PAUL J. CHRISTO, MD, MBA,

All About Pain

Date Aired: November 10, 2017

Episode Description

Chronic pain affects over 100 million US adults and 20 percent of children worldwide. Each year, Americans spend billions of dollar on medications, surgery and therapies in a quest to find relief – often leading to more suffering and hopelessness. Chronic pain is complex. It changes brain chemistry and can cause a loss of grey matter. Women and men process pain in different parts of the brain and consequently experience pain differently. Dr. Christo explains the complex nature of pain and provides a wide range of tools and techniques scientifically proven to help patients control and defeat it.

Problem of chronic pain

  • Over 100 million suffer from chronic pain
  • Changes in the brain and spinal cord
  • Is a disease in itself

 Use of Opiates

  • Over last few years , physicians have been overly aggressive in subscribing opioidsà
    • Leads to overdose, addiction, and death
    • Worry about misuse, abuse, diversion, and addiction

 Women and Men Experiencing Pain

  • Pain is process in the amygdala for women
  • Men processed in areas where cognitive thinking takes place
  • Women feel pain more emotionally
    • May experience more depression, anxiety and more chronic intensity
    • They may respond more through cognitive behavior

 Chronic pain and the brain

  • Changes brain chemistry
  • Loss of brain tissue in the grey matter and affects he hippocampus
    • The area that processes information and help store memories
    • Can occur in chronic back pain, fibromyalgia, chronic tension headaches
  • Patients report poorer short term memory
  • Cannot retain information
  • Can reverse these changes in the brain when pain is reduced
  • Acute pain purpose to remove arm, body

Millennial Tech Neck

  • Using smart phones, look down, flexing he neck often at 60 degree angle
  • Develop neck, muscle spasms, muscle aches, stress and strain joints, tendons, ligaments
  • Can start degeneration of the discs in the neck
  • Looking down at 60 degree angle is equivalent to a weight of 60 pounds
  • Raise the smart phone to the level of the eyes
  • Are aps that will alert you when the neck is tilted down too far.
  • Deep massage, warm showers, towels can help reduce the stress and strain
  • Many people protract their shoulders (hunching forward)
    • This can lead to neck and back pain
  • Be aware of posture

 Pain Relief

  • CBD
    • The use is outpacing the science
    • Use for cancer, diabetic, HIV neuropathy pain
      • We don’t know how to dose it
    • Seems safe; is not lethal
  • NSAIDS
    • Disrupt the microbiota
  • Seizure meds, antidepressants for nerve pain

 Tension Head Aches

  • Reduce stress
  • Anti-inflammatory NSAIDs, Naprosyn, ibuprofen, Celebrex, Tylenol
  • Acupuncture for migraine and tension head aches.
  • Acupressure points on occipital ridge (above the back of the neck

Migraines

  • Often migraine head aches
  • Botox into forehead occipital, temporal, trapezius muscles (back shoulder area)
  • He believes that most sinusitis pain are from Migraines

Host’s Cure for Trigeminal Neuralgia

  • Trigeminal Neuralgia is excruciating facial pain
  • The only medical cure is through medications
  • Is called the “suicide disease”
  • Is associated with cavitations (pockets of pus in the bone caused by a previous tooth extraction or root canal.
    • Also called osteomyelitis or osteonecrosis)
    • The nerve runs through these pockets of pus causing pain
  • The cure was to inject ozone into these pockets
    • The ozone was felt to travel on the nerve
    • The pus went away, the bone grew back, and the pain went away.

Rotator cuff injury

MDs say to live with it for 1.5 years

  • If injury is partial, inject steroid anesthetic into the bursa of joint plus Tylenol
  • Host massage helped on one: an acupuncture needle and nano lights helped
  • Host Went to Dr. Luke Cua in LA who cured it in five minutes with one needle and nano light therapy

Osteoarthritis

  • One of top three pain conditions worldwide
  • He recommends anti inflammatory medications, Celebrex, naproxen, ibuprofen
  • Exercise helps reduce pain
    • 20 minute walks
    • resistance training
    • Swimming

Rheumatoid Arthritis

  • Cytokine inhibitors
  • Meds to inhibit TNF a
  • Avoid foods that are cooked at high temperatures
    • Fried foods
    • Meats
  • Shift to anti inflammatory foods
    • fish,
    • dark cherries, berries

 Fibromyalgia

  • Affects more women
  • Affects joints, muscles
  • Can have head aches,
  • irritable bowel syndrome & abdominal pain
  • three FDA approved medications
    • lyrica
    • Cymbalta
    • Not helpful to many
  • Exercise
    • g., swimming
  • Dr. Brady podcast on October 13 Fibro fix

Aroma therapy

            Topical

  • Massages on painful areas with essential oils mixed with olive oil or almond oil
    • Effective for neck, back and knee pain
  • Or place on the skin

Vaporizing essential Oils

  • Can reduce post operative pain and needle stick pain from dialysis
  • Peppermint
  • Clove has local anesthetic properties
  • Lavender
  • Eucalyptus
    • Pain reducing properties inhaled or topically

Music Therapy

  • Can reduce pain
    • Effective in post operative pain
    • Arthritic , cancer, and fibromyalgia pain
      • Pain relief lasts two weeks
    • Use patient’s music preference
    • The person can sing has meditative effects
      • Triggers he parasympathetic nervous system
      • Decreases heart rate, decreases blood pressure, results in deep breathing

Mind Body Approaches

  • Cognitive Behavioural Therapy (CBT)
    • Reframing/ reworking brains perceptive ability
    • Takes months with practice
      • Remove negative thought patterns and replace them with positive thoughts
    • Neuroimaging studies shows this rewires the brain over time
  • Interview with David Spiegel on use of hypnosis for pain will be available in December 2017

Herbs

  • Some are similar to anti inflammatory medications
    • Be careful when combining with medications
  • Devils Claw
    • As effective as Motrin without the harmful side effects
  • Willowbark
    • Aspirin is derived from this
    • As good as anti inflammatory meds
  • Feverfew
    • Member of daisy family
    • Has anti inflammatory
      • Head aches
      • Arthritis
      • Menstrual cramps

 Pulsed Radio Frequencies

  • Uses electromagnetic waves to help reduce how pain is transmitted in nerves
    • Specifically peripheral nerves
      • Groin pain, occipital pain (occipital neuralgia)
      • Device is place on skin above the nerve
      • More sustained pain relief

Regenerative Approaches

  • Help restore damaged tissues
  • Stem cells
  • Prolotherapy
    • Uses dextrose ( a sugar) injected around damaged tendons and ligaments – helps elicit the inflammatory response which helps regenerate the damaged tissues
  • Plasma rich therapy
    • Uses our own blood which is spun down so the platelets are concentrated
      • Platelets are important in coagulation
      • Platelets have have molecules in them that when released recruit other cells such as collagen to rebuild tendons, ligaments
        • help restore function
        • help reduce pain
        • Help restore damaged tissue
      • Most of the studies are on animals

Summary

  • Don’t wait to get pain help
  • The longer you wait, the more likely that the pain will continue
  • Use available resources
  • Don’t give up