Mark Young, MD, on Complementary and Alternative Medicine for Natural Pain Relief

By: Loolwa Khazzoom, Founder, Dancing with Pain

December 13th, 2008 • Mind-Body MedicinePrint Print

Loolwa Khazzoom: What are your thoughts about the effectiveness of pharmaceutical versus complementary and alternative medicine for natural pain relief?

Mark Young: Pharmaceuticals continue to be a mainstay of treatment of many common painful conditions, but there are alternatives. Many complementary and natural strategies can help just as well. I think there is growing recognition of the importance of some of these natural treatments for beating pain.

LK: If you’re looking at the big picture, where do you see the role of pharmaceuticals and where do you see the role of these natural remedies? Do you see them as being in opposition? Do you see them as working together?

MY: I see them as synergistic. I think natural remedies for pain are intended to be a complement. They go together with conventional treatments kind of like bagels and cream cheese. They really work together.

I think it’s important that before any treatment be applied, the actual cause of the pain be identified. I like to tell my patients that pain management is like building a house: When you build a house, you first need a foundation — the structure upon which the house is built.

Similarly, proper management of pain requires a diagnosis; that’s the foundation. Until you have the diagnosis, you can’t really treat the pain appropriately or effectively. So we try to identify the root cause of the pain.

Once we’ve done that, we can apply different treatment modalities — the traditional methods like pharmaceuticals, injections, or physical therapy. We usually try to balance these with natural forms of treatment, complementary strategies, simple methods that are likely to serve an important role.

LK: Like what? What are some of the drug-free remedies that you find to be the most effective, or does that really depend on what the cause of the pain is?

MY: Really it’s paired according to the pain. But in general, helpful treatments include botanical creams and salves. Arnica is well-known for it’s effectiveness in treating bruises and muscle strain. Comfrey cream is also helpful for treating various types of sprains and strains of the knee, ankle, and shoulder.

There are also modalities like acupuncture and acupressure, which help decrease pain. There’s exercise, yoga, and tai chi. There are nutritional remedies like a diet high in Omega 3 fatty acids. All of these methods go a long way.

LK: How many of these modalities have been given the time and attention of scientific studies? How much has been proven to date? Where do we still have to go, in terms of formally establishing the effectiveness of these treatments?

MY: There’s still a lot more research to be done. Unfortunately, research efforts have been dampened because of the power of the pharmaceutical industry. Big pharma is not motivated to explore some of the natural remedies that clearly have no profit motives.

We’re blessed, on the other hand, that’s there are organizations like the National Institute for Complementary and Alternative Medicine — a division of the National Institute of Health that researches the effectiveness of complementary treatments. Slowly but surely, we’re seeing a revolution that’s emphasizing good, solid research in establishing the effectiveness of alternative and complementary treatments.

I believe that we’ve got lots to learn from our European neighbors, who have done research in this area for a long time. Just like there’s an FDA here, regulating the drug market, so is there a European Commission that regulates the use of herbal remedies. And they’ve lent a lot of credibility to the use of alternative methods for decreasing people’s pain and suffering. They have established the effectiveness of these remedies.

LK: Why do you think that they’re more inclined to research herbal remedies? Is it because many of them have social systems of health care?

MY: I think a lot of it does have to do with the basic social infrastructure. In addition, their practitioners are probably a bit more judicious about prescribing medications, without knowing the full spectrum of effects. Lastly, in any sort of managed care or socialistic system, one needs to search for less expensive, cheaper alternatives for health care.

Just because the alternative is not as expensive doesn’t mean that it’s not as effective. Things like Arnica cream and Comfrey and Saw Palmetto (for treating prostate) are things that really got their momentum in Europe.

LK: Can you talk a little about limitations and drawbacks of pharmaceuticals?

MY: Every medication has a side effect, no matter how good it is. Pharmaceuticals, particularly for pain, have been found to cause dangerous side effects – as in the case of Cox-2 inhibitors. Several of them were taken off the market. Prescription drugs for pain include narcotic analgesics, which obviously do a lot of damage: They can affect kidney function, people’s levels of alertness, performance in the work environment. Many pharmaceutical agents have negative side effects that undo the positive effects.

LK: Is there anything else you’d like to add about complementary and alternative methods for natural pain relief?

MY: Complementary and alternative methods should be as important to clinicians as pharmaceutical intervention. We constantly have to search for new and safe ways of treating our patients, while avoiding the toxic effects of drugs.

Mark Young, MD, MBA, FACP, is a board-certified specialist in Physical Medicine and Rehabilitation (Physiatry) and is a licensed acupuncturist. He currently serves as chair of the Department of Physical Medicine and Rehabilitation at the Maryland Rehabilitation Center, and he is editor-in-cheif of the Journal of Practical Pain Management. He is the author of over 70 publications relating to rehabilitation medicine and has co-authored three rehabilitation textbooks. His articles have appeared in periodicals including Journal of the American Medical Association (JAMA), New England Journal of Medicine, and The New York Times.



Comments

VICKIE KENDALL December 31st, 2008

I HAVE R.S.D. DISEASE. 6 YEARS NOW. A MEDAL BED FRAME FELL OFF AFAFTER AND LANDED STRAIGHT DOWN ON MY BARE RIGH FOOT, GASHED IT OPEN AND FRACTURED IT. I NOW HAVE R.S.D., IN WHICH HAS SPREAD THROUGH ENTIRE LOWER LIMBS. UP RIGHT LEG THROUGH GROIN DOWN LEFT LEG IN WHICH HAS PUT ME IN A WHEEL CHAIR. I WENT THROUGH SURGERY 3 TIMES WITH THI SPINAL CORD STIMULATOR IN WHICH DOES NOT WOR FOR PAIN (NO) MORE. I AM CURRENTLY DOING ACCUPUNCTURE AND THE 3RD TIME, I WAS ABLE TO GET UP AND WALK OUT OF HIS OFFICE. I HAD SO MUCH PAIN FOR YEARS, SCALED AT 8-9. I WOULD JUST CURL UP AND CRY. I HAD TO CALL 911 ABOUT A MONTH AGO, FOR I AWOKE FRM A NAP AND COULD NOT WALK OR TALK. I HADTO BE HELD UP. I THOUGHT I WAS HAVING A STROKE. IT WAS ANXIETY!!!’THEY GAVE ME ATIVAN, FOR THE ANXIETY, AND THEN SOME MORPHINE FOR PAIN. I DISLIKE TAKING DRUGS, FOR THEY REVERSE ON ME, KEEP ME UP ALLLLL NIGHT. ONE DR. PUT ME ON METHADONE, I ONLY STAYED ON IT FOR 4 DAYS AND WENT OFF, WEIRD SIDE AFFECTS. R.S.D. DISEASE IS CONSIDERED THE HIGEST ON PAIN SCALE, PASSING UP CANCER. I AM GOING TO STICK WITH THE ACCUPUNCTURE. IT HURTS, WHEN HE PUTS THE NEEDLES IN BETWEEN MY TOES, BUT I JUST BARE WITH IT. ANOTHER THING WITH R.S.D., YOU LOSE YOUR TEETH, THEN ASOPHOGUS, AND DIGESTIVE SYSTEM. IM ALREADY AT THAT POINT. I JUST HAD TO HAVE ANOTHER TOOTH PULLED. THEY MADE ME ALL NEW PARCHELS THAT FIT PERFECT. ANOTHER IS ANXIETY, MY THROAT STARTS TO CLOSE UP, MY HEART STARTS TO POUND, AND INSOMNIA, I AWAKE EVERY MORNING AT 3AM..I HAVE TO GET UP. I JUST GET TO THE COMPUTER AND JOURNAL..THEN A COUPLE HOURS OR SO LATER I TAKE A ANXIET PILL, AND GO BACK TO BED.
I JUST WENT TO A APPT YESTERDAY TO BE FITTED FOR A POWER CHAIR, FOR I HAVE LOST ALL MY RIGHT FOOT MUSCLE MASS, ALL THATS LEFT IS BONE, AND NOW IS STARTING IN LEFT FOOT. I ALSO HAVE A APPETITE PROBLEM, I AM DONE TO 97 POUNDS..JUST CAN’T EAT, I CHOKE, I HAVE TO HAVE LOTS OF WATER TO GET IT DOWN. OR I DON’T EVEN BOTHER. THE R.S.D PAIN IS THE WORST I HAVE EVER GONE THROUGH. I CANNOT BELIEVE A PAIN CAN BE SO TERRIBLE PAINFUL. SINCERLY, VICKIE, vickiekendall@ymail.com

VICKIE KENDALL January 9th, 2010

since i  have spoken to you last, i could not take the pain anylomger..i ended up getting a pain pump put in for legs and feet..I am able to walk some now. It has, Morphine and bupivacaine in pump. I just recieved it inserted 8-10-09..I am set very low yet. I only let them go up very slowly..I am afraid of it. But it was that, or wheelchair the rest of my life..the omly problem now is weight gain..terrible..i am a little person, never been over 106 pounds. I jumped from 104-121 in a matter of 2 months since pain pump insertion..I am totally embarassed..I won’t go anywhere..Or see anyone. And to top it off, I was a passenger in a {3} car accident. It got my neck, c2-3, c-4-5, c6-7, bulged discs..Now i am going through the pain of all this..We had to be towed, we were in the middle..Drivers fault I was in…Toooo Much to handle right now…tooo many appointments, And i get so tired, I have to come home and go to bed….sleep…VICKIE KENDALL, vickiekendall@ymail.com   I JUST FEEL LIKE A HAVE BEEN HIT BY A MACK TRUCK…

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