The Link Between Pain and Inflammation: Biochemistry of Pain Management
Dr. Jacob Teitelbaum
What you need to know
Chronic pain affects over 20% of the adult population. Unfortunately, most doctors have virtually no education in treating pain, offering only a few toxic drugs. This positions the acupuncture community at the forefront of combating this epidemic.
Inflammation is a healthy response to promote healing. However, when out of balance and when the immune system becomes too pro-inflammatory, it causes tissue damage and chronic pain. Balancing inflammation with a mix of curcumin and boswellia is a simple and effective way to get started.
Low energy level in cells = Muscle contraction and pain
This is a critical concept. When muscles don’t have enough energy, they get stuck in a shortened position. Although it may seem counterintuitive, we think of the feeling your muscles get after an intense workout, when the energy is depleted – they are not relaxed, but tense.
Anything that chronically depletes muscle energy causes muscle contraction and pain, either localized, as in cases of trauma, ergonomic problems, or systemic, such as fibromyalgia, due to widespread cellular energy depletion.
SHINE approach to increase muscle energy and reduce pain
Our published research using fibromyalgia as a pain model has shown that this condition can be effectively treated using the SHINE protocol. The research also indicates that long-COVID is a form of post-viral chronic fatigue syndrome and fibromyalgia.
In the study, 91% of patients improved, with an average 90% increase in quality of life. Many people’s pain decreased dramatically to the point where they no longer met the diagnostic criteria for fibromyalgia.
The SHINE protocol includes:
- Sleep
- Hormone support
- Inflammation / Infections
- Nutrition
- Exercise and structural mobilization where possible
Inflammation and pain
Inflammation triggers pain through several mechanisms. The most important are:
- Acute and sub-acute pain (first six weeks of pain): Inflammation fights infection and injury and promotes healing, including by releasing immune and inflammatory molecules (e.g. TNF, interleukins) and stimulating nerves, which increase nociceptive receptors, making the area more sensitive to pain.
- Chronic pain: This type of pain is usually self-sustaining and counterproductive. When the inflammation and pain systems are out of balance, it leads to microglia activation, secondary central sensitization and “brain pain.”
Decreased local tissue energy (for the reasons mentioned above) also contributes. This is why, even in the presence of acutely inflamed joints or tissues, inflammation can trigger contraction and secondary muscle pain, significantly amplifying the pain caused by swelling and compression of the affected tissue.
Why is this a problem?
Inflammation is a healthy response that promotes healing. But when it gets out of balance, like when the immune system becomes too pro-inflammatory, it causes increased tissue damage and chronic pain.
The Western diet dramatically amplifies inflammation due to excess sugar, white flour and low omega-3 intake.
The standard medical approach is to take non-steroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, which help, but cause 50,000 excess deaths annually in the US. Safer alternatives are therefore recommended that can complement or, over time, replace the drugs.
Balancing inflammation to relieve pain
Fortunately, this is easy to do:
- Adopt simple dietary measures: cut down on sugar (especially carbonated drinks and fruit juices), swap white flour for wholegrains and eat grass-fed beef.
- Decreased cyclooxygenase (COX) enzyme: This is the target of NSAID drugs, but can be balanced naturally by using curcumin. A very highly absorbed curcumin in combination with turmeric oil is required.
- Lowering lipoxygenase enzyme (LOX): Boswellia, also known as frankincense, is the main herb for reducing LOX, especially when intestinal or lung inflammation is present, but it is also useful for other types of inflammation.
- Using nattokinase to break down excess inflammatory debris and DLPA (DL phenylalanine) to stimulate endorphin production.
Fortunately, all of the four natural compounds mentioned above are found together, which makes this approach simpler for practitioners and patients.
I find that when peripheral inflammatory factors and other pain triggers are treated, much of the central microglial activation or “brain pain” also begins to subside. But if it doesn’t, it can be combated by multiple treatments, including palmitoyltranolamide (PEA).
Thus the biochemical approach to pain management can significantly amplify the effectiveness of acupuncture. Balancing inflammation with a mix of curcumin and boswellia is a simple and effective way to start.
