Supplements for Pain Management

Of course "pain" is a broad term and can be applied to a number of different condition both Chronic and Acute. These supplements, in my opinion, are versatile, generally safe, and easy to find.

​Omega 3 Fatty Acids

Omega 3 Fatty Acids are used in the body to reduce inflammation. Omega 6 is used in the body to create an inflammatory reaction, which is one of the body's first responses to injury. Inflammation increases the flow of white blood cells to the area to start the healing process. Too Much inflammation, though, can cause disease. These white blood cells, with out damaged tissue to remove, begin attacking the body in an autoimmune reaction. In today's diet, there is an abundance of Omega 6's, but few Omega 3's. Because of this imbalance, the body has a tendency to inflammation without a balance of anti-inflammation, causing disease. There is evidence that supports the use of Omega 3's to reduce inflammation in cases of Rheumatoid Arthritis, as well as other causes of joint inflammation. Of the Omega 3 Components, EPA has been found to be more effective than DHA or ALA for the reduction of inflammation. ALA is the form of Omega 3 found in Vegetarian sources, and this must be converted to EPA and DHA in the body via proper digestion. Several Enzymes and proper gut flora are needed to break down the ALA form. By taking an EPA specific supplement, patients can get a more concentrated anti-inflammatory response.

I recommend Omega 3 fatty acids for anyone dealing with chronic inflammation causing pain. This is a long term dietary supplement that is used to reduce inflammation over time.

For more information on dietary fats, please click here.

​Meriva Curcumin

Turmeric contains a polyphenol called Curcumin. Curcumin is know for it's limited side effects, and drug interactions. Clients do need to be aware that it does have a low bioavailability and healthy gut flora is necessary to metabolize and assimilate into the blood stream. That being said, a very bioavailable form is available. It is trademarked Meriva. Meriva is Curcumin bound to phosphatidylcholine which is very easily absorbed into the blood stream. this bond allows more Curcumin to enter the blood stream.  Some research shows Curcumins effectiveness to be that of NSAIDS. One study found a phasing out of long term NSAID use.

I recommend Curcumin for those who need Acute pain relief, as well as long term management for pain. For the most part, Curcumin has little to no side effects or drug interactions with the exception of the drugs used in chemotherapy.

For more information on Meriva, and it's effectiveness, please click here.

Magnesium

Magnesium is needed in every cell in our body. It's importance is often overlooked, but more and more research is connecting deficiencies in Magnesium to chronic health conditions. It's main benefits can be seen in conditions such as migraines, headache, muscle cramps, athletics recovery, and nerve pain. Magnesium works as a natural muscle relaxant and anti-inflammatory.

There are several different forms of Magnesium.

Magnesium oxide is often seen for very cheap, but is not easily absorbed. This form is the common form found in Milk of Magnesia. Because it is not effectively absorbed into the blood stream, it works well for digestive upset and constipation. 

Magnesium Citrate is not as effective in reducing inflammation and pain, it is used primarily for constipation, and digestive upset. Magnesium Citramate is Magnesium Citrate bound Citrate-Malate to improve digestibility. It is useful for muscle aches, and muscle recovery.

Magnesium Sulfate (form found in Epsom salts), is easily absorbed through the skin directly into the muscles. You can now purchase this in a gel or spray, for those who cannot take Epsom salt baths. They are also beginning to add Magnesium sulfate to drugs such as Lidocane and steroid injections, or post-operative to make pain medication more effective. Some research connects Magnesium deficiency with Migraines.

Newer blood testing is linking Magnesium not Vitamin D to chronic pain sensory. Vitamin D should never to taken alone. Magnesium and Vitamin K are essential to the absorption and uptake of Vitamin D. Without proper levels of Magnesium, Vitamin D can cause musculoskeletal problems.

I recommend additional Magnesium to almost everyone. The majority of people I see have some level of Magnesium deficiency, but especially for those suffering from muscle contraction or twitching conditions that are causing pain. I prefer to give patients topical or enzyme bound forms of magnesium to help with absorption. It is estimated that 50% of the Magnesium we consume is lost in the digestive process, even more for less absorbable forms.

​Hyaluronic Acid

Hyaluronic Acid is a natural lubricant of our spine and joints. As we age we natural produce less and must consume it in our diet. It is naturally found in our skin and synovial fluid. This supplement is very important for those suffering from osteoarthritis, or other joint/cartilage issues. This supplement should be used in conjunction with other anti-inflammatory and pain management supplements as it aids in lubricating joints that may have diminishing to treat the underlying cause of the pain, but does not treat the inflammation and pain directly. Hyaluronic Acid is often taken with Glucosamine and Chondroitin.

I recommend Hyaluronic Acid for those suffering from degenerative joint conditions such as Degenerative Disc Disease, Knee and Shoulder Cartilage Loss, and Hip Joint Pain, or those recovery from joint surgery. Like Omega 3 fatty acids, hyaluronic acid may interfere with blood thinners.

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1. Omega 3 fatty acids in Rheumatoid Arthritis - Overview

2. Eicosapentaenoic acid and docosapentaenoic acid monoglycerides are more potent than docosahexaenoic acid monoglyceride to resolve inflammation in a rheumatoid arthritis model.

3. An Update on the Role of omega 3 fatty acids on inflammatory and degenerative diseases

4. Effect of Different Omega-6/Omega-3 Polyunsaturated Fatty Acid Ratios on the Formation of Monohydroxylated Fatty Acids in THP-1 Derived Macrophages

5. Intrathecal curcumin attenuates pain hypersensitivity and decreases spinal neuroinflammation in rat model of monoarthritis.

6. Meriva®+Glucosamine versus Condroitin+Glucosamine in patients with knee osteoarthritis: an observational study.

7. Comparative evaluation of the pain-relieving properties of a lecithinized formulation of curcumin (Meriva(®)), nimesulide, and acetaminophen.

8. Efficacy and safety of Meriva®, a curcumin-phosphatidylcholine complex, during extended administration in osteoarthritis patients.

9. The antinociceptive effects of magnesium sulfate and MK-801 in visceral inflammatory pain model: The role of NO/cGMP/K+ATP pathway.

10. Effects of combining methylprednisolone with magnesium sulfate on neuropathic pain and functional recovery following spinal cord injury in male rats.

11. The effect of magnesium sulfate on motor and sensory axillary plexus blockade

12. Effects of acetaminophen and ibuprofen in children with migraine receiving preventive treatment with magnesium.

13. Blood Magnesium levels in migraineurs within and between the headache attacks: a case control study.

14. The association between serum 25-hydroxyvitamin D3 concentration and risk of disease death in men: modification by magnesium intake.

15. Synergistic Effects of SDF-1α and BMP-2 Delivery from Proteolytically Degradable Hyaluronic Acid Hydrogels for Bone Repair.

16. Hyaluronic acid in knee osteoarthritis: preliminary results using a four months administration schedule.

17. Efficacy and safety of cross-linked hyaluronic acid single injection on osteoarthritis of the knee: a post-marketing Phase IV study.