Natural Pain Relievers

July 19, 2010 Written by JP    [Font too small?]

There are few things in life that are more difficult than being in constant pain or seeing someone you love in the same predicament. Chronic pain related conditions are notoriously difficult to manage in the long term without accompanying side effects from the treatments themselves. But what can one do? You either live with the pain and forego conventional therapies or you take the best pharmacological and surgical advice your doctors have to offer. The latter is what most people settle on and it’s completely understandable. However, there are also natural pain relieving options available. My Healthy Monday tip is that patients and physicians consider adding alternative and complementary techniques to their list of viable interventions.

One of the most popular columns I’ve written deals with the topic of krill oil. Antarctic krill (Euphausia superba) are marine crustaceans with a prawn-like appearance. They’re prized for their unique lipid composition which features a mixture of astaxanthin (an antioxidant carotenoid), omega-3 fatty acids (DHA and EPA) and phospholipids such as choline. A new study presented in the journal BMC Musculoskeletal Disorders reports that mice with an experimental form of rheumatoid arthritis may benefit from the inclusion of krill oil in their diets. Arthritis scores and swelling were reduced to a greater degree in mice that consumed krill oil as opposed to fish oil or a placebo. The authors of the trial concluded that, “In the present study, krill oil was able to reduce the severity of arthritis by about 50%”. (1)

The omega-3 content of krill oil was likely responsible for at least some of the benefits found in the previously mentioned study. However, the issue of fatty acids extends beyond this limited scope. This is illustrated in the June 2010 edition of Pain Medicine which describes yet another connection between fatty acids and pain. A total of 20 patients with Complex Regional Pain Syndrome (CRPS) and 15 patients who were pain-free had their blood analyzed for fatty acid levels. The patients with CRPS exhibited elevated levels of omega-6 fatty acids and trans-fats. Furthermore, the levels of trans fatty acids were “positively correlated with pain-related disability and anxiety”. It should be noted that omega-6 fatty acids are commonly found in vegetable oils. Trans fats are present in margarine and many processed foods that contain hydrogenated and partially-hydrogenated fats. This preliminary investigation suggests that people living with chronic pain should consider an oil change. (2)

This next section may require some of you to suspend your disbelief. Holistic modalities such as guided imagery and Therapeutic Touch often illicit eye-rolling, scoffing and other skeptical reactions. All I ask is that you consider what I’m presenting in the same way as did the physicians that “peer-reviewed” this data prior to authorizing its publication.

  • A study presented in the latest issue of the Journal of Holistic Nursing found that applying Therapeutic Touch to 21 patients recovering from vascular surgery resulted in lower cortisol levels, pain and an elevation in the number of natural killer cells as compared to patients who only received “usual care”. Natural killer cells are an important component of the immune system and may help reduce the risk of infection following surgical procedures. (3)
  • Involving patients in a guided imagery session prior to surgery was recently shown to reduce anxiety levels, measures of pain and hasten departure from a “postoperative anesthesia care unit”. The researchers believe that the decline in anxiety contributed to the pain relieving effect and recovery promotion. (4)
Glucosamine vs. Placebo in Patients with Chronic Low Back Pain
Source: JAMA. 2010;304(1):45-52. (link)

Unfortunately, not all studies involving natural remedies yield such promising results. A newly published study in the Journal of the American Medical Association describes a disappointing trial that used glucosamine sulfate in patients with “chronic low back pain (LBP) with degenerative lumbar osteoarthritis (OA)”. This is a major let down because glucosamine is probably the best known nutritional supplement for OA. The dosage of glucosamine used in the study was acceptable – 1,500 mg/day. The length of the trial was adequate – 1 year. However, the findings just weren’t that impressive. Only minor, non-significant improvements in pain and quality of life measures were detected in the glucosamine group vs. the placebo group. (5)

Poor results are a fact of life in medical research. This applies to the allopathic and natural health sectors of medicine. But just because one remedy isn’t successful doesn’t mean that there aren’t other safe options available. A group of researchers from Oklahoma State University provide a perfect example of this truism. A pilot study involving 27 men and women with low back pain were prescribed specific mattresses based on their “dominant sleeping positions”. The hypothesis was that improper sleeping positions were contributing to the pain experienced by the test subjects. Over the course of 12 weeks, the OSU researchers monitored symptom severity in all the study participants. A comparison of test scores from the beginning and end of the trial revealed that individually prescribed beds using “medium-firm mattresses specifically layered with foam and latex” reduced back pain, stiffness and the number of days per week of poor sleep and subsequent discomfort. (6)

One of my primary goals is to present as many evidence-based, non-toxic treatment options as possible on this site. I’m fully aware that not every one of them will appeal to all of my readers and their family and friends. In fact, I can very easily relate to that point of view. I am just as happy if you find pain relief from guided imagery rather than krill oil or Therapeutic Touch as opposed to a new mattress. As long as you’re comfortable with it and it works in a safe manner, I’m all for it.

Note: Please check out the “Comments & Updates” section of this blog – at the bottom of the page. You can find the latest research about this topic there!

Be well!


Tags: , , ,
Posted in Alternative Therapies, Bone and Joint Health, Mental Health

33 Comments & Updates to “Natural Pain Relievers”

  1. Iggy Dalrymple Says:

    Glucosamine & chondroitin not only help with joint health but they are among the few supplements that improve human mortality.

    A few months back I injured my knee when I tried to set a new personal speed record. The injury was slow to heal. It may be a coincidence but shortly after I started taking Jean Carper\’s \”Super Osteo Gold\”, the pain stopped. The supplement contains glucosamine, chondroitin, MSM, and hyaluronic acid.

  2. Mark Says:

    Very interesting post on krill oil. I wonder if krill oil would help with the inflammation of tendinitis, which I suffer from frequently.

    As far as Therapeutic Touch, I believe it’s all in the human connection. Yes, the slight massage is a benefit, but I believe it’s more the patient feeling connection with another that cares enough to want to help them recover. The mind is great healer!

  3. JP Says:


    There’s pretty strong evidence supporting the use of glucosamine and glucosamine blends re: knee OA. The reason I presented the back study was to illustrate that glucosamine by itself may not relieve every pain that involves connective tissue.

    The real take home message is to keep trying different options if one doesn’t work out for you.

    I’m happy to hear about your recovery with the Super Osteo Gold product. Several of my family members are currently using a supplement that contains chondroitin, hyaluronic acid and various phytochemicals. It seems to be helping with various aches and pains. Not a miracle worker but still helpful.

    Be well!


  4. JP Says:


    My hunch is that it could help. I’ve read reports about non-arthritic inflammation and pain being reduced/relieved by krill oil. In fact, my mom seems to have benefited from the inclusion of krill oil into her daily routine.

    I agree that human contact is invaluable. I don’t know if there’s more to TT than that. But I think the connection that is associated with caring/compassionate touch is certainly therapeutic. The bond even extends beyond the human realm. This is believed to be one of the factors that contributes to the positive results found with animal assisted therapy.

    Be well!


  5. primalocity Says:

    What about the benefits of ginger?

  6. Ellen Says:

    I actually experienced similar results with Super Osteo Gold. I suffered from chronic pain in both knees for a number of years, due to having been a runner since my 20’s. (I am 52 now.) Within about a month of using the product, I noticed an immediate reduction in pain. I’m not sure why, but it’s the only such product I’ve ever taken that has helped me. I HIGHLY recommend it to anyone who has been unable to get relief from other glucosamine preparations. You can get it from Stop Aging Now:

  7. JP Says:


    Ginger is also an effective anti-inflammatory. I’ve addressed it in previous columns:

    Be well!


  8. JP Says:

    Thank you for sharing your successful experience with us, Ellen. 🙂

    Be well!


  9. Alan Says:

    In my ten or twelve years of fliping from prescription to prescription for chronic pain I found several are sometimes more beneficial when saving face due to their ungodly adverse-reactions when it comes to alternative or natural healing herbs or remedies. I am yet to acclamate which to give the highest star rating for lower back neuralgia and acheing whether sulfate or hydrochloride(glucosamine),although it is categorized as a sugar,
    it is a wonder to me it has any therapeutic qualities when used
    solo. I have tried both but the sulfate is less readily available. I have tried just everything from California Poppy to various adaptogens like Winter Cherry or Indian Ginseng with some suprising relief.My nerve pains stem from spondylolisthesis(grade 1),but that doesn’t mean it is a elementary level horror.I like any course of different proven natural herbal guardians!-AA

  10. JP Says:

    Update 05/19/15:

    Prim Health Care Res Dev. 2015 Jul;16(4):424-8.

    Mindfulness-Based Stress Reduction: pilot study of a treatment group for patients with chronic pain in a primary care setting.

    AIM: The study objective was to evaluate an eight-week Mindfulness-Based Stress Reduction (MBSR) treatment group for chronic pain in terms of effects on pain disability, subjective ratings of pain and psychological distress related to pain, and activity level and willingness to experience pain. This pilot study evaluated the impact of two eight-week MBSR treatment groups that were delivered in a clinic in Winnipeg, Manitoba.

    BACKGROUND: Chronic pain is one of the most common presenting problems in primary care settings.

    METHODS: Adult patients with chronic pain were recruited from 20 clinics that are part of a collaborative care programme and outcome measures were administered at baseline and programme completion. Findings Despite a modest attendance rate and the short length of programme, a pre-post evaluation involving 17 patients revealed significant and/or clinically relevant improvements in level of pain disability, psychological distress, engagement in life activities, willingness to experience pain, and subjective rating of current pain.

    Be well!


  11. JP Says:

    Update 07/14/15:

    Anesth Pain Med. 2015 Jun 22;5(3):e25085.

    The Effects of Topical Sesame (Sesamum indicum) Oil on Pain Severity and Amount of Received Non-Steroid Anti-Inflammatory Drugs in Patients With Upper or Lower Extremities Trauma.

    BACKGROUND: Most patients with trauma experience different levels of pain. Due to side effects as well as economic burden of drugs used for pain relief after trauma commonly, it is important to use low-cost methods independently or combined with drugs to alleviate pain.

    OBJECTIVES: Therefore, this study aimed to investigate the effects of topical sesame oil on pain severity and frequency of received NSAIDs of patients with trauma.

    PATIENTS AND METHODS: This randomized clinical trial study was conducted on 150 patients with upper or lower extremities trauma in Dezful Ganjavian Hospital, Ahvaz, Iran, in 2014. Data was collected by a researcher-made questionnaire and Visual Analogue Scale (VAS). Patients were divided into two groups of control (n = 75) and intervention (n = 75) randomly. In the intervention group, patients applied topical sesame oil beside the routine cares, while in the control group patients just received routine cares. Severity of pain and frequency of received NSAIDs was assessed in the first, third, seventh and tenth days after the intervention in the both groups. Data was analyzed by SPSS19 software using descriptive and analytic (Chi-square and independent sample t-test) statistical methods.

    RESULTS: Based on student sample t-test, there was a significant difference between intervention and control groups regarding the pain severity in the first (P = 0.06), third (P = 0.001), seventh (P = 0.001) and tenth (P = 0.001) days after the intervention. Besides, the frequency of received NSAIDs in the intervention group and the control group showed significant difference in four days after the intervention (for four days P = 0.001).

    CONCLUSIONS: Topical application of sesame oil could reduce pain severity and frequency of received NSAIDs in patients with upper or lower extremities trauma. Therefore, it is recommended to use this oil in complementary medicine for pain relief due to low cost, easy usage and lack of adverse effects.

    Be well!


  12. JP Says:

    Updated 07/26/15:

    Int J Biomed Sci. 2015 Jun;11(2):54-60.

    Evaluation of the Effect of Mega MSM on Improving Joint Function in Populations Experiencing Joint Degeneration.

    Joint degeneration has become a commonplace problem in aging populations. The main clinical manifestations include joint pain, joint stiffness and joint swelling with functional disorder. Mega MSM is a nutritional supplement that may provide potential relief for joint problems associated with joint degeneration. The current experiment performed was a 12-week, randomized, double-blind, controlled study conducted on populations in China experiencing joint degeneration. The objective of the study was to determine whether the daily use of Mega MSM capsules could improve joint function, relieve symptoms of joint degeneration and improve the quality of life in aging populations. A total of 100 male and female participants over 50 years old who had at least one of the related symptoms of joint degeneration (joint pain, joint stiffness, joint swelling, difficulty walking, difficulty getting up from bed and difficulty going down stairs) were recruited and their symptoms of joint degeneration before and after the intervention were recorded. In this study, Mega MSM shows positive effects in improving joint function, relieving symptoms associated with joint degeneration and improving the quality of life in aging populations.

    Be well!


  13. JP Says:

    Updated 08/11/15:

    Pain Med. 2015 Aug 8.

    A Brief Mindfulness Meditation Training Increases Pain Threshold and Accelerates Modulation of Response to Tonic Pain in an Experimental Study.

    OBJECTIVE: Research shows that mindfulness meditation (MM) affects pain perception; however, studies have yet to measure patterns of change over time. We examined effects of MM on perception of experimental heat pain using multiple psychophysical indices, including pattern of change in response to tonic painful stimuli. We also tested the potential moderating role of baseline mindfulness.

    METHOD: Forty participants were randomly assigned to a brief MM training or control group. We assessed: a) heat pain threshold (HPT), b) temperature which induces pain at a fixed, target intensity level, and c) response pattern over time to tonic heat pain.

    RESULTS: Compared to control group, the MM group showed increased HPT and more rapid attenuation of pain intensity for tonic pain stimuli. Moderation analyses indicated that baseline mindfulness moderated effects of MM on HPT.

    CONCLUSIONS: A brief MM intervention appears to affect perception of experimental pain both by increasing pain threshold and accelerating modulation of response. Findings may help elucidate mechanisms of MM for chronic pain.

    Be well!


  14. JP Says:

    Updated 08/23/15:

    Int J Yoga. 2015 Jul-Dec;8(2):128-33.

    Effectiveness of mindfulness meditation on pain and quality of life of patients with chronic low back pain.

    BACKGROUND AND AIM: Recovery of patients with chronic low back pain (LBP) is depended on several physical and psychological factors. Therefore, the authors aimed to examine the efficacy of mindfulness based stress reduction (MBSR) as a mind-body intervention on quality of life and pain severity of female patients with nonspecific chronic LBP (NSCLBP).

    METHODS: Eighty-eight patients diagnosed as NSCLBP by physician and randomly assigned to experimental (MBSR+ usual medical care) and the control group (usual medical care only). The subjects assessed in 3 times frames; before, after and 4 weeks after intervention by Mac Gil pain and standard brief quality of life scales. Data obtained from the final sample analyzed by ANCOVA using SPSS software.

    RESULTS: The findings showed MBSR was effective in reduction of pain severity and the patients who practiced 8 sessions meditation reported significantly lower pain than patients who only received usual medical care. There was a significant effect of the between subject factor group (F [1, 45] = 16.45, P < 0.001) and (F [1, 45] = 21.51, P < 0.001) for physical quality of life and (F [1, 45] = 13.80, P < 0.001) and (F [1, 45] = 25.07, P < 0.001) mental quality of life respectively. CONCLUSION: MBSR as a mind-body therapy including body scan, sitting and walking meditation was effective intervention on reduction of pain severity and improvement of physical and mental quality of life of female patients with NSCLBP. Be well! JP

  15. JP Says:

    Updated 11/27/15:

    Complement Ther Clin Pract. 2015 Nov;21(4):223-8.

    A pilot randomized double-blind placebo-controlled trial on topical chamomile (Matricaria chamomilla L.) oil for severe carpal tunnel syndrome.

    OBJECTIVE: To assess the effectiveness of standardized topical Chamomile (Matricaria chamomilla L.) oil in patients with severe carpal tunnel syndrome, as a complementary treatment.

    METHOD: A pilot randomized double-blind placebo-controlled trial was conducted. Twenty six patients with documented severe carpal tunnel syndrome were treated in two parallel groups with a night splint plus topical chamomile oil or placebo. They were instructed to use their prescribed oil for 4 weeks, twice daily. Symptomatic and functional status of the patients and their electrodiagnostic parameters were evaluated when enrolled and after the trial period, as our outcome measures.

    RESULTS: A significant improvement of symptomatic and functional status of patients in the chamomile oil group was observed (p = 0.019 and 0.016, respectively) compared with those in the placebo group. However, electrodiagnostic parameters showed no significant changes between the two groups.

    CONCLUSION: Chamomile oil improved symptomatic and functional status of patients with severe carpal tunnel syndrome.

    Be well!


  16. JP Says:

    Updated 1/23/16:

    Acupunct Med. 2016 Jan 21.

    Randomised controlled trial of contralateral manual acupuncture for the relief of chronic shoulder pain.

    OBJECTIVE: To explore the effects of contralateral manual acupuncture (MA) on patients with chronic shoulder pain.

    METHODS: Eighty patients with chronic shoulder pain were randomly allocated to receive contralateral MA (n=38) for 4 weeks or to remain on a waiting list while receiving conventional orthopaedic therapy (n=42). Visual analogue scale (VAS) scores were taken as the primary outcome measure and used for a priori power calculation. Secondary outcome measures for the assessment of shoulder mobility and quality of life included the Jobe test, the Constant-Murley (CM) score, the Disabilities of the Arm, Shoulder and Hand (DASH) score, and the 36 item Short Form Health Survey (SF-36).

    RESULTS: Intention-to-treat (ITT) analysis demonstrated significant pain relief with contralateral acupuncture, with mean differences in VAS scores compared to the waiting list group of -19.4 (-28.0 to -10.8) at 2 weeks, -40.4 (-49.0 to -31.8) at 4 weeks, -41.1 (-49.7 to -32.5) at 8 weeks, and -40.9 (-49.5 to -32.3) at 16 weeks. CM and DASH scores were also improved at all time points (p<0.01). Shoulder mobility, physical functioning, social functioning and mental health components of the SF-36 were also improved by contralateral acupuncture at 8 weeks. No significant adverse effects were observed.

    CONCLUSIONS: These results demonstrate beneficial effects of contralateral acupuncture in the treatment of chronic shoulder pain, both in terms of pain and function. Future research is required to compare directly the effects of local and contralateral acupuncture and to quantify the specific and non-specific effects.

    Be well!


  17. JP Says:

    Updated 05/29/16:

    J Back Musculoskelet Rehabil. 2016 May 20.

    Effect of a stress management program on subjects with neck pain: A pilot randomized controlled trial.

    BACKGROUND: Studies have shown that stress is implicated in the cause of neck pain (NP).

    OBJECTIVES: The purpose of this study is to examine the effect of a simple, zero cost stress management program on patients suffering from NP.

    METHODS: This study is a parallel-type randomized clinical study. People suffering from chronic non-specific NP were chosen randomly to participate in an eight week duration program of stress management (N= 28) (including diaphragmatic breathing, progressive muscle relaxation) or in a no intervention control condition (N= 25). Self-report measures were used for the evaluation of various variables at the beginning and at the end of the eight-week monitoring period. Descriptive and inferential statistic methods were used for the statistical analysis.

    RESULTS: At the end of the monitoring period, the intervention group showed a statistically significant reduction of stress and anxiety (p= 0.03, p= 0.01), report of stress related symptoms (p= 0.003), percentage of disability due to NP (p= 0.000) and NP intensity (p= 0.002). At the same time, daily routine satisfaction levels were elevated (p= 0.019). No statistically significant difference was observed in cortisol measurements.

    CONCLUSIONS: Stress management has positive effects on NP patients.

    Be well!


  18. JP Says:

    Updated 06/11/16:

    Int Rev Psychiatry. 2016 Jun 10:1-7.

    Yoga-based intervention in patients with somatoform disorders: an open label trial.

    Somatoform disorders are common mental disorders associated with impaired functioning and increased utilization of health resources. Yoga-based interventions have been used successfully for anxiety, depression, and chronic pain conditions. However, literature on the use of yoga in treatment of somatoform disorders is minimal. The current study assessed the effect of a specific yoga-based intervention in patients with somatoform disorders. Consenting patients meeting ICD-10 criteria for somatoform disorders were offered a specific yoga module (1 h per day) as a treatment. Assessments including Visual Analogue Scale (VAS), Brief Pain Inventory (BPI), and others were carried out at baseline and after 2, 6, and 12 weeks. Sixty-four subjects were included in the study and 34 completed 12 weeks follow-up. Significant improvement was noted in pain severity from baseline to 12 weeks after regular yoga sessions. The mean VAS score dropped from 7.24 to 2.88. Worst and average pain score in the last 24 h on BPI dropped from 7.71 to 3.26 and from 6.12 to 2.0,7 respectively. Results of the study suggest that yoga-based intervention can be one of the non-pharmacological treatment options in somatoform disorders. These preliminary findings need replication in larger controlled studies.

    Be well!


  19. JP Says:

    Updated 08/03/16:

    Mater Sociomed. 2016 Jun;28(3):220-3.


    INTRODUCTION: In patients with cancer, pain may influence their life style, and feeling of satisfaction and comfort, leading to fatigue, and cause impairment of their quality of life, personal relationships, sleep and daily activities. The aim of this study was to evaluate the effect of therapeutic touch (TT) on pain related parameters of in patients with cancer.

    METHODS: In a randomized clinical trial a total of 90 male patients referring to Specialized Oncology Hospital in Mashhad, were conveniently selected and randomly divided into three intervention, placebo, and control groups. The intervention consisted of TT in 7 sessions for a 4-week period. The data were collected using a demographic questionnaire along with the Brief Pain Inventory, which were then analyzed and compared using Kruskal-Wallis and Mann-Whitney tests.

    RESULTS: By comparing scores parameters of pain scales (general activity, mood, walking ability, relations with other people and sleep) in the three groups, there was no significant difference at the beginning of the first session. However, a significant difference was observed at the end of TT sessions between the three groups (p= 0.001). Furthermore, the groups were compared two-by-two by using Mann-Whitney test and Bonferroni correction, and the result indicated significant differences between the two intervention and placebo groups as well as between the two intervention and control groups.

    CONCLUSION: The results of the study showed that TT had a positive impact on the positive management of pain related parameters in cancer patients. Therefore, TT is suggested to be used by healthcare providers as a complementary method for managing pain and its parameters.

    Be well!


  20. JP Says:

    Updated 08/27/16:

    Iran J Nurs Midwifery Res. 2016 Jul-Aug;21(4):391-6.

    Effects of music therapy on pain responses induced by blood sampling in premature infants: A randomized cross-over trial.

    BACKGROUND: Premature infants are subjected to many painful procedures during care and treatment. The aim of this study was to assess the effect of music therapy on physiological and behavioral pain responses of premature infants during and after blood sampling.

    MATERIALS AND METHODS: This study was a cross-over clinical trial conducted on 20 infants in a hospital affiliated to Tehran University of Medical Sciences for a 5-month period in 2011. In the experimental group, Transitions music was played from 5 min before until 10 min after blood sampling. The infants’ facial expressions and physiological measures were recorded from 10 min before until 10 min after sampling. All steps and measurements, except music therapy, were the same for the control group. Data were analyzed using SAS and SPSS software through analysis of variance (ANOVA) and Chi-square tests.

    RESULTS: There were significant differences between the experimental and control groups (P = 0.022) in terms of heart rate during needle extraction and at the first 5 min after sampling (P = 0.005). Considering the infant’s sleep-wake state in the second 5 min before sampling, the statistical difference was significant (P = 0.044). Difference was significant (P = 0.045) during injection of the needle, in the first 5 min after sampling (P = 0.002), and in the second 5 min after sampling (P = 0.005). There were significant difference in infants’ facial expressions of pain in the first 5 min after sampling (P = 0.001).

    CONCLUSIONS: Music therapy reduces the physiological and behavioral responses of pain during and after blood sampling.

    Be well!


  21. JP Says:

    Updated 09/02/16:

    Int J Yoga Therap. 2016 Sep 1.

    Mindful Yoga Pilot Study Shows Modulation of Abnormal Pain Processing in Fibromyalgia Patients.

    Published findings from a randomized controlled trial have shown that Mindful Yoga training improves symptoms, functional deficits, and coping abilities in individuals with fibromyalgia and that these benefits are replicable and can be maintained 3 months post-treatment. The aim of this study was to collect pilot data in female fibromyalgia patients (n = 7) to determine if initial evidence indicates that Mindful Yoga also modulates the abnormal pain processing that characterizes fibromyalgia. Pre- and post-treatment data were obtained on quantitative sensory tests and measures of symptoms, functional deficits, and coping abilities. Separation test analyses indicated significant improvements in heat pain tolerance, pressure pain threshold, and heat pain after-sensations at post-treatment. Fibromyalgia symptoms and functional deficits also improved significantly, including physical tests of strength and balance, and pain coping strategies. These findings indicate that further investigation is warranted into the effect of Mindful Yoga on neurobiological pain processing.

    Be well!


  22. JP Says:

    Updated 10/20/16:

    PLoS One. 2016 Oct 18;11(10):e0164302.

    Selenium and Zinc Status in Chronic Myofascial Pain: Serum and Erythrocyte Concentrations and Food Intake.

    INTRODUCTION: Nutritional disorders have been reported to be important causal factors that can intensify or cause a painful response in individuals with chronic musculoskeletal pain.

    AIM: To assess the habitual intake of and the serum and erythrocyte levels of selenium and zinc in patients with chronic myofascial pain.

    MATERIALS AND METHODS: A case-control study of 31 patients with chronic myofascial pain (group I) and 31 subjects without pain (group II). Dietary record in five days for assessing food intake were used. The serum and erythrocyte concentrations of selenium and zinc were analyzed using an atomic absorption spectrophotometry. Pain intensity was assessed using a visual analog scale.

    RESULTS: The group of patients with chronic myofascial pain, compared with the control group, showed a lower erythrocyte concentration of selenium (79.46 ± 19.79 μg/L vs. 90.80 ± 23.12 μg/L; p = 0.041) and zinc (30.56 ± 7.74 μgZn/gHb vs. 38.48 ± 14.86 μgZn/gHb, respectively; p = 0.004). In this study, a compromised food intake of zinc was observed in the majority of the subjects in both groups. The selenium intake was considered to be safe in 80% of the subjects in both groups; however, the likelihood of inadequate intake of this mineral was twice as high in group I (49.5% vs. 24.4%, respectively). In the logistic regression analysis, the erythrocyte concentration of zinc was associated with the presence of pain. In each additional 1 mg of Zn2+ per gram of hemoglobin, a reduction of 12.5% was observed in the risk of the individual having chronic myofascial pain (B = -0.133; adjusted OR = 0.875, 95% CI = 0.803 to 0.954, Wald = 9.187, standard error = 0.044, p = 0.002). Physical inactivity and obesity were noted more commonly in group I compared with the control group.

    CONCLUSION: In this study, patients with chronic myofascial pain showed lower intracellular stores of zinc and selenium and inadequate food intake of these nutrients.

    Be well!


  23. JP Says:

    Updated 11/22/16:

    Int J Vitam Nutr Res. 2016 Nov 21:1-10.

    Polyphenol-Rich Foods Alleviate Pain and Ameliorate Quality of Life in Fibromyalgic Women.

    OBJECTIVES: The present study aimed to describe the antioxidant dietary intake of patients with fibromyalgia and explore the association of the results with glutathione status, pain, quality of life, and socioeconomic status.

    METHODS: 38 fibromyalgic female patients and 35 female controls (mean age = 48.6 ± 8.1 and 47.6 ± 10.0 years, respectively) were evaluated. The number of tender points, pain threshold, quality of life, physical activity, socioeconomic status, nutritional status, intake of antioxidant micronutrients and foods with high total antioxidant capacity, and total salivary glutathione were evaluated.

    RESULTS: The number of tender points, pain threshold, and quality of life were worse in the fibromyalgia group. The consumption of vegetable juices was more common among women with fibromyalgia and consumption of red wine and beer were more common among healthy women. The adjusted mean intakes of antioxidant vitamins as well as selenium were higher for the control group (p ≤ 0.01). There was no difference for salivary levels of glutathione between the groups and no correlation for intake of antioxidant micronutrients and pain or quality of life among fibromyalgic women. However, intake of foods rich in polyphenols was associated with lower numbers of tender points (coffee, r = – 0.346; pear, r = – 0.331) and better quality of life (red fruits, r = – 0.342; dark chocolate, r = – 0.404) in the fibromyalgic group. In these women, associations between glutathione levels and food intake, pain or quality of life were not found.

    CONCLUSION: This study indicated that antioxidant protection from bioactive compounds present in fruit and vegetables could have an adjuvant role in fibromyalgia treatment.

    Be well!


  24. JP Says:

    Updated 12/29/16:

    Int J Rehabil Res. 2016 Dec 27.

    The effect of vitamin D supplementation on pain, quality of life, and nerve conduction studies in women with chronic widespread pain.

    The aim of this study was to investigate the effects of vitamin D supplementation on pain, quality of life, and nerve conduction studies (NCSs) in women with chronic widespread pain (CWP) diagnosed with Vitamin D insufficiency. Thirty-three female participants with CWP and vitamin D insufficiency were included in this open-label trial. They were evaluated by routine NCSs in upper and lower limbs, pain scales, and the Nottingham Health Profile before and 8 weeks after starting vitamin D supplementation therapy. The P-value was adjusted to account for the number of comparisons performed in each assessment. After 8 weeks of treatment, participants reported significantly lower pain scores (P=0.000). The total Nottingham Health Profile score and subscores for pain, emotional reactions, and physical activity domains were significantly lower (0.000≤P≤0.008). However, no statistically significant changes in NCSs were detected, except trends toward increases in the amplitudes of left median and ulnar sensory nerve potentials and a decrease in the distal latency of the right median sensory potential (0.01≤P≤0.04). Vitamin D supplementation therapy decreased pain and increased quality of life without significantly affecting nerve conduction in patients with CWP.

    Be well!


  25. JP Says:

    Updated 01/17/17:

    Pain. 2017 Feb;158(2):273-277.

    Dietary intake mediates the relationship of body fat to pain.

    Prior studies have documented an association of obesity with chronic pain, but the mechanism explaining the association remains unknown. This study evaluated the degree to which dietary intake of foods with anti-inflammatory effects mediates the relationship of body fat to body pain. Ninety-eight community-residing healthy adults (60% women; mean age = 43.2 ± 15.3 years; range: 20-78 years) participated in a home-based study of home environment, food-related behaviors, health, and adiposity. During a 3-hour home visit evaluation, 3 measures of body fat were collected, including height and weight for calculation of body mass index (BMI). Participants also completed a 24-hour food recall interview and self-report measures of bodily pain (BP; BP subscale from the Medical Outcomes Study Short Form-36) and psychological distress (Hospital Anxiety and Depression Scale). Quality of dietary intake was rated using the Healthy Eating Index-2010. Mediation models were conducted with the PROCESS macro in SAS 9.3. Mean BMI was consistent with obesity (30.4 ± 7.8; range: 18.2-53.3), and BP values (73.2 ± 22.1; range: 0-100) and dietary intake quality (59.4 ± 15.5; range: 26.8-88.1) were consistent with population norms. Modeling in PROCESS revealed that Healthy Eating Index-2010 scores mediated the relationship between BMI and BP (bindirect = -0.34, 95% confidence interval = -0.68 to -0.13). The mediation model remained significant when controlling for biomechanical factors (arthritis/joint pain), medication use, psychological distress, age, and education, and models remained significant using the other 2 body fat measures. Thus, the data indicate that dietary intake of foods with anti-inflammatory effects mediates the relationship of body fat to body pain in healthy men and women.

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  26. JP Says:

    Updated 01/19/17:

    J Evid Based Complementary Altern Med. 2017 Jan;22(1):18-24.

    Exploring the Effectiveness of External Use of Bach Flower Remedies on Carpal Tunnel Syndrome: A Pilot Study.

    BACKGROUND: A randomized, pilot, placebo-controlled clinical trial was conducted with the aim of evaluating the effectiveness of a cream based on Bach flower remedies (BFR) on symptoms and signs of carpal tunnel syndrome.

    METHODS: Forty-three patients with mild to moderate carpal tunnel syndrome during their “waiting” time for surgical option were randomized into 3 parallel groups: Placebo (n = 14), blinded BFR (n = 16), and nonblinded BFR (n = 13). These groups were treated during 21 days with topical placebo or a cream based on BFR.

    RESULTS: Significant improvements were observed on self-reported symptom severity and pain intensity favorable to BFR groups with large effect sizes (η2partial > 0.40). In addition, all signs observed during the clinical exam showed significant improvements among the groups as well as symptoms of pain, night pain, and tingling, also with large effect sizes (φ > 0.5). Finally, there were significant differences between the blinded and nonblinded BFR groups for signs and pain registered in clinical exam but not in self-reports.

    CONCLUSION: The proposed BFR cream could be an effective intervention in the management of mild and moderate carpal tunnel syndrome, reducing the severity symptoms and providing pain relief.

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  27. JP Says:

    Updated 06/23/17:

    Biomed Res Int. 2017;2017:3804356.

    A Pilot Study on Bioactive Constituents and Analgesic Effects of MyrLiq®, a Commiphora myrrha Extract with a High Furanodiene Content.

    The analgesic properties of myrrh (Commiphora myrrha) have been known since ancient times and depend on the presence of bioactive sesquiterpenes with furanodiene skeletons. MyrLiq is a C. myrrha extract with a standardized content of curzerene, furanoeudesma-1,3-diene, and lindestrene (12.31 ± 0.05 g kg-1, 18.84 ± 0.02 g kg-1, and 6.23 ± 0.01 g kg-1, resp.) and a high total furanodiene content (40.86 ± 0.78 g kg-1). A balanced sample of 95 female and 89 male volunteers (with ages ranging from 18 to older than 60 years) exhibiting different pain pathologies, including headache, fever-dependent pain, joint pain, muscle aches, lower back pain, and menstrual cramps, was divided into two groups. The experimental group received 1 capsule/day containing either 200 mg or 400 mg of MyrLiq (corresponding to 8 mg and 16 mg of bioactive furanodienes, resp.) for 20 days, and the placebo group was given the same number of capsules with no MyrLiq. A score was recorded for all volunteers based on their previous experience with prescribed analgesics. For the male volunteers, pain alleviation was obtained with 400 mg of MyrLiq/day for almost all pathologies, whereas, for female volunteers, alleviation of lower back pain and fever-dependent pain was observed with only 200 mg of MyrLiq/day. These results indicate that MyrLiq has significant analgesic properties.

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  28. JP Says:

    Updated 07/02/17:

    Eur J Pharmacol. 2017 Jun 27.

    Methylsulfonylmethane is effective against gastric mucosal injury.

    Methylsulfonylmethane (MSM) is a natural organosulfur compound has been widely used as a dietary supplement. MSM has protective effects against various disorders through its anti-inflammatory and antioxidant properties however the effect of MSM on gastric mucosal injury remains unclear. The aim of the present study is to determine whether MSM has beneficial effects on ethanol/HCl-induced gastric ulcer in mice. Macroscopic and histopathological evaluation of gastric mucosa revealed that ethanol/HCl administration produced apparent mucosal injuries, while pretreatment with MSM (200 and 400mg/kg, orally) could effectively protect gastric mucosa against the injuries caused by acidified ethanol. MSM significantly increased the levels of glutathione (GSH), catalase (CAT) and prostaglandin E2 (PGE2), and decreased the levels of malondialdehyde (MDA), myeloperoxidase (MPO), carbonyl protein, and nitric oxide (NO) in gastric tissues compared with those in the ethanol group. MSM suppressed gastric inflammation by reducing the levels of proinflammatory cytokines tumor necrosis factor (TNF)-α, interleukin (IL)-1β, IL-6, monocyte chemoattractant protein (MCP)-1 and matrix metalloproteinase (MMP)-9. Moreover, pretreatment of mice with MSM decreased the expression of nuclear factor kappa B (NF-κB) as a key regulator of inflammation in gastric mucosa. Taken together, these data suggest that MSM is able to decrease the severity of ethanol/HCl-induced gastric mucosal injury through inhibition of oxidative stress and inflammation.

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  29. JP Says:

    Updated 1/1/18:

    J Back Musculoskelet Rehabil. 2016 Nov 21;29(4):661-671.

    The effectiveness of transcutaneous electrical nerve stimulation in the management of patients with complex regional pain syndrome: A randomized, double-blinded, placebo-controlled prospective study.

    OBJECTIVE: To investigate the effect of transcutaneous electrical nerve stimulation (TENS) on clinical recovery in the management of patients with complex regional pain syndrome Type I (CRPS Type I).

    MATERIAL AND METHOD: The study included 30 patients with stage 1 and 2 CRPS Type I in the upper extremities. The patients were randomly assigned into 2 groups, group 1 (n= 15) received conventional TENS therapy for 20 minutes, and group 2 (n= 15) received sham TENS therapy. The standard physical therapy program, which included contrast bath for 20 minutes; whirlpool bath for 15 minutes; assisted active and passive range of motion, and static stretching exercises up to the pain threshold, was also conducted in both groups. Therapy was scheduled for 15 sessions. A visual analogue scale (VAS) was used to assess spontaneous pain. The Leeds Assessment of Neuropathic Signs and Symptoms (LANSS) scale and the Douleur Neuropathique en 4 Questions (DN-4) were used to assess neuropathic pain. In addition, range of motion (ROM) was measured using a goniometer and volumetric measurements were taken to assess edema. Functional capacity was assessed using a hand dynamometer and the Duruöz Hand Index (DHI). All measurements were performed at baseline and after therapy.

    RESULTS: Significant improvements were achieved in spontaneous and neuropathic pain scores, edema, ROM, and functional capacity in both groups (p< 0.05). However, improvement was found to be significantly greater in group 1 regarding pain intensity, neuropathic pain assessed using LANNS, edema, and in the 2nd-3rd finger ROM measurements (p< 0.05). No significant difference was detected between groups regarding improvements in 4th-5th finger and wrist ROM measurements, grip strength, and DN4 and DHI scores (p> 0.05).

    CONCLUSION: The addition of TENS to the physical therapy program was seen to make a significant contribution to clinical recovery in CRPS Type 1.

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  30. JP Says:

    Updated 1/9/18:

    Ann Palliat Med. 2017 Dec 12.

    The role of clinical hypnosis and self-hypnosis to relief pain and anxiety in severe chronic diseases in palliative care: a 2-year long- term follow-up of treatment in a nonrandomized clinical trial.

    BACKGROUND: Patients with severe chronic diseases and advanced cancer receiving palliative care, have a complex range of pain and anxiety that can arise early in the course of illness. We studied two groups of patients with severe chronic diseases who participated in a nonrandomized clinical trial of early integration of clinical hypnosis in palliative care versus standard pharmacological care. The purpose of this investigation was to evaluate whether a long-term intervention of 2 years with clinical hypnosis and self-hypnosis as an adjuvant therapy in chronic pain and anxiety, is more effective than pharmacological therapy alone.

    METHODS: The study was performed at the Center of Anesthesiology, Intensive Care and Pain Therapy at the University of Verona, Italy. The study population consisted of 50 patients, 25 in the hypnosis group and 25 in the control group. Fourteen men and 36 women participated in the study. Evaluations with Visual Analog Scale (VAS) for pain and Hamilton Anxiety Rating Scale (HAM-A) for anxiety and the evaluation of the use of opioids and analgesic medicines were conducted at baseline and for a long-term follow-up (after 1 and 2 years).

    RESULTS: The two groups were homogeneous in the distribution of sex, age, type and subtypes of diseases and use of opioids and analgesic medicines at baseline. The patients suffered from 3 main types of severe chronic diseases: rheumatic (n=21), neurologic (n=16) and oncologic (n=13). The VAS score at baseline was similar in both the hypnosis group and control group (mean ± standard deviation, SD: 78±16 and 77±14, respectively). The average VAS value for the hypnosis group decreased from 81.9±14.6 at baseline to 45.9±13.8 at 1-year follow-up, to 38.9±12.4 at 2-year follow-up. The average VAS value for the control group decreased from 78.5±14.8 at baseline, to 62.1±15.4 at 1-year follow-up, to 57.1±15.9 at 2-year follow-up. The variance analysis indicated that the decrease in perceived pain was more significant in the hypnosis group patients than in the control group, after 1- and 2-year follow-up (P=0.0001). The average HAM-A Hamilton anxiety score decreased from 32.6 at baseline to 22.9 and 17.1 respectively at 1-year and 2-year follow-up for the hypnosis group, but it remained almost the same in the control group (29.8, 26.1 and 28.5 at baseline, first and second year respectively). ANOVA showed that the difference between the two groups was statistically significant (P<0.0001). Univariate analysis showed a 4-times greater risk of increasing analgesic medicines and opioids in the control group (adj.IRR: 4.36; 95% CI: 1.59-12.0) after 2-year follow-up.

    CONCLUSIONS: The patient group receiving hypnosis as an adjuvant therapy showed a statistically significant decrease in pain and anxiety and a significantly lower risk of increasing pharmacological pain treatment in a long term follow-up after 1 and 2 years compared to the control group. Clinical hypnosis can be considered an effective adjuvant therapy for pain and anxiety control in cancer as well as in severe chronic diseases for patients receiving palliative care.

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  31. JP Says:

    Updated 1/11/18:

    Evid Based Complement Alternat Med. 2017;2017:2378973.

    Foot Reflexotherapy Induces Analgesia in Elderly Individuals with Low Back Pain: A Randomized, Double-Blind, Controlled Pilot Study.

    Introduction: This study evaluated the effects of foot reflexotherapy on pain and postural balance in elderly individuals with low back pain.

    Design: Randomized, controlled pilot study. Participants (n = 20) were randomly assigned to 2 groups: individuals submitted to conventional foot massage (control group) or foot reflexotherapy (RT, intervention group) for a period of 5 weeks. Questionnaires on pain and disability (visual analogue scale [VAS] and Roland-Morris Disability Questionnaire [RMDQ]), heart rate variability, and orthostatic balance and baropodometric analysis were assessed at two intervals: before and after intervention.

    Results: RT group showed statistically significant differences when compared to control group in the following parameters: decrease in VAS scores for pain throughout the study, decrease in parasympathetic activity, and improvement in RMDQ scores. The two groups did not statistically differ in either orthostatic balance or baropodometric analyses.

    Conclusion: This study demonstrated that foot reflexotherapy induced analgesia but did not affect postural balance in elderly individuals with low back pain.

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  32. JP Says:

    Updated 1/23/18:

    J Med Food. 2018 Jan 22.

    Effect of Alpha-Lipoic Acid on Clinical and Neurophysiologic Recovery of Carpal Tunnel Syndrome: A Double-Blind, Randomized Clinical Trial.

    The objective of our study was to examine the effect of alpha-lipoic acid (ALA) on clinical and neurophysiologic outcomes after surgery for idiopathic carpal tunnel syndrome (CTS). We conducted a randomized, double-blind, placebo-controlled clinical trial in 20 adults diagnosed with idiopathic CTS after clinical and neurophysiologic assessment. Eligible participants took 600 mg ALA or placebo per day for 1 month before surgery, and for 2 months afterward. Further clinical and neurophysiologic assessments were undertaken immediately before surgical decompression, and at 12 weeks postoperatively with additional clinical assessments at the 4th and 8th week after surgery. Clinical outcome measures were taken by Boston Questionnaire score, the presence or absence of Tinel’s sign, and Phalen’s test findings. Median nerve conduction studies were also undertaken and interpreted according to Dumitru’s reference values. Nineteen patients completed the study; one member of the placebo group was lost during follow-up. There were significant improvements in clinical and neurophysiologic variables in the ALA treatment group, present even before surgery. Boston Questionnaire scores had improved significantly in both groups. In the ALA group, none of the participants had positive Phalen’s or Tinel’s signs at 12 weeks, and motor and sensory fiber latency and amplitude had significantly improved; in the placebo group, only the sensory distal latency had improved significantly. In conclusion, ALA administered 1 month before open decompression and for 2 months afterward improves the clinical and neurophysiologic outcomes after surgery.

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  33. JP Says:

    Updated 03/16/18:

    Pain Manag Nurs. 2018 Mar 5.

    The Effect of Aromatherapy Massage on Knee Pain and Functional Status in Participants with Osteoarthritis.

    This study was conducted to evaluate the effect of aromatherapy massage on knee pain and functional status in subjects with osteoarthritis. The study was designed as a non-randomized interventional study. The study was carried out on patients who referred to the outpatient clinics of the Department of Orthopedics, Physiotherapy and Rehabilitation at Bozok University Research and Application Hospital, and were diagnosed with osteoarthritis. A total number of 95 patients were included in the study, and of those, 33 were allocated to aromatherapy massage group, 30 were allocated to conventional massage group, and 32 were allocated to the control group. The study data were collected using the Patient Identification Form, visual analogue scale, the Western Ontario and McMaster University Osteoarthritis Index. Repeated measures analysis of variance test was used to analyze the outcomes in the aromatherapy, conventional massage and control groups, according to the weeks of follow-up. Bonferroni test was used for further analysis. Baseline mean visual analogue scale score and the Western Ontario and McMaster University Osteoarthritis Index were not significantly different between the groups (p > .05). Visual analogue scale (rest-activity) scores and the scores in the Western Ontario and McMaster University Osteoarthritis Index in the aromatherapy massage group were lower, and the difference compared to the control group was statistically significant (p < .001). Aromatherapy massage performed in patients with osteoarthritis reduced knee pain scores, decreased morning stiffness, and improved physical functioning status. Thus, as long as specific training is provided for aromatherapy massage, aromatherapy can be recommended for routine use in physical therapy units, hospitals and homes.

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