People google the term ‘chronic pain’ more than 65,000 times each month. People are searching to understand chronic pain and to find lasting relief. It’s estimated that over 20% of U.S. adults suffer from chronic pain.1 It’s one of the most common reasons that adults seek medical care. Chronic pain can cause limited mobility, anxiety, depression, reduced quality of life, and dependence on opioids. Opioid use has skyrocketed since the 1990s.2 The rising number of people using opioids has greatly increased the number of people struggling with opioid addiction and overuse. Each day 130 people die from overdosing on opioids.3
Even as medical journals and news outlets report on the dangers of opioid drugs, conventional medicine addresses chronic pain relief mainly through prescription drugs. This is a crisis that functional medicine helps to resolve by finding the cause fueling chronic pain instead of just masking the symptoms.
Conventional Chronic Pain Treatments
With so many people searching for chronic pain relief, conventional medicine only addresses the symptom and not the cause. This results in a quick but temporary solution. These drugs come with a long list of side effects, so you have to choose between pain relief and safety. The focus is placed on managing your symptoms. Often, they don’t look for the underlying cause of chronic pain. So the underlying cause is never treated.
Both over the counter (OTC) drugs and prescription medication are given to address the ongoing pain.
Nonsteroidal anti-inflammatory drugs (NSAIDs) - These OTC medications were designed for pain that comes from inflammation and swelling. Common NSAIDs are Ibuprofen, Advil, Motrin, and Aleve. With long term use, side effects include stomach pain, ulcers, and kidney problems.4
Acetaminophen - The other common name for this drug is Tylenol. According to the Mayo Clinic, doctors aren’t sure exactly how this drug works, but it’s mainly used for back pain, arthritis, and skin injuries. Side effects include kidney damage and liver failure.5
COX-2 Inhibitors - The common name for this class of medication is Celebrex or Celecoxib. These medications also were designed to reduce inflammation and pain. The side effects include ulcers, kidney problems, dizziness, and high blood pressure.6
Anti-depressant and seizure medication - The pain relief goal for this class of medication is to help quiet nerve pain and improve a patient’s mood.7 The side effects include nausea, dizziness, drowsiness, and worsened depression.
Opioids - This class of drugs is highly addictive and aimed at relieving acute pain. They muffle pain signals within the body, so less pain is perceived.8 Side effects include drowsiness, dizziness, nausea, vomiting, constipation, addiction, and slowed breathing.9
Each of these pain management options offers to mask the pain symptoms for a limited time. Acute pain happens quickly after a traumatic injury and goes away as the injury heals. Chronic pain can be caused by many different conditions with no visible injury seen. Dependence on prescription medication for chronic pain becomes a lifetime commitment if the cause of chronic pain isn’t uncovered and fixed.
Common Chronic Pain Conditions
The most common conditions linked with chronic pain are chronic fatigue syndrome, endometriosis, fibromyalgia, inflammatory bowel disease, and temporomandibular joint dysfunction (TMJ problems).10 Many of these conditions are linked with systemic inflammation. The most common approach to these conditions is to manage the symptoms using medication instead of addressing the cause.
Causes of Chronic Pain and Inflammation
Inflammation is part of the body’s immune system. It’s a tool that the body uses to heal itself by identifying and removing harmful stimuli. Chronic inflammation results when the immune system stays fired up and active. Many different causes drive chronic inflammation.
Diet - What you eat matters. One study shows that the immune system responds to a poor diet just like it would for a bacterial infection.11 The result is chronic low-grade inflammation in the body. The same study found that diet can also positively impact the immune system and help it power down to clear the inflammation. It concluded that a more holistic approach was needed to take into account the combinations of foods and how different people are affected by them.
Toxic Exposure - When we are exposed to various toxic chemicals and mold, the effect can be chronic inflammation that results in chronic pain. Patients who didn’t have chronic pain before being exposed to indoor mold developed numbness, tingling, and shooting pain.12 Researchers also found that people who were exposed to benzene, halocarbons, ketones, nitrosamines, and other toxic chemicals (commonly found in homes and businesses) could have their immune system compromised and develop chronic inflammatory diseases.13
Autoimmune Conditions - Almost all autoimmune conditions cause chronic pain. For example, thyroid diseases like Graves and Hashimotos are caused by the body misidentifying healthy tissue and sending antibodies to attack the thyroid. Thyroid disorders are known to cause fibromyalgia and linked with widespread pain. The same autoimmune response that attacks the thyroid also creates chronic systemic inflammation and results in pain.
Stress - When our mind begins to feel pressured or stressed, our body has a physical reaction to this stress. This reaction activates the immune system, which turns up inflammation.14 The more you are stressed, the more your immune system is turned on. Many people with chronic stress also have chronic pain.
Finding the root cause behind the inflammation is the only way to stop the chain reaction that perpetuates the pain. Functional medicine uses your complete history, examination findings, and advanced testing to find the source driving your condition. Once the cause is discovered, a treatment plan can address the cause and reduce inflammation and chronic pain. This holistic approach works to improve your whole health.
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Endnotes
1 Dahlhamer J, Lucas J, Zelaya, C, et al. Prevalence of Chronic Pain and High-Impact Chronic Pain Among Adults — United States, 2016. MMWR Morb Mortal Wkly Rep 2018;67:1001–1006. DOI: http://dx.doi.org/10.15585/mmwr.mm6736a2
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2 National Institute on Drug Abuse. “Opioid Overdose Crisis.” NIDA, 22 Jan. 2019, www.drugabuse.gov/drugs-abuse/opioids/opioid-overdose-crisis.
3 National Institute on Drug Abuse. “Opioid Overdose Crisis.” NIDA, 22 Jan. 2019, www.drugabuse.gov/drugs-abuse/opioids/opioid-overdose-crisis.
4 “Taking Pills for Chronic Pain?” Mayo Clinic, Mayo Foundation for Medical Education and Research, 14 Feb. 2018, www.mayoclinic.org/chronic-pain-medication-decisions/art-20360371.
5 “Taking Pills for Chronic Pain?” Mayo Clinic, Mayo Foundation for Medical Education and Research, 14 Feb. 2018, www.mayoclinic.org/chronic-pain-medication-decisions/art-20360371.
6 “Taking Pills for Chronic Pain?” Mayo Clinic, Mayo Foundation for Medical Education and Research, 14 Feb. 2018, www.mayoclinic.org/chronic-pain-medication-decisions/art-20360371.
7 “Taking Pills for Chronic Pain?” Mayo Clinic, Mayo Foundation for Medical Education and Research, 14 Feb. 2018, www.mayoclinic.org/chronic-pain-medication-decisions/art-20360371.
8 “Taking Pills for Chronic Pain?” Mayo Clinic, Mayo Foundation for Medical Education and Research, 14 Feb. 2018, www.mayoclinic.org/chronic-pain-medication-decisions/art-20360371.
9 Benyamin, Ramsin, et al. “Opioid Complications and Side Effects.” :::::Pain Physician::::: 2008, www.painphysicianjournal.com/linkout?issn=1533-3159&vol=11&page=S105.
10 “Chronic Pain Information Page.” National Institute of Neurological Disorders and Stroke, U.S. Department of Health and Human Services, 2019, www.ninds.nih.gov/Disorders/All-Disorders/Chronic-pain-Information-Page.
11 Minihane, Anne M., et al. “Low-Grade Inflammation, Diet Composition and Health: Current Research Evidence and Its Translation.” British Journal of Nutrition, vol. 114, no. 7, 2015, pp. 999–1012., doi:10.1017/s0007114515002093.
12 Dillard, J.N. “Chronic Pain, Indoor Mold Exposure, Mycotoxin Excretion, and Response to Antifungal Therapy.” Aspergillus & Aspergillosis Website, 2018, www.aspergillus.org.uk/conference_abstracts/chronic-pain-indoor-mold-exposure-mycotoxin-excretion-and-response-antifungal-0.
13 Parke, D V, and A L Parke. “Chemical-Induced Inflammation and Inflammatory Diseases.” International Journal of Occupational Medicine and Environmental Health, U.S. National Library of Medicine, 1996, www.ncbi.nlm.nih.gov/pubmed/8972163.
14 “Stress, Inflammation and Chronic Pain.” Institute for Chronic Pain, 24 Nov. 2014, www.instituteforchronicpain.org/blog/item/152-55stress-inflammation-and-chronic-pain.