Book Notes: Pain Free 1-2-3
Chapter 5: When Inflammation Leads to Pain
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What Mediates Inflammation?
As noted above, the body creates inflammatory chemicals called “cytokines” in response to injury. These attract the different cells that mediate inflammation. In people with excess inflammation, the cytokine levels are elevated. Although there are a very large number of different cytokines (it is not necessary to go into all the different ones), two simple tests will tell you whether you have excess inflammation. These are the sedimentation rate (costs approximately $15) and the C Reactive Protein (CRP, which costs approximately $70). In fact, people with an elevated CRP may be three times as likely to have a heart attack—making it more sensitive than cholesterol as a predictor of future heart attacks. A normal CRP is one or less. Between one and two is considered mildly elevated. Over two is considered very elevated. Elevated CRP can also be seen in strokes, cancer, colitis, autoimmune diseases (e.g. Lupus), Alzheimer’s, and many other medical problems.
All this tells us that there is a balance point where inflammation serves us, but if it is out of balance it can wreak havoc. Again, it is important not to confuse the trigger for the inflammation (e.g. inhalation and food allergens, dust, wear and tear, etc.) with why your body is prone to the inflammation. Being overly prone to inflammation, or
“pro-inflammatory,” means that the chemicals in your body that regulate inflammation are out of balance. Conventional medicine uses anti-inflammatory drugs to poison parts of the inflammatory system. These can be effective, but they can also result in high levels of toxicity and do not seem to prevent long-term damage like the natural approaches.
Arthritis Pain
Other Types of Arthritis:
Psoriatic Arthritis. Psoriatic arthritis is non-destructive symmetrical inflammation of joints, which occurs along with the skin disease psoriasis. A clue to its presence is “pitting” in the fingernails, which looks like someone stuck a needle tip into several places in the nails.
Gouty Arthritis and Pseudo Gout. Gout is arthritis caused by the accumulation of uric acid crystals in the joints. The big toe joint is most commonly affected. Gouty arthritis is very painful. The diagnosis is made when crystals are found in fluid aspirated from the affected joint, although a clinical diagnosis is often made by an elevated uric acid blood test and sudden pain and swelling in the joints (especially the big toe). It is treated in the acute phase (first week) with NSAIDs. If attacks happen more than twice a year, Allopurinol® is often prescribed, after the acute attack settles down, to decrease accumulation of uric acid. Colchicine® can also be used for acute attacks. Although attacks of gout can be slightly decreased by avoiding organ meats, seafood, beans, and peas, the benefit is modest and I don’t know if it is really worth bothering with. I think it is worthwhile, however, to avoid fructose, beer and excess alcohol (beer is more of a problem with gout than other types of alcohol).3
Pseudo Gout (calcium pyrophosphate deposition disease) is a very similar disease, but the crystals look different under the microscope, and they are not uric acid.
Systemic Lupus Erythematosus and Other Auto-immune Diseases. These can also cause arthritis. See Chapter 11 for information on how to treat this disease.
Hemochromatosis. Arthritis of the hand joints occurs in the disorder of excess iron called hemochromatosis. Its treatment is iron elimination by donating blood regularly and avoidance of iron supplements. It often occurs in association with diabetes and/or liver inflammation. Suspect this if you have elevated iron (check an “iron percent saturation and ferritin”). If elevated, see a gastroenterologist or liver specialist. If caught early, it is easy to treat. If caught late, it can kill you. It is often familial/genetic, so if one family member has it, everyone in the family should be checked for it. It is not rare, and missing this diagnosis is tragic. In fact, it is enough of a problem that we elected to leave iron out of the vitamin powder (for this and other reasons).
Homeopathy is not based on the diagnosis (e.g. osteoarthritis) but rather on the specific nature of the symptoms. Homeopathic remedies have the benefits of being very safe and also rather inexpensive. Because it is so diluted, one drop of a substance can make thousands of gallons or many thousands of tablets of the homeopathic remedy. For the homeopathic remedies below, look for a 6, 12, or 30 C potency, and take it 4 to 6 times a day. Only take it as long as it is helping. Below are some of the better known homeopathics for different kinds of arthritis pain (for more information, see Dana Ullman’s book Homeopathic Family Medicine, available online at http://www.homeopathic.com/.):
1. Rhus Tox (poison ivy). This is a commonly used homeopathic for acute arthritis pain. It is especially helpful when the pain is worse on first waking and decreases after you’ve moved around awhile. Morning stiffness is one example of this. It is especially helpful for those of you who tend to be sensitive to wet and cold weather and feel worse at night. If this does not work, try rhododendron.
2. Bryonia. This remedy is best used when your pain is activated by moving around, especially if the pain is severe and helped by heat and laying still.
3. Apis. This remedy is best used if you have great swelling in your joints with hot burning, stinging pain, and pain that is aggravated by hot compresses and eased up by cold.
4. Belladonna. This remedy is best used if you have red, hot, swollen joints that are aggravated by touch or motion and have rapid onset and relief with hot compresses (e.g. gout and perhaps rheumatoid arthritis).
5. Ruta. Consider using this if your pain developed at the site of an old injury, is aggravated by motion and cold, and is worse in the morning.
6. Kalmia (Mountain Laurel). This remedy is most helpful for sudden onset of severe arthritis that moves from joint to joint, is aggravated by cold and helped by heat, and is associated with numbness, weakness, and heart conditions.
7. Caulophyllum (Blue Cohosh). This remedy is best used if your arthritis predominantly affects the small joints in your hands or feet, and closing one’s hands creates a lot of pain.
8. Arnica. Although more often used for acute traumatic injury (my favorite is a cream called Traumeel®), it can also be helpful for arthritis pain.
