When the pain won’t stop

There are times when pain is expected. Pain is normal after injury or surgery — and it should resolve in a matter of weeks. But pain can also be an indicator of a persistent underlying disease condition.

No one should suffer needlessly. And in the short-term, modern medicine has provided effective pain treatments in the form of strong narcotic pain relievers. They certainly have an important role and there is a definite need for these types of medications.

But what about pain that gets worse with time? Moderate to severe pain takes a special approach — and it’s one that would not be complete without considering the psychology of chronic pain.

When pain becomes chronic it becomes another discussion entirely — mainly because of the very real danger of addiction…

In the U.S, an estimated 2.5 million American adults are addicted to opioids and heroin. ¹ That is largely due to the liberal prescribing by doctors, especially conventional types who rely solely on medication to “help” their patients deal with chronic pain.

In 2012, 259 million opioid pain medication prescriptions were prescribed — enough for every American to have their own bottle of the pills. ²  In 2014 just over 50 people died every day in America — a result of prescription narcotic overdose. That’s 18,893 according to the CDC report. ³

Obviously, the conventional approach to chronic pain isn’t working.

The psychology of chronic pain

There is a unique psychology of chronic pain.  The American Society of Addiction Medicine describes it this way: “Addiction is a primary, chronic and relapsing brain disease characterized by an individual pathologically pursuing reward and/or relief by substance use and other behaviors.” ⁴

It is somewhat similar to the surge of dopamine (the feel-good brain neurotransmitter) that comes when you binge on sugary foods — for lack of a better analogy. Opioids cause an even stronger feel — good neurotransmitter. It’s the ongoing use of them that creates addiction.

So it’s not hard to understand how addiction happens. If you’ve never experienced chronic pain, it’s hard to judge another’s path. But it’s the job of the medical profession to seek better ways to stop or manage the pain, instead of allowing addiction to take hold.

Unfortunately, many doctors have gotten lazy and prefer to just dole out pills instead of dealing with the bigger picture. Or they have never looked outside of the box beyond the physical problem.

When pain takes hold and continues it’s important to heal the mental and emotional factors contributing to the pain — as well as the physical roots causing the pain — to be free of it.

Here is my approach to treating ongoing pain:

• Exercise the rest of your body that is not in pain. This will increase natural endorphins (morphine-like chemicals). This will also keep you mentally and physically strong.
• Have a personal coach, counselor, or emotional therapist, even if you think you are emotionally strong. Chronic pain can wear the strongest among us down.
• Pray to your higher source or spirit guides (who, by the way, are connected to the same supernatural healing power – which I have personally experienced twice). Focus your mind as to what it is you desire. To learn more about this, see the documentary movie, The Secret. ⁵
• Optimize nutrient-rich foods; eliminate sweets and other comfort foods you know are not healthy for you. Refined sugar impairs healing and lowers your emotional power.
• Get acupuncture if it is a localized pain
• Try non-narcotic pain relievers, nerve modulators (Gabapentin, Lyrica), and topical compounded cream combinations (see my previous article on the safe use of these medications) before using narcotics.
• Use Ultram (tramadol), it has far less addictive potential and is used for moderate pain. Tramadol communicates to your brain at the mu receptor (not the opioid receptor). Its common side effects are not dangerous (nausea, dizziness, etc.) except it can add to the serotonin effect of antidepressants because it is a weak serotonin enhancer. I stepped down from hydrocodone to tramadol for a month while recovering from my total colon removal surgery at age 33.
• If narcotic is used, take a two-day drug holiday every 3 to 5 days. Alternate with Ultram, capsaicin, arnica, and keep moving (exercises) and motivated!
• Don’t use narcotics concurrent with benzodiazepines (Valium, Ativan, Klonipin, Xanax, etc.). If you cannot sleep or feel anxious, treat the cause of this. Look for my upcoming article on insomnia.
• If you have joint pain, get prolotherapy or prolozone. Read more here.
• Other effective options are cold lasers or transcutaneous electrical nerve stimulation (TENS) units. Go online; you can buy your own.
• Speak with a surgeon to get a surgically implanted nerve modulator
• Marijuana (for medicinal purposes only) is actually a great option without the side-effects or addiction we see with narcotics. According to a 2006 study in the United Kingdom, of those using medical marijuana to treat rheumatoid arthritis, 72% reported their pain as “much better” and 28% said it was “a little better.” ⁶ Click here and here for my two-part series on medicinal marijuana.

My colleague Dr. Mark Wiley has dealt with pain all his life. When conventional medicines and therapies let him down, he turned to alternative solutions, much like I’ve suggested above — and more. Recently he combined what he found worked best in his book, Conquering Pain. It includes multiple tools you can use to finally take control of your pain — and beat it for good — instead of temporarily masking symptoms and risking addiction. You can click here to get your own copy.

To feeling good in health,
Michael Cutler, M.D.

[1] National Institute on Drug Abuse. Available online at https://www.drugabuse.gov/
[2] http://www.asam.org/docs/default-source/advocacy/opioid-addiction-disease-facts-figures.pdf
[3] Center for Disease Control and Prevention, National Center for Health Statistics, National Vital Statistics System, Mortality File. (2015). Number and Age-Adjusted Rates of Drug-poisoning Deaths Involving Opioid Analgesics and Heroin: United States, 2000–2014. Atlanta, GA: Center for Disease Control and Prevention. Available online at http://www.cdc.gov/nchs/data/health_policy/AADR_drug_poisoning_involving_OA_Heroin_US_2000- 2014.pdf.
[4] American Society of Addiction Medicine. (2011). Public Policy Statement: Definition of Addiction. Chevy Chase, MD: American Society of Addiction Medicine.
[5] http://www.thesecret.tv/products/the-secret-film-dvd/
[6] The use of a cannabis-based medicine (Sativex) in the treatment of pain caused by rheumatoid arthritis.  Rheumatology (June 2006) 45 (6): 781. Found online at: http://rheumatology.oxfordjournals.org/content/45/6/781.1.short