The Institute of Medicine estimates that 100 million Americans suffer from chronic pain. This is even more alarming when you consider that the population of the United States is currently 318 million. Chronic pain can limit enjoyable activities and, when severe, can result in significant loss of function and feelings of hopelessness if pain is not adequately treated.
Traditionally, after other medical and surgical options are exhausted, many physicians treat painful conditions with anti-inflammatory medications (like Ibuprofen or Naproxen) and progress to narcotic pain medication when pain is more significant or long lasting. Although narcotic pain medications are invaluable to relieve pain in acute situations, their use in chronic pain is increasingly coming under fire due to the potential of addiction and problems with tolerance which require increased dosages of medications or more frequent dosing. According to the US government (on the website “drugabuse.gov”), in the year 2010 enough painkillers were prescribed to medicate every adult in the United States continuously every 4 hours for 1 month! In addition to the risk of addiction, chronic use of these medications can lead to liver injury due to the acetaminophen content. As a result, the acetaminophen content of common narcotic pain medications has recently been restricted in an effort to avoid liver toxicity in patients who are frequent users. There is also some evidence in the medical literature showing that chronic narcotic use leads to decreased immune function which could make you susceptible to infections and even some forms of cancer.
If you suffer from chronic pain you may wonder what else can be done to make life manageable in the face of this daily struggle. The good news is that there is hope! What is required is a better understanding of what causes pain (especially chronic pain) and a “bigger toolbox” for treating chronic pain.
Most pain begins in the periphery (at the skin or bone nerve ending level). To put it simply, think of this as a trough (like the one from which an animal might drink). When this “peripheral pain trough” overflows, the pain impulses may travel to the brain and become “centralized” pain. This is much harder to treat. Narcotic pain medications just treat the central component of pain and often come with undesirable side effects (nausea, constipation, drowsiness, dizziness, addiction). While taking these medications alone the “peripheral pain trough” is still full and continues to send messages to the brain which keeps the vicious cycle going.
At Vine Healthcare we address root causes of disease. When it comes to pain, we offer several integrative and holistic modalities to help with chronic pain. First, we ensure that patients have had proper referrals to interventional pain management physicians for regional anesthetic blocks if needed. Next, we place our patients on an anti-inflammatory diet and address any issues with stress which is well known to worsen chronic pain. We then use natural anti-inflammatory supplements such as Curcumin, Vitamin D3, and Fish-oil. Some patients (especially those with fibromyalgia, inflammatory bowel disease, and autoimmune disease) may benefit from compounded low-dose naltrexone. This medication stimulates the release of natural endorphins (pain relieving substances) within our bodies which can help reduce the need for narcotics. Another unique option which we offer at Vine is the use of individualized compounded pain preparations for topical (skin) use. Our highly specialized topical pain compounds provide local treatment using combinations of medications that address the specific molecular pathways involved in chronic pain. We use compounds containing medications such as amitriptyline, ketamine, gabapentin, clonidine, and ketoprofen (alone or in combination) to provide significant pain relief with minimal systemic absorption. This means that the active ingredients stay at nerve endings and do not get into the bloodstream in a significant enough amount to cause side effects which are seen when these medications are taken in pill form. The compounding pharmacy can also make special formulations with better penetration to reach deep tissues like the hip joint or deep nerves within the spine. Local anesthetics can also be formulated into lozenge or lollipop form to treat painful conditions of the mouth or throat.
Although we cannot always eliminate chronic pain, at Vine Healthcare we are committed to treating your pain individually at the molecular level and providing you with the best quality of life possible while treating the whole person.