There are few medical issues that bring about a “must deal with” mentality than pain. Acute or chronic, it can have various causes: nerve pain, muscle pain, trauma, cancer, visceral, bone, various organ pain…it can be described as shooting, stabbing, dull, throbbing, aching, excruciating, and debilitating. Whatever the cause or description, when you have it you want it gone.
Pain treatment often involves initial therapy with NSAIDS, perhaps RICE therapy (rest, ice, compression and elevation), and acetaminophen. If pain escalates or initial therapy doesn’t work as hoped, narcotics are often introduced, initially short acting, then longer acting. Adjunctive therapy often involves gabapentin, pregabalin, amitriptyline, valproic acid or steroids. Unfortunately, many people can remain in pain despite all of these well-meaning measures.
We often see people who want an alternative to these meds. They feel they need more or need something that has less side effects. There are several ways to try to accomplish this. I say “try” because whether you are giving a recommendation for a cold, high blood pressure, depression, or any ailment, there are never any guarantees with medicine. There are a few ways I have seen results without debilitating side effects.
One of these is through compounding. Using transdermal formulations that include many ingredients that may be given orally for pain, a better success rate is possible with less side effects. Using active ingredients such as amitriptyline, gabapentin, ketoprofen, ketamine, lidocaine, clonidine, baclofen, cyclobenzaprine, and more. In the interest of keeping it short, Dr. John Ritter and myself penned an article for Rehab and Community Care on this subject. It can be read online at:
Also, this article has a description of wound therapy, which is also an important way to deal with pain.
But what else can you do to treat pain without a prescription in an effective way that has been studied with good science? Here are some of my suggestions:
- Omega-3 is the first one that comes to mind. It mirrors regular NSAIDS in its ability to treat pain. Current science is driving us in the direction of a modified Omega-3 molecule that is being studied as a pain reliever and anti-inflammatory.
- Antioxidants such as vitamin E, vitamin C cysteine and Coenzyme Q10 have all been studied for their benefits in pain relief. Lipoic acid is effective in neuropathic pain.
- B vitamins (specifically B1,2,6, and 12) decrease various types of pain and can increase sensitivity to pain meds. There ability to treat pain is mediated through serotonergic neurotransmitters.
- Vitamin D is one of my favorite suggestions for pain patients. Many chronic pain patients often present with low vitamin D.
- Choline, inositol and oleic acid are also promising compounds in pain relief.
- Curcumin, quercetin, boswellia, and systemic enzymes have also been used in inflammatory conditions.
Several minerals are also suggested in pain relief:
- Copper supplementation is used in arthritic pain. Chronic copper supplementation can deplete zinc, so zinc supplementation should coincide with copper.
- Selenium improves muscle pain in deficient patients.
- Magnesium is often low in people regardless of pain status. It lowers pain by blocking receptors in the spinal cord and is used for post operative pain.
Specific diseases call for specific measures with pain therapy. Headaches, fibromyalgia, polymyalgia, post exercise muscle pain, etc all have their own ways of being elusive in pain relief. Sometimes an NSAID is not always the way to go.