The Place to Manage Your Pain

 

NUTRITIONAL SUPPLEMENTS IN THE MANAGEMENT OF PAIN

On a physiological level, nutritional supplements can decrease pain through a variety of mechanisms. They can reduce inflammation and muscle fatigue from overexertion, help support joint function, maintain joint range of motion, protect bone, and stimulate the formation of cartilage . The following is an alphabetical list of key nutritional supplements with analgesic and anti-inflammatory properties.

Bromelaine

Bromelaine, also called Bromelin, is a proteolytic enzyme sulphydryl from the pineapple family Ananas Comosus (Bromelainceae). The pure form of bromelaine, from the stem of the plant, has a high pH of 9.5–10.0, which results in an average pH of 5.0–8.0 when activated. Bromelaine from the fruit of the plant has an acidic pH of 4.0–5.0 .

This enzyme assists in the digestion of protein. It also stimulates the production of prostaglandins, reduces inflammation, and decreases blood platelet aggregation. Because it relaxes skeletal muscle, it can be used to avoid muscle strain and prevent injury, such as in preparation for athletic competition . Due to the high pH, it also can prevent gastric ulcer exacerbation and enhance wound healing. For many people it helps relieve sinus problems, likely due to its anti-inflammatory effect. Because of these anti-inflammatory properties, bromelaine has important roles in pain management :
• Activates proteolytic activity at the site of inflammation
• Reduces kininogen, activates plasmin and reduces kinin
• Inhibits pro-infammatory prostaglandins and induces accumulation of the antiinflammatory prostaglandin E1, which then inhibits the release of polymorphonuclear (PMN) leukocytes and lysosomal enzymes
• Induces fibrinolysis
• Inhibits the mobilization of arachidonic acid, decreasing joint inflammation and atherogenesis factors
Dose: 1,800–2,500 mg orally per day, or 500–1,500 mg in three divided doses between meals.

Clinical applications:

1. Athletic injury; muscle strain
2. Premenstrual syndrome; dysmenorrhea
3. Angina
4. Arthritis
5. Pancreatic insufficiency
6. Cellulitis
7. Sinusitis
8. General edema
9. Thrombophlebitis
Toxicity: No negative side effects have been reported. Long-term use is well
tolerated. In people sensitive to pineapple, bromelaine may cause a temporary allergic reaction, including rash, urticaria, nausea, and diarrhea. There are no reported cases of anaphylaxis.

Cartilage Factors

Many European studies have supported the use of hydrolyzed collagen peptides to support joints and protect cartilage . One of the observed mechanisms of these peptides is the stimulation of the collagen matrix restructuring process . They also maintain healthy enzyme function and aid in nutrient and energy consumption. Bovine cartilage specifically contains enzymes for proteolysis that may build and maintain cartilage in joints.
Dose: Load 5–10 g orally per day for 6 months.

Clinical applications:

1. Decreases joint inflammation
2. Promotes build-up of cartilage
3. Strengthens collagen
4. Supports chondrocytes in cartilage
Toxicity: No negative side effects have been reported.

Cayenne Pepper (Capsicum frutescens)

Other common names for cayenne pepper are capsaicin, chili pepper, American
pepper and red pepper. This fruit, which is technically a berry, is native to tropical America, but it is now located throughout the world. It is particularly used in the foods of Southeast Asia, Italy, and Mexico.

Cayenne pepper decreases pain by depleting the neurotransmitter substance P, the chemical mediator of pain, from the periphery of the body. Substance P activates inflammatory mediators such as those that occur in joint tissue in patients with osteoarthritis and rheumatoid arthritis. Cayenne pepper also contains vitamins A and C and volatile oils .

When taken internally, cayenne pepper can reduce cholesterol and triglycerides and decrease platelet aggregation, thus reducing the likelihood of developing arthrosclerosis.
Dose:
• 0.025% or 0.075% capsaicin cream or ointment; apply topically three to four times per day to the painful area.
• As a food spice, cayenne pepper can be used as tolerated.

Clinical Applications:

1. Asthma
2. Fever
3. Sore throat
4. Digestive disturbance
5. Cancer
6. Diabetic neuropathy
7. Cluster headache
8. Rheumatoid arthritis
9. Other arthritis
10. Psoriasis
11. Post-herpetic neuralgia
424 Part III / Therapeutic Techniques
12. Trigeminal neuralgia
13. Post-surgical mastectomy pain
14. Mouth sores and pain from chemotherapy or radiation

Toxicity: No negative side effects have been reported. Cayenne pepper has been used liberally in cuisine without complications. It has a grade of GRAS (Generally Recognized as Safe) in the United States. When applied topically or taken internally, it may produce a temporary burning sensation, which can feel severe, but there is increased tolerance with increased use. Contrary to popular belief, it does not cause gastric ulcer, and can even have a positive effect as a digestant and carminative .

Chondroitin Sulfate

Bovine chondroitin sulfate is an ingredient that is responsible for building
and supporting cartilage. Chondroitin is also commonly formulated as chondroitin hydrochloride .
Dose: 500–1,000 mg orally per day in two to three divided doses. Use in combination with glucosamine.

Clinical applications:

• Osteoarthritis
• Anti-inflammatory
Toxicity: No negative side effects have been reported.

CMO (Cetyl-myristoleate)

This is an ester of the fatty acid myristoleic acid . There is some support
for the use of this ingredient for joint and collagen health . It maintains a healthy immune response at the cellular level and promotes joint lubrication. It also acts as an immune system modulator, mediating the histamine and leukotriene response .
Dose: 1,000–1,500 mg orally per day in two divided doses.

Clinical Applications:

1. Osteoarthritis
2. Rheumatoid arthritis
3. Fibromyalgia
4. Temperomandibular joint dysfunction
Toxicity: No negative side effects have been reported.


Cucurmin

Cucurmin is the yellow pigment of the Cucurma longa or Turmeric plant, which is
both a spice and a medicinal plant. Cucurmin contains diferuloyl methane, which has anti-inflammatory and antioxidant effects. It inhibits the formation of leukotrienes and other inflammatory mediators. It has the ability to stimulate the formation of adrenal corticosteroids, potentiating the action of cortisol and also preventing the breakdown of cortisol .

Cucurmin is reported to be as effective as cortisone, or the potent anti-inflammatory drug phenylbutazone, in models of acute inflammation, with no major side effects.

A dosage of 1,200 mg per day of cucurmin has been shown to have comparable
anti-inflammatory efficacy to 300 mg per day of phenylbutazone . In people with rheumatoid arthritis, there was reduction of joint swelling, decrease in the duration of morning stiffness, and improvement in walking time with use of cucurmin .

Turmeric is a fabulous spice for a wide variety of foods. One can also receive the benefits of cucurmin by taking it as a supplement.
Dose: 1,500–2,000 mg orally per day in three divided doses, for anti-inflammatory effect. (This is equivalent to 8,000–60,000 mg per day of turmeric.) The absorption of cucurmin is improved if taken with bromelaine minutes before a meal or on an empty stomach. Fish oil, lecithin, or essential fatty acids may also help to increase absorption.

Clinical Applications:

1. Rheumatoid arthritis (especially in an acute exacerbation)
2. Osteoarthritis
3. Joint inflammation
4. Pelvic inflammatory disease
5. Temperomandibular joint disorder
6. Cancer pain
7. Postoperative inflammation
Toxicity: No negative side effects have been reported. No toxicity has been observed in animals fed with high doses of cucurmin up to 3 g per kg body weight.

Devil’s Claw

Harpagophytum procumbent is a plant indigenous to South Africa. It is known
as devil’s claw due to its claw-like extensions. Other common names are grapple plant and wood spider. Its health benefit is connected to the tuberous root extension. Devil’s claw maintains healthy interleukin and leukocyte activity. It relieves pain and inflammation. Clinical studies have supported its properties in the promotion of musculoskeletal flexibility and function . Studies in Europe have found that it increases flexibility of the neck, back and shoulders, and promotes better hip and knee function . Devil’s claw can also be used as a diuretic.
Dose: 500–1500 mg orally per day in two divided doses with meals.

Clinical Applications:

1. Osteoarthritis
2. Rheumatoid arthritis
3. Allergies
4. Liver detoxification
5. Gall bladder and kidney disorders
6. Lumbago
7. Gout
8. Menopausal symptoms
Toxicity: Devil’s claw enhances gastric juice production and is therefore contraindicated with stomach and intestinal ulcers. It should not be used in pregnancy.

Ginger (Zingiber officinalis)

Ginger is native to Asia, but it is also available in other tropical areas such as India, Jamaica, Nigeria, and Haiti. The root of the plant is used for culinary and medicinal purposes. It has been used in China to treat numerous conditions since the fourth century BC.

Ginger has many pharmacological properties. It has an analgesic effect by inhibiting the release of substance P (similar to the action of capsaicin in red pepper) . It inhibits the synthesis of prostaglandins, thromboxane and leukotriene, and inhibits platelet aggregation. It has an antioxidant effect. It helps to lower cholesterol. It can calm diarrhea, improve cardiac muscle function, and raise metabolic rate. It has some natural antibiotic activities. It can also be used to decrease the risk of gastric ulcers in those who are sensitive to indomethicin, aspirin, or other common ulcerogenic medications .
Dose: For acute inflammation, 5–10 g per day orally of a powdered form, in two to three divided doses. (One gram of powder is equivalent to 10 g of fresh ginger root or maintenance or chronic use, 500–1,000 mg per day orally in three divided doses for ginger extract (20% gingerol and shogaol)).

Clinical Applications:

1. Inflammatory conditions such as rheumatoid arthritis
2. Migraine headaches
3. Osteoarthritis
4. Muscular discomfort
5. Nausea and vomiting
6. Motion sickness
Toxicity: No negative side effects have been reported. Some people experience
gastrointestinal discomfort with high doses of 6 g per day or more.


Glucosamine

The failure of our body to manufacture enough glucosamine to maintain joint
cartilage has been suggested as a major contributing factor to osteoarthritis .
Supplementation of glucosamine is currently being used all over the world in the
treatment of arthritic conditions. It has the ability to block enzymes that degrade cartilage . For many years glucosamine has been the most widely sold over the counter supplement due to its endorsement by many physicians as an alternative for joint pain. Commercially it is sold as glucosamine sulfate, and this form has been extensively studied for clinical efficacy. Glucosamine is often combined with chondroitin to build up proteoglycan and connective tissue in the joint cartilage .
There is no food source of glucosamine. The supplement is usually derived from
chitin, a substance in the shells of shrimp, lobster, or crabs.
Dose: 1,000–2,500 mg orally per day in two divided doses.

Cinical Applications:

1. Osteoarthritis
2. Use as alternative to non-steroidal anti-inflammatory medications.
Toxicity: No negative side effects have been reported. It is well tolerated by most people. Some light gastrointestinal problems can occur in highly sensitive individuals. If this occurs, glucosamine should be taken with meals. There are recent case reports of a possible increase in total cholesterol.


Hyaluronic Acid

This denatured low molecular weight type 2 collagen supports joints by promoting cartilage and synovial fluid synthesis, enhancing the integrity and motility of joints. Hyaluronic acid also supports the elasticity and firmness of skin. It attracts water, promoting hydration and moisture retention within the dermal matrix. This function leads to its use in skin therapeutic care to diminish fine lines and wrinkles. Hyaluronic acid is available in an oral powdered form, and an injectable form for intraarticular use .
Dose: 100–200 mg orally per day in one to two divided doses. For intraarticular use the dose varies depending on the manufacturer.
• Intra-articular—dose varies depending on the manufacturer.

Clinical Applications:

1. Knee osteoarthritis (intraarticular form)
2. Fibromyalgia
3. Gout
4. Temperomandibular joint dysfunction
5. Lumbago
Toxicity: No significant toxicity. There is a very high L-50 (lethal dose) level. Doses
higher than 300–400 mg per day can cause a detoxification crisis syndrome from rapid detoxification. Excess medication is completely removed by the liver and kidneys.

MSM (Methylsulfonylmethane)

Methylsulfonylmethane is a well-known nutrient for the support of cartilage and
connective tissue strength, and is used to decrease joint pain. The sulfur helps to enhance the structure and integrity of proteoglycans . MSM is the major metabolite of DMSO (dimethylsulfoxide), a sulfur-based compound known to help maintain connective tissue and support the collagen and keratin in skin, nails and hair. It is essential to methionine, cysteine, and protein metabolism. It also supports the immune and respiratory systems .
Dose: 1,000–3,000 mg per day orally in two to three divided doses. Start with a low dose and increase as tolerated to avoid rapid detoxification.

Clinical Applications:

1. Osteoarthritis
2. Rheumatoid arthritis
3. Premenstrual syndrome
4. Fibromyalgia
5. Gout
6. Allergies
7. Gastrointestinal disturbances / disorders
8. Gastroesophageal reflux disease
428 Part III / Therapeutic Techniques
9. Migraine headaches
10. Muscle aches and pains
Toxicity: May cause insomnia with long-term use. If taken in very large doses, may cause a detoxification crisis that is reversible .

Omega-3 Fatty Acids (Fish Oil)

It is well known and accepted that consumption of fish oil is beneficial to general health. In terms of pain management, studies have reported that omega-3 fatty acids can ameliorate the signs and symptoms of psoriasis and rheumatoid arthritis due their efficacy in reconditioning cellular membranes and their antiinflammatory effects. The omega-3 fatty acids are eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA). They are also called polyunsaturated fatty acids and are found in shellfish, sea mammals, phytoplankton, and fish, specifically herring, cod liver, salmon, mackerel
and sardines. Commercial fish contain less DHA and EPA than wild fish.
Dietary omega-3 fatty acids are also found in foods such as tofu, canola oil, black currant oil, flaxseed oil, nuts, and soybeans. However, these sources can contain more omega-6 fatty acids than omega-3, which can neutralize many of the therapeutic benefits.
Dose:
• 5,000–15,000 mg orally per day of EPA and DHA for at least three months per year for reconditioning of the cell membranes
• 1,000–3,000 mg orally per day for maintenance.

Clinical Applications:

1. Reconditioning of cellular membranes to improve absorption of nutrients
2. Cardiovascular disease
3. Angina pectoris (reduces frequency of attacks)
4. Migraine headache (changes prostaglandin synthesis; reduces platelet serotonin release;
reduces cerebral vasospasm)
5. Hyperlipidemia
6. Hypertension
7. Rheumatoid arthritis (decreases morning stiffness and joint tenderness)
Toxicity:
• 1.8 g of EPA daily is safe for long-term use.
• Omega-3 fatty acids are commonly formulated with vitamins A and D, both of which can cause vitamin toxicity if taken in high doses. Omega-3 alone is safer and more beneficial.
• Some studies indicate an effect in prolongation of bleeding time due to inhibition of platelet aggregation and a decrease of thromboxane A2 production. Caution should be taken when a person is also taking aspirin or warfarin.

 


Soothanol X2

 
Works on all kinds of joint pain
Ease away pain on contact Back, hip and joint pain soothed
Pleasant scent Easy to apply FEEL THE DIFFERENCE
From muscle strains to bumps and bruises.
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Directions:

 Adults and children 2 years of age and older:
Apply 2-5 drops to affected area not more than 3 to 4 times daily.
Wash hands before and after use.

Children under 2 years of age: Consult a physician.

 Ingredients: Arnica Oil, Calendula Oil, Cayenne pepper, DMSO, Emu Oil, Ginger, Limonene Oil, Menthol, MSM, Olive Oil, St. John's Wort Oil, Wintergreen.

For more information about Soothanol

 

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