After 12 shoulder surgeries I was left with a lot of pain and arthritis and osteoarthritis. Seeing a pain specialist to deal with the pain, he put me on two different types of morphine and told me that I would be on it for life. Thinking that this was as good as it gets I reluctantly took the morphine but my pain levels were still between 6-8 on a scale of 1-10.
It’s a confusing topic because there have been many studies showing both the benefits and the dangers of multivitamins.
My answer? Two words: personalized medicine.
Personalized medicine starts with the idea that because everyone is different, there cannot possibly be one answer that applies to everyone. You are genetically unique; your life stressors are not the same as those of the person next to you, and your diet for the past five years is uniquely yours.
All these factors determine whether or not you need a multi right now. And these differences explain why all medical and health programs need to be tailored to each individual. To better understand how to use personalized medicine to answer the multi question, let’s first talk about what vitamins actually do.
Vitamins help to activate all the enzymes that make your cells and organs function optimally. Vitamins and minerals also provide antioxidants necessary for a healthy immune system; they protect your tissues from damage; and provide nutrients for efficient liver detox.
How do you know if you don’t have enough and need a supplement?
Here are the 7 signs you might be low on what your body needs:
- You have been diagnosed with an illness of any kind.
- You are having symptoms such as fatigue, brain fog, hair loss, peeling nails, or bumpy skin on the back of your arms, to name just a few. Or you have symptoms your doctor can’t figure out.
- You’ve been a vegan or vegetarian for many years and might be low in B12 and zinc.
- You don’t eat many fruit and vegetables.
- You’ve had a lot of stress for a long time. If so, your body needs more Bs and minerals than usual, since stress causes you to burn through these nutrients quickly.
- You have digestive issues, or if you’re taking an antacid or proton pump inhibitor, you might not be absorbing your vitamins very well, and therefore need to supplement with higher amounts to get them into your body.
- You are hypothyroid, and you have a higher need for the minerals zinc, selenium, and maybe iodine.
Of course, it’s impossible to list all the conditions that indicate you may need more vitamins, but to help you figure this out, you can see a functional Medicine doctor who can look do specialized testing.
In my practice, we can actually test how your cells are functioning and whether or not you’re low in any particular vitamin, which helps us to customize your treatment plan.
1. What is pain?
Pain is such a simple word, but the problem is that what people think it means is not really what it means. All of my patients tend to associate what’s going on in their arm or their back as pain out there in the body. But it’s not. It’s something we call nociception — electrochemical signals generated in our body in response to injury that get transmitted along nerve fibers to our spinal cord and up to our brain, where they’re processed and become the experience of pain.
For example, if you cut your finger, that’s not pain in your finger, that’s nociception. But nociception is such a terrible word; it doesn’t exactly roll off the tongue, and it’s not easy for people to remember.
Pain can be an acute event, which signals there is harm and you need to get away from it. Unfortunately, when pain becomes chronic — when it’s present for long periods of time after the tissue has healed — we can still have this perception of pain even though there is no obvious tissue damage or injury. At that point, pain fundamentally causes rewiring and alterations in our nervous system.
We need to think about pain as a disease in and of its own right — much like any other chronic disease, such as diabetes, asthma, or heart disease.
2. What are common myths about pain?
One is that it’s all in your head. This has some basis in truth, but we have to be careful. Yes, pain is all in our brain, but that doesn’t mean it’s made up. I spend a lot of time with my patients validating their experience of pain and then helping them understand how pain really is influenced in the brain by a multitude of factors — stress, anger, catastrophizing, anxiety, belief systems, expectations — all of these play a significant role in our experience of pain.
Another myth is that you have to live with it. We need to first find out if there are any medical causes that can be corrected for someone’s pain, so it’s not just a matter of telling someone you have to live with it. But it’s up to us physicians to show people how to best manage that pain, whether through medication, surgery, physical and occupational therapy, or mind/body approaches — all of these show significant benefit in reducing patients’ pain and helping them improve quality of life and physical functioning.
One other myth is that patients sometimes think medication is going to cure pain. Most of the time, medications help reduce or alleviate patients’ pain, but in very few cases do they have disease-modifying properties. The truth is, for many of these chronic painful conditions, we haven’t found specific cures for the pain, but we have found wonderful ways to manage it.
3. Is chronic pain different for men and women?
Yes. This is a hot topic right now. What we know is there’s a larger percentage of women who experience chronic pain –the data in my clinic is two-thirds women to one-third men. Women are more likely to get certain chronic painful conditions, such as fibromyalgia and irritable bowel syndrome. Some conditions tend to affect men more, such as cluster headaches.
Women are also more sensitive to experimentally evoked pain (pain produced in a laboratory or research study) — heat, cold, electrical stimuli, pressure. But we have to be careful not to interpret this increase to mean that women are weaker than men because there are genetic, hormonal, and central brain differences in women that we believe may be playing a role.
4. What promising new drugs or treatments are on the horizon?
There are drugs under investigation that modulate [adjust] the immune response in certain autoimmune diseases, like rheumatoid arthritis, that lead to chronic pain. Some of these are showing promise.
Researchers are working on gene therapy approaches to chronic pain, using viruses to turn on and off our own internal chemical plants to release pain-relieving substances. An example of this is when you get a runner’s high: You can have gene therapy that turns that on continuously. These are still in the early stages, but they hold promise.
Scientists are investigating different ways of implanting stimulators into our nervous system and into our brain to turn off the signals responsible for pain. I think we’re going to be seeing exciting treatments for chronic pain in the future.
5. What do we now know about pain that we didn’t a few years ago?
The mind and body are very linked, and research is showing that linkage more and more.
Recently, we developed technology [a type of MRI scan called fMRI, or functional magnetic resonance imaging] that allows us to focus on a specific region of the brain responsible for the perception of pain. We had people think about their chronic pain as being this terrible, horrific experience. Then we asked them to think about it in a calming, soothing, pleasant manner. We found their brain activity went up and went down as a consequence. They could see their brain activity, and over time they would eventually learn how to control a specific area of their brain and their pain.
Even so, we’re still predominantly using fMRI as a way of better understanding the brain and its relationship to pain, but it’s not yet ready for prime time as a treatment. We’re just at the tip of the iceberg in understanding the role of the brain in pain.
How can you combat Osteoarthritis?
The first step in combating osteoarthritis, or OA, is knowing what it is. You can have a great impact on how any arthritic condition effects you if have some understanding of it. There are a two main questions that must be answered here.
What is Osteoarthritis?
Why is it effecting me?
Let’s explore these two questions separately:
What is osteoarthritis?
The most common form of arthritis doesn’t appear to be a classic arthritic condition. A more appropriate term for it is degenerative joint disease. This describes what is actually going on. Essentially it’s the abnormal destruction of cartilage in the joints of the body.
Slicker than Teflon…
Cartilage forms super slick pads covering the ends of bones in joints. These pads glide over each other effortlessly and keep the bones from grinding themselves to dust during everyday movements.
The cartilage is bathed in a nutrient rich liquid called synovial fluid within a closed capsule. During movement, the fluid is squeezed out of the cartilage while under pressure and rushes back in as the pressure is reduced.
While walking, for instance, every step causes synovial fluid to be flushed in and out. This brings a fresh supply of nutrients and helps keep the cartilage soft, slick, and healthy.
As cartilage cells wear out they are replaced with new healthy cells. Normally this process is in balance.
When things go wrong…
For many people, the process becomes tilted towards the wrong side. Cartilage is damaged and torn down but the repair process lags behind. Slowly, the normally smooth and super slick surface of the cartilage becomes pitted and rough. This increases the friction and wear. The cartilage becomes thinner and thinner. In osteoarthritis knees and other joints of the body are losing this battle.
As cartilage between bones wears out the bones begin to impact on each other. Bone spurs develop which aggravate the condition and cause much pain. This action creates a source of inflammation that effects the surrounding joint as a whole.
Swelling, heat, and pain occur as the immune system attempts to clear out damaged tissue. Chemicals from the inflamed tissue damage more healthy cartilage cells.
A positive feedback loop occurs since the condition doesn’t “heal”. The inflammation builds on itself and gets out of control. The result is a worsening condition, destroyed joints, and chronic pain.
The body in action…
Let’s look at an example of a normal immune response:
If you cut your finger, the immune system immediately gets a signal to go into action. Swelling, redness, heat, and pain occur at the site of the cut. As the cut heals those symptoms gradually disappear. Eventually as the cut is healed the inflammation ceases. The signal that activated the immune system in the first place is turned off. Only some scar tissue remains as evidence. This is a normal immune response cycle.
With arthritis, on the other hand, that cycle is not completed. Because the body does not regenerate the lost cartilage the bone on bone impact continues. This signals to the immune system stay “on”. The result is a continuous cycle of inflammation, swelling, and pain.
Not everyone will develop this condition.
What are the contributing factors? Let’s take a look…
Why is osteoarthritis effecting me?
There are several factors that can predispose you to this condition. More than one usually combine to cause it to erupt. These conditions tend to overlap and intertwine. Here are some of the possible contributing factors or causes of osteoarthritis:
Poor Diet: Excess weight, hormonal imbalances, inflammation, and nutrient deprivation to cartilage
Age: Old injuries accumulate, muscle declines, weight often climbs.
Injury: Repetitive stress or acute cartilage damage can trigger problems.
Genetic Factors: Unfortunately, genes can play a big role in developing OA
Poor Muscle Strength: Causes poor alignment of joints and faster wear.
Being Overweight: Excess stress on joints
Accumulated AGE’s: Debris which slows cartilage repair
Reduced Blood Supply: Slows nutrient flow and repair mechanisms
Infection: An infection in the joint can lead to OA
As you can see, many of the possible causes are interrelated. It is hard to pinpoint the specific factor or event leading to the condition. It does appear that after a certain threshold these factors combined spark the osteoarthritis process.
Regardless of how it begins, most people just want to know what can be done about it. There are three areas where you can have an impact on the condition. They are:
You could be eating yourself into more pain and misery! Changing the way you eat can slow the progression of many diseases, including degenerative joint disease. Learn more about eating a healthy anti inflammatory diet.
A proper exercise program strengthens muscle to improve body alignment. Stronger muscles help joints function efficiently. This slows the wear and tear effect. Exercising also keeps joint cartilage healthy and functioning properly. It balances certain hormones which lessens the effects of degenerative joint disease.
The knees are particularly susceptible to osteoarthritis. A proper arthritis knee exercise program can get you back on you feet, increase mobility, and reduce knee joint pain.
For those with advanced joint discomfort an arthritis water exercise program may be very beneficial. Water has advantages which makes exercise easier, safer, and more effective for those suffering from degenerative joint diseases.
Certain nutritional supplements have been proven to slow or even reverse the effects of osteoarthritis. Adding these supplements to an anti inflammatory diet has a dramatic impact on joint health for OA sufferers.
Glucosamine stimulates cartilage production and binds water into the cartilage matrix keeping it functional. It also stimulates collagen formation. This combination makes glucosamine a powerhouse in the fight against OA.
Chondroitin also has a positive effect on cartilage production. It prevents cartilage breakdown and acts as an anti inflammatory by inhibiting certain joint destroying enzymes and chemicals.
The functions of Glucosamine and Chondroitin are synergistic. This means they work together better than either of them taken alone. Sort of a 1+1=3 situation.
Omega 3 Fish Oil increases your body’s anti inflammatory hormones. It also inhibits pro inflammatory hormone production. Fish oil is so beneficial to overall body health that it should be included in any nutritional supplement regimen.
Antioxidants acting as fee radical scavengers have anti inflammatory effects. Certain antioxidants like vitamin C are important for collagen formation and strengthen bone as well as cartilage.
Other Natural Anti Inflammatories such as certain plant extracts act as powerful suppressors of inflammation. By blocking inflammatory chemicals joint breakdown is slowed, pain is reduced, and normal function can be maintained.
We now know what Osteoarthritis is and why it is effecting you. Taking action in the key areas of diet, exercise, and proper supplementation may halt or reverse the effects of this condition.
These actions are critical regardless of whether you seek medical intervention. You can do something right now to ease the pain. The fight against degenerative joint disease must begin with you.