defined as a deficiency of, or weakness in, the connective
tissues. The main connective tissues in the body are the muscles, ligaments,
tendons, skin, hair, nails, and vascular system. The symptoms can vary
from chronic pain to varicose veins, depending on the connective tissues
involved. Chronic pain, simply put, most often represents a weakness in
a particular connective tissue. For instance, the physician can reproduce
most chronic knee pain by palpating the medial aspect (inside) of the knee,
which is the location of the pes anserina tendons. The traditional doctor
diagnoses "pes anserina tendonitis." A better term, however,
is "pes anserina tendon weakness." The allopathic (traditional)
physician believes the problem relates to excess inflammation, therefore,
anti-inflammatory medication or cortisone shots are administered. As discussed
in our books, these medications, at best, just cover up the pain; but more
importantly, they accelerate the weakness and degeneration of the tendon.
A better approach to cure the chronic pes anserina tendon pain is to utilize
treatments that will strengthen the weakened tendons. Likewise, for chronic
neck and back pain, treatments that aid in the regeneration of the weakened
ligaments are in order. Top
The treatment of
connective tissue deficiency involves three main principles:
1. Stop ingesting substances
that inhibit connective tissue regeneration.
2. Start ingesting substances that stimulate connective tissue regeneration.
3. Directly stimulate the connective tissues to regenerate.
If these simple principles
are followed, the likelihood of curing the chronic pain is great. Top
Connective Tissue
Inhibitors
It is sad to realize that most people with connective tissue deficiency
have it because of medications prescribed by their doctors. As discussed
at length in our books, the main inhibitors of connective tissue are the
following:
· Nonsteroidal
anti-inflammatory medications (NSAIDs)
· Corticosteroids (Steroids)
· Estradiol and its synthetic derivatives (Birth Control pills and traditional
hormone replacement therapy)
· Narcotics (Pain medications)
All of the above substances
have the potential to halt the healing process. Ibuprofen and other
anti-inflammatory medications are often given right after an injury,
thus causing the non-healing of many connective tissue injuries.
When these do not help the pain, the patients are then advanced
to various steroids, such as cortisone shots and oral Prednisone,
which further inhibit healing. Because women have much more estradiol
than men, they are especially at risk for nonhealing of their injuries.
Unfortunately, the most commonly prescribed drug in America is
Premarin, which contains estradiol that is derived from pregnant
mare urine (hence the name Premarin) and thus contributes to this
problem. Most people in chronic pain do not know that narcotic
pain prescriptions are also potent inhibitors of connective tissue
regeneration because they suppress the immune system. Top
Nuke the Narcotics
Yes, narcotics have tremendous immunosuppressive effects. No one has really
ever adequately explained why cancer or chronic pain patients, once
placed on narcotics, seem to never be able to come off of them. Well,
as it turns out, in vitro (in a petrie dish) and in vivo (in living
subjects)) studies have show that one of the long-term side effects
of narcotics is a suppression of mononuclear cell function.1, 2 Mononuclear
cells are part of the immune response that helps repair the connective
tissues after injuries. Even more frightening is the following statement
taken directly out of the main pharmacology text used by medical students, "… the
administration of morphine to animals causes suppression of the cytotoxic
activity of natural killer cells and enhances the growth of implanted
tumors."3 Synthetic narcotics, like morphine, cause hypoplasia
(shrinkage) of the thymus gland, which is the main gland from which
the immune cells that repair or heal the body originate.4, 5 Basically,
synthetic narcotics, like codeine, Vicodin, and Morphine have negative
effects on the immune system, which inhibit soft tissue or connective
tissue healing. This is probably why chronic pain patients and cancer
patients continue to get worse when placed on these medications, even
when appropriate treatments are given. The treatments cannot work because
of the negative effects the synthetic narcotics have on the immune
system. Of interest is a statement out of the same pharmacology text
book on our own natural narcotics, "By contrast, B-endorphin enhances
the cytotoxic activity of human monocytes in vitro and increases the
recruitment of precursor cells into the killer cell population: this
peptide can also exert a potent chemotactic (attraction) effect on
these cells.3 One can surmise from the above statements that our bodies
need to produce our own natural narcotics which stimulate the immune
system after suffering trauma or injury. Substituting these for synthetic
narcotics or anti-inflammatory medications is just going to inhibit
the repair process.
To further stress this point, think of narcotic medications
as low dose chemotherapy. Chemotherapy, as everyone knows,
has a significant inhibitory
affect on the immune system. Well, so do narcotics. According to the 1998
Journal of Neuroimmunology in a summary article on the effects of narcotics
on the immune system, the verdict is clear. "The literature describing
the effects of morphine on the cells of the immune system points to the
clear conclusion that morphine given in vivo suppresses a variety of immune
responses that involve the major cell types in the immune system, including
natural killer cells, T cells, B cells, macrophages and polymorphonuclear
leukocytes. A good amount of literature is available demonstrating the
down regulation of phagocytic cell function by morphine, particularly for
human peripheral blood mononuclear cells and polymorphonuclear leuckocytes.
Phagocytosis, chemotactic responses, interleukin production, and generation
of activated oxygen intermediates and arachidonic acid products (needed
for inflammation) have all been reported to be inhibited. In aggregate,
the literature supports the existence of an in vivo neural-immune circuit
through which morphine acts to depress the function of all cells of the
immune system." Narcotic medications inhibit the body's healing abilities.
No doubt about it! Top
Weaning from Narcotics
We are commonly asked, "How can I get off of the narcotic medications
when I am in so much pain?"
In order for the body
to be able to heal, it is vital for patients to get off of these
narcotic medications. The sooner the narcotic medications are weaned,
the quicker the patients will improve. Various dietary and nutritional
supplements are also given to assist the body's healing ability,
depending on each individual case. Anabolic hormones are also used,
such as DHEA or testosterone. Prolotherapy injections are given
to stimulate the exact site of the injury to heal. Patients are
typically seen once per month for follow-up, until complete healing
is achieved.
It is important for patients to realize that narcotics are physiologically
addicting and must be weaned slowly. Depending on the dose of the medication,
a person can typically safely decrease the narcotic dose by decreasing
by one pill every five days. For example, a person who normally takes ten
Vicodin ES per day, will decrease to nine per day after five days; then
decrease to eight per day five days later; and so on. If the weaning is
done too quickly, drug withdrawal symptoms may occur. These include symptoms
such as intense craving for the drug, insomnia, fatigue, vomiting, diarrhea,
anxiety, tremors, sweating, nightmares, muscular aches, and chills. If
these occur during the weaning process, you should contact our office.
To help make the weaning process more tolerable, various nutritional supplements
are given. These can include protease enzymes such as Bromelain or TRMA,
Ashwaghanda and Ginseng (adaptogens), as well as many others.
Various supplements are given depending on the physical and emotional state
of the person.** It is important to remember that the weaning process can
be very tolerable, but it starts with you wanting to do it! Motivation
is a key element required to wean from the narcotics.
If you are really scared or do not think you can the above types of things,
there are various programs that will assist you in the weaning process.
If you are looking to wean off narcotics quickly, the best program we know
is called Ultra Rapid Opiate Detoxification (UROD) and is located at the
University of Illinois Medical Center at Chicago. In this program, you
are detoxified from the narcotics in a 24-hour period, by being anesthetized
in the hospital. This is then followed by a comprehensive counseling program.
To obtain further information on this program, please contact the Center
for the Investigation and Treatment of Addictions at the University of
Illinois at 1-888-996-2482 or 1-312-355-0746. The following places also
have UROD available: Mount Sinai Medical Center, Miami, Florida; Centinela
Hospital and Medical Center, Los Angeles, California; and SunHealth Specialty
Hospital; Denver, Colorado.
**For further information
on herbal supplements used to help wean people off of narcotics
please contact Beulah Land Nutritionals at www.benuts.com or call
1-708-848-5011. Top
Herbal Connective
Tissue Regenerators
In reviewing the lab results with a young lady who originally
came to the office for Prolotherapy to relieve her headaches,
but instead first received
a battery of lab tests on her first visit, her mother demanded, "Why
were these tests done and how are they going to help my daughter's headaches?" This
is not unusual for people to react this way because it is not the traditional
approach to treating pain. Prolotherapy starts the inflammatory reaction
at the site the pain, but it is your own immune system that repairs the
painful area. The stronger your overall health and immune function, the
more effective the Prolotherapy will be.
A person must be able
to mount an immune reaction to the injected solutions in order
that Prolotherapy work. This means that you should feel stiffness
and/or swelling for at least 24 hours after Prolotherapy. If this
does not occur, then the Prolotherapy solution may not be strong
enough or the immune system may be weakened for some reason. In
the latter situation, it is helpful to obtain diagnostic testing
to determine the reason for the impaired immune system and to start
an herbal connective tissue regeneration (CTR) program. These products
are a good idea to help speed up the healing process even if you
have a healthy immune system. Let's face it, we could all probably
use a little help as we age.
CTRs are substances
that enhance connective tissue healing of cartilage, ligaments,
tendons, and muscles by either providing substrates for the connective
tissues or enhancing the repair process by optimizing immune system
function. Most of the natural nutriceuticals that are effective
at helping people heal soft tissue injuries fall into these two
categories.
There are characteristically
three stages that the body goes through to heal the ligament and
tendons after an injury or Prolotherapy (because Prolotherapy actually
mimics a new injury): inflammatory, proliferative, and remodeling.
It is this normal healing inflammatory cascade that requires stimulation
for complete healing to occur. Natural nutriceuticals act at various
points in this cascade to aid healing. For instance, glucosamine,
a well-known component of connective tissues such as cartilage,
is used as a substrate by fibroblasts to form collagen. What most
people do not know is that fibroblasts need an array of amino acids,
such as proline and cysteine, to adequately form collagen, as well
as numerous vitamins and minerals. To aid in immune system activation,
various nutriceuticals, such as ginseng, gotu kola, and nucleotides,
can be taken. To help phagocytosis, the process by which macrophage
cells clean up injured damaged debris, proteolytic enzymes, such
as bromelaine, trypsin, and chymotrypsin, are used. A wide array
of nutriceuticals may be used to promote healing. A summary of
some of these products can be seen below. For a more thorough explanation
on these substances and others that are used to help heal soft
tissue injuries please refer to the references. 6-13 Top
Nutriceutical Connective
Tissue Regenerators
Nutritional Product Mechanism of Action
Proline Provides substrate
for collagen
Cysteine Helps give collagen its pliability
Glucosamine Provides a component of tendon and ligament tissue
Horsetail Provides a natural source of silica
Gotu Kola Enhances connective tissue structure
Fo-Ti Stimulates cellular immunity
MSM Provides a natural source of sulfur
Grape Seed Procyanadins Provides a natural antioxidant
Ginseng Increases ability to handle stress
Nucleotides (RNA) Stimulates immune function
Proteolytic Enzymes Assists in removal of necrotic (dead) tissue
Whey protein Provides a source of branched-chain amino acids
Carnitine Transports fatty acids
Cayenne pepper Stimulates circulation
Malic Acid Provides energy production
Cod Liver Oil Provides essential fatty acids Top
The Connective Tissue
Regeneration Program
Curing chronic pain has connective tissue regeneration at its core. Unfortunately,
most people in chronic pain ingest innumerable quantities of Vicodin, codeine,
Celebrex, Ibuprofen, and other narcotics and anti-inflammatory medications,
instead of taking herbal connective tissue regenerators (CTRs),. A better
approach that has more long-term healing effects is to start a regime of
nutriceuticals that contain CTRs. A list of the products that Beulah Land
Nutritionals carries is found below. Many of these products were developed
because of the unique needs of the chronic pain patients in our office,
combining CTRs with substances that help handle stress. This is necessary
because the adrenal gland (stress gland) in most people with chronic pain
has been on overdrive for so long, that it is often not producing the necessary
hormones for proper immune function by the time they reach Caring Medical
in Oak Park, Illinois. Thus, many of the products used at Caring Medical
contain various adaptogenic substances which help people handle stress,
such as Ginseng, Gotu kola, and Ashwaghanda. Top
Nutriceutical Products
for Connective Tissue Regeneration
| Nutriceutical Product |
Condition treated/reason for taking |
| Prolo Max |
Chronic pain/assist Prolotherapy |
| Super Vites |
General well being/multivitamin |
| Pro-Collagen |
Brittle hair/nail/full hair and strong nails |
| Trauma Enzyme |
Chronic pain or injury/protease enzymes
to speed healing |
| BromelainMax |
Muscle pain/enzyme to naturally decrease "bad" inflammation
and speed healing |
**For a complete listing of the vitamins, minerals, and nutriceuticals
available for purchase, contact Beulah Land Nutritionals at www.benuts.com or 1-708-848-5011. Top
Direct Connective
Tissue Regeneration
As good as herbal nutriceutical products are, the body will often still
not completely heal a connective tissue injury, even if appropriate products
are taken. All the products can do is get the body in the healing mode,
which does not ensure that the injury will be healed. It is quite common
to hear people tell us that the nutriceutical products listed above have
helped decrease their pain by 50% or more, but they desire complete pain
relief. The person who has whole body pain or severe pain, a 50% reduction
is great; but the 50% remaining may still be life-altering. Direct connective
tissue regeneration is needed with Prolotherapy for people like this. Prolotherapy
is the only treatment that directly stimulates connective tissue structures,
such as tendons and ligaments, to regenerate. In other words, Prolotherapy
can take weakened, degenerated, tendons and ligaments, and stimulate them
to heal by inflammation. Prolotherapy, thus, directly stimulates the exact
pain-producing structure. It is then up to the immune system to repair
the area.
The woman with chronic
low back pain, for example, most often needs to cure the chronic
pain by direct stimulation to the sacroiliac joint. Prolotherapy
to the structures in and around the joint will start the normal
healing inflammatory reaction. Strong immune systems will allow
each subsequent treatment to produce more and more healing, until
the injured structure is eventually repaired. The typical person
with chronic pain usually requires anywhere from three to six Prolotherapy
treatments. A person with a weakened immune may require more treatments.
For this reason, most people who need Prolotherapy do better with
nutriceutical CTRs to aid the healing process. In addition, most
people would rather take a few extra supplements than experience
a lot more injections! Top
Summary
People in chronic pain have a deficit in the amount or strength in their
various connective tissues. Thus, it is best to think of chronic pain
as a connective tissue deficiency problem. The treatment of connective
tissue deficiency involves three main principles:
1. Stop ingesting substances that inhibit connective tissue regeneration.
2. Start taking substances that stimulate connective tissue regeneration.
3. Directly stimulate the connective tissues to regenerate with Prolotherapy.
Most people in chronic
pain experience connective tissue deficiency, in large measure,
because of the medications that have been prescribed by their doctors.
The main inhibitors of connective tissue are nonsteroidal ant-iinflammatory
medications (NSAIDs), corticosteroids, estradiol and its synthetic
derivatives, and narcotics. People desiring to maximize the chances
of healing their weakened connective tissues, must stop the consumption
of these drugs.
To assist connective
tissue healing, it is better to intake herbal connective tissue
regenerators. These are substances that assist the normal healing
inflammatory reaction. These substances are necessary, in some
cases, because of the inability to heal, even with Prolotherapy.
There are a myriad of substances, many of which contain such nutriceuticals
as glucosamine, horsetail, gotu kola, proteolytic enzymes, malic
acid, minerals, vitamins, and various protein sources. These substances
generally either provide the substrates necessary to heal, help
the immune system clean up the damaged cells, or aid in the immune
reaction that occurs after an injury or Prolotherapy.
For the person unable
to heal even with nutriceuticals, direct connective tissue regeneration
is needed. Prolotherapy is the only treatment that directly stimulates
the exact site of the pain. Prolotherapy stimulates the body to
repair the painful area(s). Once the area is completely repaired,
the chronic pain is totally eliminated. Top
End notes
1. Written correspondence with Brewer Library 1/6/99 written by Maria Fracchia,
Reference Librarian.
2. Sibinga, N. Opioid peptides and opioid receptors in cells of the immune
system. Ann. Rev. Imunol. 1988; 6: 219-249.
3. Jaffe, J. Opioid analgesics and antagonists. In Gilman, A. (ed.) Goodman
and Gilman's The Pharmacological Basis of Therapeutics. New York: McGraw-Hill,
1990, 485-496.
4. Bryant, H. Role of adrenal cortical activation in the immunosuppressive
effects of chronic morphine treatment. Endocrinology. 1991; 128: 3253-3258.
5. Sei, Y. Morphine-induced thymic hypoplasia is glucocorticoid-dependent.
Journal of Immunology. 1991; 146: 194-198.
6. Murray, M. Encyclopedia of Natural Medicine. Revised 2nd edition. Prima
Publishing, Rocklin, California,1998.
7. Seaman, D. Clinical Nutrition for Pain, Inflammation, and Tissue Healing.
NutrAnalysis, Inc. Hendersonville, NC, 1998.
8. Werbach, M. Nutritional Influences on Illness. Keats Publishing, New
Canaan, Conneticut, 1988.
9. Lininger, S. The Natural Pharmacy. Prima Publishing, Rocklin, California,
1998.
10. Barney, P. Doctor's Guide to Natural Medicine. Woodland Publishing,
Pleasant Grove, Utah, 1998.
11. Bucci, L. Nutrition Applied to Injury Rehabilitation and Sports Medicine.
CRC Press, Boca Raton, Florida, 1995.
12. Wolinsky, I. Sports Nutrition. CRC Press, Boca Raton, Florida, 1997.
13. Hauser, R., Hauser, M. Prolo Your Sports Injuries Away! Beulah Land
Press, Oak Park, Illinois, 2001.
Disclaimer: Certain
persons considered experts may disagree with one or more statements
made. Nevertheless, what is stated is based on sound authority,
medical experience, and actual treatments of patients. Top |
