Options Exist for Treating Chronic Pain
By: Dustin Moffitt, ND
Chronic pain can be a significant issue for individuals and can reduce quality of life. A study published in 2021 by the International Association for the Study of Pain cited chronic pain as one of the most common chronic conditions in the United States, with approximately 20% of American adults, or more than 50 million people, who reported feeling pain on most days or every day. [1]
What is Chronic Pain?
Many different kinds of pain can fall under the definition of chronic pain. I generally define chronic pain as pain that doesn’t go away and is persistent for three months or longer. Pain can be dramatic enough to affect daily activities and work, or it can be the kind of pain people ignore and live with. It is the latter kind of pain that is not paid attention to often enough. Pain calls attention to something that is out of balance or in disrepair.
Other common causes of chronic pain include overuse, injuries, and arthritis. At the Riordan Clinic, I see a lot of low back and knee pain, which is often caused by jumping, lifting items that are too heavy, and age-related causes. For example, farmers can experience pain as a result of using older equipment, lifting, and working with animals. Other conditions such as cancer and chronic infections – i.e., Lyme disease and tension migraines – can also contribute to chronic pain.
Another cause of chronic pain that can often be overlooked is hormonal imbalance or decline. With men, I have found that adjusting their testosterone levels can often ease the pain. However, women are less straightforward, with an imbalance of estrogen, progesterone, or testosterone – or some combination – having an impact on pain.
In treating chronic pain, I check in with my patients at each visit. Pain is subjective, and the best way I find to measure it is to view it from the patient’s perspective. I don’t use the Visual Analog Scale (VAS) for pain reporting, which features green, yellow, and red colored drawings of faces expressing different levels of discomfort.
I prefer to use a percentage indicator with the patient expressing at what percent of their functioning the pain is affecting. In addition to rating the pain, I also ask how they determined the rating, what the pain feels like – i.e., is it pressure, sharp, cramping, stiffness, throbbing, or other sensations – and how does the pain move in the body. I ask patients at every visit to best evaluate the progress of their treatments.
Types of Regenerative Therapy Treatments
In traditional medicine, pain is often addressed with pain killers, steroid injections, or surgery, which can have mixed results.
I favor a naturopathic approach with Regenerative Injection Therapies (RIT). A variety of conditions are listed on the Riordan Clinic’s website that may be improved with injection therapies. These include arthritis, back pain, carpal tunnel syndrome, chronic tendonitis, degenerated discs, herniated discs, fibromyalgia, neck pain, scars, sciatic pain, sports injuries, trigger/tender points, unresolved whiplash injuries, and partially torn tendons, ligaments, and cartilage.
RIT is a minimally-invasive injection that stimulates the body’s natural healing process to repair and strengthen chronically impaired ligaments and tendons damaged from overuse or injury. We offer three primary types of Regenerative Injection Therapies at the Riordan Clinic.
Prolotherapy: Also known more broadly as regenerative therapy, this has been used for more than 40 years as an injection technique to stimulate the body’s natural healing response. Proliferant (growth-promoting) and irritant solutions are injected in multiple areas in and around the injured joint or body part to stimulate the body to respond through inflammation. This inflammation brings new blood cells and nutrients to the affected areas. [2]
Prolozone Therapy: This involves the injection of ozonated oxygen into painful areas to stimulate the body’s natural healing response. It is like prolotherapy, but it is less painful and less comprehensive. A prolozone injection contains ozone and nutrients, which are believed to bypass the inflammatory response and directly stimulate a healing response without triggering inflammation. [3]
Platelet-Rich Plasma (PRP): This is a technique where a solution derived from the patient’s own blood sample is injected into an area to stimulate healing and repair. PRP is derived from a normal blood sample spun in a centrifuge. This concentrated plasma contains powerful healing properties and is rich in growth factors. [4]
My recommendation for which therapy is used depends on the patient, the patient’s lifestyle, and the pain itself. If the patient either can’t or won’t slow down during treatment, such as an athlete or a farmer, I frequently recommend PRP, which can yield results more quickly in some cases. Prolotherapy is superior for ligament and tendon pain or for breaking up scar tissue, among other things. In my experience, most patients receiving prolotherapy or prolozone improve after 4 to 6 sessions. PRP usually requires fewer sessions, approximately 2 to 4, although every patient may differ.
At times, surgery is the best option, such as in cases where there is a known tear of more than 80% or a fracture.
I try to meet patients where they are. Not everyone is comfortable with injection therapies. In those cases, I will refer the patient to physical therapy and massage therapy. Class 4 Laser Therapy is also an option, which may improve blood flow in soft tissues. [5] Yoga is another activity I highly recommend to patients, regardless of how they treat pain.
I wish more people realized that corticosteroids and medications aren’t the only ways to treat pain. There are natural ways to help your body do what it does best, heal itself.
Chronic Pain and Mental Health
Chronic pain can cause issues for patients and their families beyond the pain itself. Chronic pain and mental health are often interconnected. The American Psychiatric Association reports that people with chronic pain are at heightened risk for mental health problems, including depression, anxiety, and substance abuse disorders. It estimates that 35% to 45% of people with chronic pain experience depression. [6]
A study by the Mayo Clinic shows that imaging studies suggest a relationship exists between chronic pain and mental health disorders, possibly because pain and mental health disorders may share some neural mechanisms. [7]
Additionally, other studies show some evidence to suggest that depression – like pain – is linked to inflammation. [8]
Other effects of chronic pain can include anger, outbursts, short temper, and forgetfulness. If you see these qualities in a loved one, the individual may be dealing with chronic pain.
You do not have to live with chronic pain. It can be managed, and you have options.
Resources
- Yong RJ, Mullins PM, Bhattacharyya N. Prevalence of chronic pain among adults in the United States. Pain. 2022 Feb 1;163(2):e328-e332. doi: 10.1097/j.pain.0000000000002291. PMID: 33990113.
- Rabago, D., Slattengren, A., & Zgierska, A. (2010). Prolotherapy in primary care practice. Primary care, 37(1), 65–80. https://doi.org/10.1016/j.pop.2009.09.013
- Prolozone™ – regenerating joints and eliminating pain. Journal of Prolotherapy. (2017, September 19). Retrieved October 25, 2022, from https://journalofprolotherapy.com/prolozone-regenerating-joints-and-eliminating-pain/
- Platelet-rich plasma (PRP) injections. Platelet-Rich Plasma (PRP) Injections | Johns Hopkins Medicine. (2022, October 14). Retrieved October 25, 2022, from https://www.hopkinsmedicine.org/health/treatment-tests-and-therapies/plateletrich-plasma-prp-treatment
- Larkin, K. A., Martin, J. S., Zeanah, E. H., True, J. M., Braith, R. W., & Borsa, P. A. (2012). Limb blood flow after class 4 laser therapy. Journal of athletic training, 47(2), 178–183. https://doi.org/10.4085/1062-6050-47.2.178
- Chronic pain and mental health often interconnected. Psychiatry.org – Chronic Pain and Mental Health Often Interconnected. (2020, November 13). Retrieved October 25, 2022, from http://www.psychiatry.org/News-room/APA-Blogs/Chronic-Pain-and-Mental-Health-Interconnected
- Chronic pain and mental health often interconnected. Psychiatry.org – Chronic Pain and Mental Health Often Interconnected. (2020, November 13). Retrieved October 25, 2022, from http://www.psychiatry.org/News-room/APA-Blogs/Chronic-Pain-and-Mental-Health-Interconnected
- Krishnadas R, Cavanagh J. Depression: an inflammatory illness? J Neurol Neurosurg Psychiatry. 2012 May;83(5):495-502. doi: 10.1136/jnnp-2011-301779. Epub 2012 Mar 15. PMID: 22423117.
