Carbohydrates make up the majority of the calories in many Americans’ diets. Carbohydrates are a type of macronutrient which provide the body with energy. Grains such as bread, cereals, pasta and rices are all types of carbohydrates. Carbohydrates also come from fruits, vegetables and the natural sugars found in dairy products.
Some quick education on Carbs can help patients to have a better understanding of foods to be wary of in fighting chronic pain. Refined carbohydrates, such as white bread, white rice, cookies and candies, sodas, contain very little benefits to our general health. Refined carbs are low in fiber, vitamins and minerals. Complex carbohydrates such as whole wheat bread, brown rice, broccoli and asparagus, are rich in dietary fiber, help to stabilize blood sugar levels and are better choices for pain patients. Complex carbohydrates also contain high levels of vitamins and minerals.
Interesting enough most chronic pain patients, specifically Fibromyalgia, patients tend to have more frequent cravings for carbohydrates than healthy individuals. When patients give into the simple carbs they can enter a hypoglycemic state, or a sudden drop in blood sugar, perpetuating the fatigue and pain of fibromyalgia and other chronic pain conditions.
Cutting out all carbohydrates from the diet is not recommended, since they do serve an important function in the metabolic process. Instead, we recommend cutting out all refined carbohydrates and choosing complex carbohydrates to make up 30-40% of your daily calorie intake.
These changes can significantly decrease inflammatory levels, improve energy and decrease pain.
To help find a ‘cure’ for you pain, we require our patients to become proactive. This requires patients to take the initiative to improve their situation. Instead of letting your current circumstances be the driving force of determining your future we help patients to determine their choices and act to improve their situation instead of only reacting.
We help our patients realize that even when they feel they have limited choices or little hope there is always a direction that allows the patient to be in control of their pain and therefore their outcome. We teach our patients that they get to choose how their pain and conditions define them. Patients that currently feel helpless are allowing their circumstances and conditions to control them. For example a helpless patient may respond with “there’s nothing I can do about my pain”. We teach our patients to focus their time and energy on things they have control over. For example, our patients get to decide if they will wake up and do something productive today. They get to decide if they will interact positively with their family despite how their pain is making them feel. We help to teach our patients ways to empower their situation. That feeling of empowerment propels patients to gain more and more control of their pain. Focusing on items we do control instead of the items we can’t control help to reduce stress levels which decrease anxiety and help our patients to better cope with their pain.
We teach patients to eliminate certain phrases including: “I can’t”, “I must”, “If only”, ‘there’s nothing I can do”. We help patients break the handcuffs of negativity that surround and influence their painful condition.
We help patients look at alternative so that they can instead take a different approach and be in control, only then can you find a ‘cure’ for your pain.
Meditation is an effective tool to help avoid additional prescription medications and help cure pain. Meditation can rewire the brain’s pain circuitry. Neuronal pathways within the brain get programmed every time you expect pain to occur — in time, less and less stimulus is needed to trigger the pain reflex. Eventually, the simple thought of pain becomes the true source, not necessarily the ailment itself.
Meditation can unhook your emotional reaction to pain. Our patients can get stuck in a brutal feedback loop, without even realizing it. Their anticipation of pain creates stress, stress leads to physical tension within the body — especially near the painful area, which ultimately leads to more pain.
Meditation teaches you how to emotionally detach from your negative thoughts and physical sensations, where you no longer expect pain, nor resist it when it does occur.
Meditation can also help us treat our natural flight or fight response to pain which can be abnormally triggered in chronic pain patients. The flight or fight increases cortisol stress levels. Elevated stress levels increase blood pressure, increase inflammatory markers and increase pain. Meditation helps to reduce these harmful stress hormone levels.
Meditation can also boost natural endorphin levels which act as a natural pain reliever, decrease cortisol levels and allow patients to be in control of their pain
Aquatic therapy is an excellent form of physical exercise which can be a critical component to helping patient’s find a ‘cure’ for their chronic pain. Water is one of the oldest mediums of physical treatment with both physiological and psychological benefits. Water provides an environment where one can move and exercise with little or no pain which can significantly lower stress on the joints. The buoyancy provided by water allows chronic pain patients the ability to move with less effort. Exercise in water allows for improved flexibility and ease of stretch. The activity of water therapy also helps to boost natural endorphin levels a key to healing. Staying active in a less stressful controlled water environment improves a patient’s quality of life, improves mood and can decrease a patient’s fear of pain.
Aquatic therapy represents a positive, rewarding and useful activity for enhancing mood. It can help build hope and provide the motivation to continue activity. Aquatic therapy provides an environment where patient’s can focus on their abilities, not disabilities. As we have mentioned in previous articles, becoming an active participant and enrolling in aquatic therapy is a positive decision our patients can make to decrease and control, possibly even cure, their pain.
To ‘cure’ your pain a patient must learn patience. Your chronic pain is a complex web that developed through a course of misfortunate events and set up an engrained neurological pathway signal of pain to your brain. We give the example of a girl walking across a dewy meadow. A girl walks across the meadow in the morning, you would not see her path later in the day. However, if that same girl walks across the meadow everyday for the next 6 months, even if she then misses one day you will be able to see the path she has walked. This is the same as chronic pain patterns.
It took a long time to get to the point of your chronic pain and your ‘cure’ will also take a period of time and be a process to heal. Don’t expect any magical healthcare provider to be able to solve all your ills in one visit. Instead, understand that a patient with patience and understanding will have the best results. Patience also helps to curb anxiety that intensifies pain and hinders the healing process.
We recommend mindful meditation, prayer, exercise or relaxation techniques to help patients practice patience. These techniques will help decrease stress cortisol levels, boost natural endorphins and will help patients become more in tune with their body and help the healing process.
Chronic pain is a misunderstood and complex condition to treat. Research on the biology and neurobiology of pain has shown a relationship between spirituality and pain. Using a number of cognitive and behavioral strategies to cope with pain, including religious/spiritual factors, such as prayer or seeking spiritual support to manage pain is an essential component to finding a ‘cure’ for your pain.
Many patients confuse spirituality with religion. Although the two can overlap there is a difference between the religion and spirituality. Religion is an organized faith system grounded in institutional practices while spirituality is grounded in personal beliefs and practices that can be expresses with or without a specific formal religious belief.
The role of spirituality in treating chronic pain is vital as it helps patients to create a meaning and purpose that is essential in fighting chronic pain. Spirituality can help patients cope with the physical as well as the psychological component to chronic pain. The psychological meaning that patients assign to their pain impacts how they process their pain long term.
Spirituality lies in the sense of connection and inner strength and peace that individuals derive from the relationship with themselves, others, nature and possibly a connection to a specific religion. The role of a more spiritual patient is vital to improving a patient’s overall well-being and quality of life. This improved well being takes time and training to accomplish but works through visualization, meditation, positive thinking and possibly even prayer.
A sense of connection to one’s environment, nature and a higher power helps to give patient’s an improved outlook on their treatment and significantly improved outcomes in treating their pain. Patients that find the ability to improve their inner strength will have an improved outlook, a sense of purpose and will lead them to their ‘cure’.
This is an absolutely huge topic, I can’t state that enough! In fact, this article is only a primer to an entire book we are writing that will help to attack and treat Fibromyalgia. I will give a few of the highlights on our ‘cure’ for Fibromyalgia.
Before we can treat Fibromyalgia, let’s try to put to the side the past stigmas associated with Fibromyalgia. For many years a majority of physicians did not believe in Fibromyalgia and there are still a few physicians who refuse to recognize or treat Fibro. While rounding on patients in the hospital, I overhead a colleague label Fibromyalgia as the “depressed, overweight, middle age, housewife syndrome”. On the other spectrum, you had the theory that Fibromyalgia was a warning of things to come. This group looked at Fibromyalgia patients similar to the theory of the canary in the coal mine.
Luckily, the medical community is finally coming around to recognizing this chronic pain condition. Current Fibromyalgia research and philosophy is a mixed component of a central nervous system dysfunction with a chronic myofascial component. Below is a list of recommendations we make to all of our Fibromyalgia patients on there first visit.
- Fibromyalgia is a diagnosis of exclusion, make sure to have labs to rule our other connective tissues diseases first, like Rheumatoid Arthritis, before accepting the Fibro diagnosis.
- Every Fibro patients needs a sleep study to treat any underlying sleep disorders that will directly complicate pain.
- Treat any underlying depression.
- Check underlying vitamin deficiencies that can complicate pain, including Vitamin D, Vitamin B12, Vitamin B1
- Start a daily home exercise/stretching program, Fibro will worsens with inactivity.
- Eliminate all soda’s immediately, totally toxic and can increase inflammatory levels in the body complicating pain.
- Restrict the ‘nightshade plants’ from the diet to limit their inflammatory related issues
- Limit yeast foods, so many of my patients struggle with this one but it will dramatically improve your energy.
- Work with a local physician and consider one of the FDA approved medications for Fibromyalgia: Cymbalta, Lyrica or Savella.
- Consider a workup for gluten allergy.
So much more to cover in future blogs, but this will give you a good starting point and as always consult your local healthcare provider before starting any new health lifestyle modification.