A New Way to Deal with Pain
Relief may finally be on the way.
In the fitness business, we deal with a lot of pain. Minor bruise and sore pains, major injury pains and the relentlessness of chronic pain. But regardless of the type you're experiencing, we've faced three big obstacles in dealing with it.
The first obstacle is a problem of measurement. With most medical conditions, there are clearly defined things you can measure. If you're a diabetic, you can take a quick test to see what your blood sugar levels are and how much insulin you might need. The amount of pain you're experiencing has no such standardized scale. What we have are guesses.
If you stub your toe, you might say the pain is a 7 out of 10. But a family member might classify the same pain as a 3 out of 10. What's worse is that there are more than 20 different pain measurement scales.
Some people use the visual analog scale (VAS) where you specify your level of pain by pointing to a spot along a continuous line. You might use a numerical rating scale (NRS) that could range from 0-10 or 0-100. There's even the Wong-Baker FACES pain rating scale that uses a series of six faces to help you identify the level of pain you feel.
The second obstacle is a problem of definitions. Sometimes what people think of as pain... isn't. For example, when you get tired from exercise, the thing that slows you down is usually fatigue, not pain.
Our bodies have a group of nerve fibers called ergoreceptors. These fibers respond to metabolites released by our muscles when we exercise, calcium ions, lactate and hydrogen ions. When our brains receive signals from these ergoreceptors, those signals force you to slow down so that your muscles don't use up all their available energy. They try to keep something in reserve.
Understanding the difference between fatigue and pain can be difficult. Fatigue can create anxiety and fear in people unaccustomed to it, stopping them from pushing themselves hard enough during workouts to see results. We think of it as pain, but it's just our bodies saying they're tired.
The third obstacle is a problem of effectiveness. In a study published in The Annals of Internal Medicine in 2019, researchers wanted to see how effective various topical pain creams were. There were three groups in the trial, with several different types of pain creams (and a placebo). The goal was to measure the average pain score, one month after treatment.
What the researchers found, was that there were no differences in pain reduction between people who had any of the different types of pain measured. It also didn't matter if the subjects used a pain cream or a placebo, there were no differences in the pain reducing effects.
You can read an overview of this study by clicking this link: Compounded Topical Pain Creams to Treat Localized Chronic Pain: A Randomized Controlled Trial.
For people who deal with chronic pain, this isn't news. Many have moved from one pain reliever to another, always hoping the next one will provide relief, but to no avail.
Help is coming. Scientists now think they have a way to deal with the first problem of measurement. In 2013 neuroscientists from the University of Colorado Boulder, New York University, Johns Hopkins University, and the University of Michigan used functional magnetic resonance imaging (fMRI) to identify objective measures of pain. Using heat as a pain source, they were able to predict the pain level someone was going to experience with about 95% accuracy.
The reason that's so important is that it allows researchers to properly measure the pain RELIEVING capabilities of things like creams, gels and pills. Instead of relying on someone saying, “Yeah that lowered my pain from a 9 to a 3” they can document the precise level of relief it provides.
There's also some hope dealing with the third problem, finding a product that's more effective than a placebo. As cannabis is being decriminalized across the country, there are dozens of clinical trials looking into it's uses as a pain reliever. In early trials some oils and creams made with cannabis have shown to be surprisingly effective, at rates much higher that traditional therapies.
I'm not a fan of suggesting that people try experimental products. But in this case, because the current treatments are often no more effective than taking a sugar pill, I'm going to suggest you bring up cannabis treatments with your doctor. For the first time in a long time, researchers think cannabis may provide relief where other options have failed.
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