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WMMII-Lesson11 Western Materia Medica Pain By Terry Willard ClH, PhD Botanicals Pain Pain is transmitted to the brain from sensory nerves. Substances that decrease pain either interfere with the ability of nerves to conduct messages, or alter the brain’s capacity to receive sensations. Pain may be a symptom of an underlying pathological condition, such as inflammation. It may also be due to other causes, such as bruising, infection, burns, headaches, or sprains and strains. Use caution when treating pain without understanding its cause—this may delay diagnosis of conditions that could continue to worsen without medical attention. Checklist for Pain D-phenylalanine (DPA), Vitamin B12, American scullcap, Arnica, Cannabis, Cayenne (capsaicin; topical use only), Corydalis, Cramp bark, Feverfew, Passion flower, Phyllanthus, Piscidia erythrina, St. John’s wort, Valerian, Willow. Symptoms of pain include discomfort that is often worsened by movement or pressure and may be associated with irritability, problems sleeping, and fatigue. People with pain may have uncomfortable sensations described as burning, sharp, stabbing, aching, throbbing, tingling, shooting, dull, heavy, and tight. Lifestyle changes that may be helpful: Body weight may be related to pain tolerance. One study indicated women who are more than 30% above the ideal weight for their age experience pain more quickly and more intensely than do women of ideal weight.1 No research has been found that investigated the effect of weight loss on pain tolerance. Exercise increases pain tolerance in some situations, in part because exercise may raise levels of naturally occurring painkillers (endorphins and enkephalins).2,3,4 Many types of chronic pain are helped by exercise, though some types of physical activity may aggravate certain painful conditions. People who want to initiate an exercise program for increasing pain tolerance should first consult a qualified health professional.5,6,7,8 ©2011 Wild Rose College of Natural Healing 1 All Rights Reserved. Western Materia Medica Pain By Terry Willard ClH, PhD Botanicals Nutritional supplements may be helpful: Certain amino acids have been found to raise pain thresholds and increase tolerance to pain. One of these, a synthetic amino acid called D-phenylalanine (DPA), decreases pain by blocking the enzymes that break down endorphins and enkephalins, the body’s natural pain-killing chemicals. DPA may also produce pain relief by other mechanisms which are not well understood.9,10,11 D-phenylalanine (DPA) Other amino acids may be beneficial in reducing pain. In the central nervous system, L-tryptophan serves as a precursor to serotonin. Serotonin participates in the regulation of mood and may alter responses to pain. In a preliminary trial, 2,750 mg per day of L-tryptophan decreased pain sensitivity. Another preliminary trial found that L-tryptophan (500 mg every four hours) taken the day before a dental procedure significantly decreased the postoperative pain experienced by patients. In another preliminary trial 3 grams of L-tryptophan taken daily for four weeks significantly decreased pain in a group of people with chronic jaw pain. No research has been published investigating the pain control potential of 5- hydroxytryptophan (5-HTP), another serotonin precursor, that, unlike L-tryptophan, is currently available without a prescription.12,13 L-tryptophan Vitamin B12 has exhibited pain-killing properties in animal studies. In humans with vertebral pain syndromes, injections of massive amounts of vitamin B12 (5,000 to 10,000 mcg per day) have reportedly provided pain relief. Further studies are needed to confirm the efficacy of this treatment.14,15 ©2011 Wild Rose College of Natural Healing 2 All Rights Reserved. Western Materia Medica Pain By Terry Willard ClH, PhD Botanicals Herbs that are helpful: Capsaicin is an extract of cayenne pepper that may ease many types of chronic pain when applied regularly to the skin. In animal studies, capsaicin was consistently effective at reducing pain when given orally, by injection, or when applied topically. 16,17 A controlled trial in humans found that application of a solution of capsaicin (0.075%) decreased skin sensitivity to all noxious stimuli.18 In several uncontrolled and at least five controlled clinical trials, capsaicin has been consistently shown to decrease the pain of many disorders, including trigeminal neuralgia, shingles, diabetic neuropathy, osteoarthritis, and cluster headaches.19,20,21,22,23 For treatment of chronic pain, capsaicin ointment or cream (standardized to 0.025 to 0.075% capsaicin) is typically applied to the painful area four times per day.24 It is common to experience stinging and burning at the site of application, especially for the first week of treatment; avoid getting it in the eyes, mouth, or open sores. Chinese researchers also note that 75 mg per day of THP (an alkaloid from the plant corydalis) was effective in reducing nerve pain in 78% of those tested.25 Relaxation exercises may decrease the perception of pain. Pain increases as anxiety increases; using methods to decrease anxiety may help reduce pain. In one controlled hospital study, people who were taught mind-body relaxation techniques reported less pain, less difficulty sleeping, and fewer symptoms of depression or anxiety than did people who were not taught the techniques.26,27 Acupuncture has been shown to decrease pain by acting on the enkephalin-based, pain-killing pathways. In 1997, the National Institutes of Health (NIH) stated that acupuncture is useful for muscular, skeletal, and generalized pain, as well as for anesthesia and post- operative pain. The NIH statement was based on a critical review of over 67 controlled trials of acupuncture for pain control.28 ©2011 Wild Rose College of Natural Healing 3 All Rights Reserved. Western Materia Medica Pain By Terry Willard ClH, PhD Botanicals Hypnosis has been shown to significantly reduce pain associated with office surgical procedures that are performed while the patient is conscious (i.e., without general anesthesia).29 In one study people, who were undergoing office surgical procedures, received standard care, structured attention or self-hypnotic relaxation. Those using self-hypnosis had no increases in pain during the procedures, compared to those in the other groups. Hypnosis also appeared to stabilize bleeding, decrease the requirement for narcotic pain drugs during the procedure, and shorten procedure time. References: 1..Pradalier A, Willer JC, Dry J. Pain sensitivity in obese individuals. Ann Med Interne (Paris) 1982;133:528–31. 2..Guieu R, Blin O, Pouget J, Serratrice G. Nociceptive threshold and physical activity. Can J Neurol Sci 1992;19:69–71. 3..Fordyce W, McMahon R, Rainwater G, et al. Pain complaint—exercise performance relationship in chronic pain. Pain 1981;10:311–21. 4..Schwarz L, Kindermann W. Changes in beta-endorphin levels in response to aerobic and anaerobic exercise. Sports Med 1992;13:25–36 [review] 5..Ferrell BA, Josephson KR, Pollan AM, et al. A randomized trial of walking versus physical methods for chronic pain management. Aging (Milano) 1997;9:99–105. 6..McCain GA. Nonmedicinal treatments in primary fibromyalgia. Rheum Dis Clin North Am 1989;15:73– 90 7..Kottke TE, Caspersen CJ, Hill CS. Exercise in the management and rehabilitation of selected chronic diseases. Prev Med 1984;13:47–65 [review] 8..Cowan P, Lovasik DA. American Chronic Pain Association: strategies for surviving chronic pain. Orthop Nurs 1990;9:47–9 [review] 9..Ehrenpreis S. Analgesic properties of enkephalinase inhibitors: animal and human studies. Prog Clin Biol Res 1985;192:363–70. 10..Guisti P, Carrara M, Cima L, Borin G. Antinociceptive effect of some carboxypeptidase A inhibitors in comparison with D-phenylalanine. Eur J Pharmacol 1985;116:287–92 11.. Walsh NE, Ramamurthy S, Schoenfeld LS, Hoffman J. D-phenylalanine was not found to exhibit opiod receptor mediated analgesia in monkeys. Pain 1986;26:409–10. 12..Shpeen SE, Morse DR, Furst ML. The effect of tryptophan on post-operative endodontic pain. Oral Surg Oral Med Oral Pathol 1984;58: 446–9. 13..Seltzer S, Dewart D, Pollack RL, Jackson E. The effects of dietary tryptophan on chronic maxillofacial pain and experimental pain tolerance. J Psychiatr Res 1982–83;17(2):185–6. 14..Hanck A, Weiser H. Analgesic and anti-inflammatory properties of vitamins. Int J Vitam Nutr Res Suppl 1985;27:189–206. 15..Hieber H. Treatment of vertebragenous pain and sensitivity disorders using high doses of hydroxocobalamin. Med Monatsschr 1974;28:545–8 16..Santos AR, Calixto JB. Ruthenium red and capsazepine antinociceptive effect in formalin and capsaicin models of pain in mice. Neurosci Lett. 1997;235:73–6. ©2011 Wild Rose College of Natural Healing 4 All Rights Reserved. Western Materia Medica Pain By Terry Willard ClH, PhD Botanicals 17..Otsuki T, Nakahama H, Niizuma H, Suzuki J. Evaluation of the analgesic effects of capsaicin using a new rat model for tonic pain. Brain Res 1986;365:235–40. 18..Nolano M, Simone DA, Wendelschafer-Crabb G, et al. Topical capsaicin in humans: parallel loss of epidermal nerve fibers and pain sensation. Pain 1999;81:135–45. 19..Hautkappe M, Roizen MF, Toledano A, et al. Review of the effectiveness of capsaicin for painful cutaneous disorders and neural dysfunction. Clin J Pain 1998;14:97–106 [review] 20..Fusco BM, Giacovazzo M. Peppers and pain. The promise of capsaicin. Drugs 1997;53:909–14 [review]. 21..Robbins WR, Staats PS, Levine J, et al. Treatment of intractable pain with topical large-dose capsaicin: preliminary report. Anesth Analg 1998;86:579–83 22..Zhang WY, Li Wan Po A. The effectiveness of topically applied capsaicin. A meta-analysis. Eur J Clin Pharmacol 1994;46:517–22 [review] 23..Ellison N, Loprinzi CL, Kugler J, et al. Phase III placebo-controlled trial of capsaicin cream in the management of surgical neuropathic pain in cancer patients.
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