This blog is a summary of a presentation I recently gave to a group of physiotherapists which got me thinking about the people I see in my clinic every day.
In my naturopathic clinic, inflammation and associated pain are very common symptoms. Often pain isn’t the reason someone has come to see me but, in taking a “functional medicine” approach to understanding what is going on in every aspect of my clients’ health, pain will often come up in some way or other. It might be sore joints, aching muscles, sore lower back, stomach pain, period pain, heartburn, headaches or some other form of pain. It might be constant or perhaps it comes and goes. It may not be your number one issue but I estimate that at least ½ of my clients have pain lurking as part of their overall health picture.
Sometimes they have a diagnosis such as osteoarthritis, rheumatoid arthritis, fibromyalgia or some other condition where pain could be part of their symptoms. However, often it’s not that clear cut.
The goal of functional medicine is to treat the root cause
From a naturopathic perspective I would see pain as a symptom of something else, quite possibly inflammation, and therefore I would be looking for the cause or drivers of that inflammation. Our goal is to do more than provide symptomatic relief through the use of pain-killers. What we want to do is find out what is causing the pain in the first place and see if we can address that once and for all.
Sometimes, the cause is obvious…a strained muscle, a sprained ankle, a headache due to dehydration. These types of pain will usually resolve readily, perhaps with the aid of some manual therapy such as physio or massage and some appropriate rest.
However, in more long-term cases, it can be helpful to consider whether there is something else going on.
Possible causes/exacerbators of pain and inflammation
Some of the more common causes or exacerbators of inflammation and pain include:
- carrying additional weight – not only does extra weight put more pressure on joints but fat cells also produce chemicals which are inflammatory, contributing to systemic inflammation
- poor sleep, fatigue and/or ongoing stress – these all become part of the picture of what is happening with your cortisol production (your natural anti-inflammatory). They also play into hormonal dysfunction and your perception of pain (e.g. Lack of sleep might make your pain feel worse)
- poor nutrition – your diet may be lacking in key nutrients such as magnesium or essential fatty acids or it could be weighted towards foods which are more likely to trigger inflammation
- gut dysfunction leading to poor digestion– which means that even if you are eating foods that are good for you, if you aren’t digesting them well, you may be absorbing molecules of food that you aren’t meant to, setting off an inflammatory response by the immune system
- eating foods to which you have an intolerance (possibly undiagnosed)
- certain pharmaceutical medications (especially NSAIDS, antibiotics and proton-pump inhibitors) can set you up for systemic inflammation due to the effect they have on your digestion, gut microbiome and the lining of your digestive tract
- toxins such as alcohol, smoking and all the chemicals we are exposed to these days also take their toll on our digestion and detoxification systems potentially leading to activation of your immune system (which generally includes increased inflammation)
- sedentary lifestyle or other lifestyle factors (e.g. an uncomfortable bed) can affect our posture and structural alignment leading to pressure in the wrong spot or poor circulation and sluggish lymphatic systems (which are responsible for removing our waste products from our bloodstream)
- low vitamin D – an immune regulator and pain modulator
- diagnosed or undiagnosed inflammatory diseases such as irritable bowel disease, rheumatoid arthritis, coeliac disease or other auto-immune condition
- infections or viruses – either frequently getting ill or perhaps just a sense there is a low-grade lingering virus
- depression – there is a great deal of evidence linking depression to inflammation
Naturopathic treatment approaches to pain and inflammation
Once we have done a full naturopathic assessment of your health, including symptom, diet and lifestyle assessment and comprehensive pathology testing, and assuming we have ruled out or addressed any specific diseases which could be part of your inflammatory picture we would look at the following diet and lifestyle recommendations.
- reduce the inflammatory foods in your diet. This will often start with processed foods, sugar, refined carbohydrates, caffeine, alcohol, fast food (and smoking)
- we also want to increase the anti-inflammatory foods (think fruit and vegetables, oily fish, good quality olive oil for starters)
- based on your symptom picture and possible testing we may need to look at eliminating certain trigger foods (common ones include wheat, dairy, potato, eggplant, tomato, capsicum)
- improve digestion, heal your gut mucosa and restore the healthy gut microbiota
- implement an appropriate weight loss or detoxification plan
- improve sleep through good sleep routine, sleep herbs and nutrients
- implement an appropriate exercise/activity plan to encourage the body’s own production of endorphins (the natural pain killer)
- address stress and introduce relaxation to help balance the nervous system…enjoyable activities, gentle exercise such as yoga, music, laughter are all great for this as are meditation and breathing exercises
- look at the big picture….is your pain a reflection of something that needs to change in your life….eg your job or relationship
- nutritional supplements when indicated and lacking in diet – this might include vitamin C, zinc and amino acids for tissue repair, essential fatty acids, vitamin D or magnesium
- Herbal supplements when indicated and not contra-indicated with pharmaceutical medicines can be very helpful to reduce inflammation and heal tissue
- Physiotherapy, massage, acupuncture and even counselling can be helpful too