The message of pain

Joanna Evans — Tue, 01 Sep 2009 09:07:00 GMT

We are a society gripped by constant pain of one sort or another—and life appears to be getting more painful by the year. In the UK alone, according to Liam Donaldson, the UK’s principle medical advisor, at least a third of all households—representing some eight million of us—have one or more members suffering from moderate-to-severe persistent pain of some variety. This is two to three times more than such sufferers in the 1970s.

Matters are even worse in the US. According to the American Pain Foundation, more than 26 million Americans aged 20–64 experience frequent back pain alone. Almost a third of all adults aged 65 or over report some variety of knee pain, and more than one-sixth report having hip pain or stiffness. Staggeringly, some 25 million cases of pain have to do with migraine, or jaw or lower facial pain such as of the temporomandibular joint (TMJ).

Despite the fact that pain is the biggest ‘illness’ of our times—vastly overtaking cancer, diabetes or any of the other degenerative diseases in its incidence—medicine’s only answer is to use chemicals to block or suppress pain signals or inflammation in the nerves, brain or muscles. Millions of patients survive for years on over-the-counter medications such as paracetamol, aspirin and anti-inflammatories, despite warnings against their long-term use.

As our cover story this month points out, the stark reality is that the pills just don’t work. Most nursing-home patients remain in constant moderate or severe pain, despite the universal use of a plethora of pain-killing medications. And most of the rest of us report that, most of the time, our pain is beyond the reach of most drugs.

This is not surprising, given what we’re now learning about how the body works. The rationale for pharmaceutical medicines rests on the premise that chemical processes in the body progress in a linear and orderly fashion, so that a drug can precisely target tab A in order to pop into slot B. However, we’re now beginning to realize that chemical reactions in the body are distinctly not linear, but chaotic.

As frontier biologist Bruce Lipton observed in his book The Biology of Belief, interactions between a small group of cellular proteins in fruit-fly cells involved in the synthesis and metabolism of RNA molecules make up an impossibly complicated web of interconnections that can never be reduced to a simple linear progression of cause and effect.

Recently, scientists have theorized that the more than 6000 proteins in the human body have a network of more than 70,000 physical interactions. Proteins with certain physiological functions such as gender determination also influence proteins that have an entirely different job, such as RNA synthesis. Trying to tease apart or isolate any protein’s sole job in any genuine sense becomes virtually impossible.

Furthermore, we are now beginning to recognize that Nature is economical with its building blocks: the same proteins or signals may be used in entirely separate organs or tissues of the body for completely different functions. Pain, we are learning, is not merely symptomatic of mechanical parts breaking down, but relates to a complex interaction between mind and body. This means that many alternative forms of new medicine can treat pain by targeting mental and emotional issues.

Practitioners of these new modalities now recognize that pain can be a symptom of too little or too much of something our body needs. New evidence, for instance, shows that pain is often the side-effect of a simple lack of vitamin D—which may be why Britons, living in a sunshine-poor country, have a proportionately high incidence of pain.

Clearly, it’s time that we stop trying to just temporarily turn off pain and, instead, listen harder to what it’s trying to tell us.

Preemptive strikes

Lynne McTaggart — Fri, 04 Jan 2008 16:54:00 GMT

Nothing makes my blood run cold so much as hearing about a new variety of ‘preventive’ medicine. This alarming notion aims to stop disease in its tracks by treating the patient with a just-in-case remedy while he is still healthy. Yet, medical preemptive strikes don’t have a good track record. They’re usually at the heart of every bright idea gone bad, leaving carnage in its wake. Hormone replacement therapy, claiming to stave off not only menopause, but also heart attacks and cancer, turned out to increase the very diseases it was meant to prevent. Diethylstilbestrol (DES), the miracle drug taken to prevent miscarriage, caused cancer and infertility among an entire generation. The list goes on and on.

The most pervasive preventative of our generation is aspirin. Since the mid-1990s, this no-frills non-steroidal anti-inflammatory drug (NSAID) has been served up to patients as a cheap and safe means to prevent heart attacks and strokes and, lately, to reduce cancer.

But new evidence shows that, far from preventing death and strokes in the elderly, aspirin brings them on. Oxford University researchers who examined data from the last quarter-century’s worth of aspirin preventative use found an astonishing sevenfold increase in bleeding in the brain—intracerebral haemorrhagic stroke—among elderly patients.

Aspirin and other NSAIDs have long been known to cause stomach bleeding—despite attempts at buffering these effects. However, the latest evidence, detailed in the January 2008 edition of WDDTY, finally places the damage in bold relief. Aspirin kills 20,000 Americans and puts another 100,000 in hospital every year through aspirin-induced GI haemorrhage.

Doctors have had numerous warnings that aspirin isn’t the magic bullet as once thought. The 1994 meta-analysis that launched aspirin as a cardiac preventative medicine was based on faulty conclusions. The Antiplatelet Trialists’ Collaboration (ATC), which pooled together smaller studies, concluded that a few weeks of antiplatelet therapy could halve the risk of deadly blood clots in high-risk patients (BMJ, 1994; 308: 235–46).

However, the Thrombosis Research Institute uncovered a laundry list of errors—including the shabby quality of the individual studies pooled, mistakes in reporting results, even basic errors in arithmetic and in the recommended dosages. The TRI concluded that the review did not provide adequate evidence to support the widespread use of aspirin to prevent stroke (BMJ, 1994; 309: 1213–7).

There is also an increasing incidence of what the medical community has chosen to call ‘aspirin resistance’. Lately, doctors have discovered that many people who religiously take aspirin in the hopes that it will save them go on to develop blood clots that result in heart attacks and strokes (Am Heart J, 2005; 149: 675–80). This led doctors to wonder whether aspirin’s effectiveness is hit and miss. But, as the Oxford evidence shows, aspirin not only fails to stop the thief in the night—it is itself the thief, responsible for haemorrhagic stroke. The Oxford researchers now believe that aspirin has outstripped high blood pressure as the leading cause of stroke in the elderly.

Ever on the look out for some quick fix to the catalogue of suffering they witness every working day, doctors uncritically embraced aspirin as a modern-day magic bullet: open to all to manufacture, within reach of the poorest of patients. But it’s now clear that aspirin is just the very latest in a long list of drugs that causes the very condition it is intended to prevent.

Lynne McTaggart - What Doctors Don't Tell You : aspirin

The message of pain

Preemptive strikes