Pain Relief by Ray Sahelian, M.D. adult health natural supplement information

Pain is a way for our body to let us know that something is wrong and should be fixed. One in 10 U.S. adults suffer pain that lasts a year or more.  Fully a quarter of American adults say they have suffered a day-long bout of pain in the past month, according to the National Center for Health Statistics, part of the CDC. Lower back pain is among the most common complaints, along with migraine or severe headache, and joint pain, aching or stiffness. More than a quarter of adults interviewed said they had experienced low back pain in the past three months. Migraines or severe headaches affected 15 percent of adults in the past three months, and 4 percent of adults had used a narcotic pain drug in the past month for pain relief.

Diet and pain
It is possible that a diet high if fish, fish oils, and vegetables could reduce pain associated with chronic inflammation, such as arthritis pain. My guess is that a diet high in sugar and junk foods may increase inflammation and cause joint and muscle aches and pains.

Form of Pain

Pain may be sharp or dull, intermittent or constant, or throbbing or steady. Sometimes pain is very difficult to describe. Pain may be felt at a single site or over a large area. The intensity of pain can vary from minor to intolerable. Pain may also be acute or chronic.

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Addiction to pain killer
I found your website by searching online for info on addiction and pain killer prescriptions. My husband, has been seeing a pain management specialist because of his back for about 4 years. And since then has been on alot of heavy prescribed pain narcotics. He is still taking the pain prescriptions. What are some required steps or guidelines, a physician could perform to monitor their patient for adversely affected signs of pain killer addiction? Meaning, is a physician required to routinely monitor pain medication levels, either by blood or urine? Or run a diagnostic test and drug screening, if prescribing a controlled substance? Knowing that some of these pain medication prescriptions may cause addiction and a doctor cant truly trust what a patient says. I thought there would be certain requirements a physician must perform. I understand we are all adults and are fully responsible for our own actions and I'm honestly not blaming the doctor for my husbands addiction to pain killers at all. When I tried searching online, I was not able to locate any material on this. And I find it hard to believe that there are no set rules or guidelines for prescribing pain medicine narcotics, otherwise a physician could prescribe narcotics for a long time to their patient and not worry if they have liver damage, toxic levels, or abusing the meds.
   A. We are not aware of any rules or guidelines since each patient is different and rules by government officials cannot micro manage a patient's need for pain medication. A doctor is supposed to use his or her best judgment.

Pain killer and high blood pressure
Popular painkillers such as aspirin, ibuprofen and acetaminophen can raise blood pressure and thus the risk of heart disease. Those who take such painkiller drugs for most days in a week are more likely to be diagnosed with high blood pressure.

Natural pain reliever
White willow bark has salicin, a substance similar to aspirin.
 

Acute Pain

By definition, acute pain after surgery or trauma comes on suddenly and lasts for a limited time, whereas chronic pain persists. Acute pain is a direct response to disease or injury to tissue, and presumably it will subside when you treat the disease or injury.

Chronic Pain

Chronic pain goes on and on--for months or even years. Common types of chronic pain include back pain, headaches, arthritis, cancer pain, and neuropathic pain, which results from injury to nerves. The first step in treating chronic pain is to identify the source of the pain, if possible. Many people with chronic pain try to tough it out. But persistent pain should never be ignored because it could signal disease or injury that will worsen if left untreated. Sometimes, it turns out that the cause of pain is unknown. Regardless of the type of chronic pain, the physical and emotional effects can be devastating.
   Which drugs are best for treating people with chronic pain, such as back pain? Opioids such as codeine or morphine are widely used as painkillers. But in the long term, while opioids may treat pain, there are concerns about their potential for addiction and side effects such as drowsiness and impotence. A review of 41 studies, done by researchers from the Institute for Work & Health and Toronto Western Hospital, sought to shed light on some of these concerns. Of the 6,019 patients included in the review, 80% had back pain or arthritis. Back pain is a leading cause of workplace disability. One surprising finding was that certain anti-depressants and anti-inflammatory drugs appeared just as effective as most opioids in improving patients' pain and ability to function. Only the strongest opioids -- morphine and oxycontin -- seemed more effective in reducing pain. However, they were no better than the other drugs in improving people's ability to function in daily life. The review appears in the May 23, 2006 issue of the Canadian Medical Association Journal.
   Transcendental meditation may reduce the brain's reaction to chronic pain.
   People who suffer from chronic pain have impaired short-term memory since the brain is multitasking.

Chronic Pain and Cytokines

Low blood levels of two anti-inflammatory proteins could be key to chronic pain. Low concentrations of two cytokines, IL-4 and IL-10, were found in patients with chronic widespread pain, according to a German study published in the August, 2006 issue of Arthritis & Rheumatism. Cytokines are proteins that act as messengers between cells.

Pain Tolerance

People differ remarkably in their ability to tolerate pain. One person cannot tolerate the pain of a small cut or bruise, but another person can tolerate pain caused by a major accident or knife wound with little complaint. The ability to withstand pain varies according to mood, personality, and circumstance. In a moment of excitement during an athletic match, an athlete may not notice a severe bruise but is likely to be very aware of the pain after the match, particularly if the team lost. People who continually have their sleep disrupted, whether by insomnia or a crying newborn, may become more susceptible to pain.

Pain Sensation with Age

The ability to tolerate pain may change with age. As people age, they complain less of pain, perhaps because changes in the body decrease the sensation of pain. Nerves may not be as sensitive. On the other hand, older people may simply be more stoic than younger people.

Pain Receptors

Pain due to injury begins at special pain receptors scattered throughout the body. These pain receptors transmit messages or signals as electrical impulses along nerves to the spinal cord and then upward to the brain. Sometimes the signal evokes a reflex response. When the signal reaches the spinal cord, a signal is immediately sent back along motor nerves to the original site of the pain, triggering the muscles to contract without involving the brain. For example, when people inadvertently touch something very hot, they immediately pull away. This reflex reaction helps prevent permanent damage. The pain signal is also sent to the brain. Only when the brain processes the signal and interprets it as pain do people become conscious of the pain. Pain receptors and their nerve pathways differ in different parts of the body. For this reason, pain sensation varies with the type and location of injury. For example, pain receptors in the skin are plentiful and capable of transmitting precise information, including where an injury is located and whether the source was sharp, such as a knife wound, or dull, such as pressure, heat, or cold. In contrast, pain receptors in the intestine are limited and imprecise. The intestine can be pinched, cut, or burned without generating a pain signal. However, stretching and pressure can cause severe intestinal pain, even from something as relatively harmless as a trapped gas bubble. The brain cannot identify the precise source of intestinal pain; the pain is difficult to locate and is likely to be felt over a large area.

Pain management
Using opioids for pain long term pain management is not a good idea. Accumulating evidence from around the world suggests that long-term opioid users have significantly lower rates of employment, worse quality of life, and increased healthcare utilization. About 90% continued to have moderate, severe, or very severe pain. Therefore, it appears that using opioids for pain management is harmful in the long term.

Pain Treatment - Opoids or Antidepressants?
Opioids such as codeine or morphine are widely used as painkillers. But in the long term, while opioids may treat pain, there are concerns about their potential for addiction and side effects such as drowsiness and impotence. A new review of 41 studies, done by researchers from the Institute for Work & Health and Toronto Western Hospital, sought to shed light on some of these concerns. Of the 6,019 patients included in the review, 80% had back pain or arthritis.  One surprising finding was that certain anti-depressants and anti-inflammatory drugs appeared just as effective as most opioids in improving patients' pain and ability to function. Only the strongest opioids -- morphine and oxycontin -- seemed more effective in reducing pain. However, they were no better than the other drugs in improving people's ability to function in daily life. This type of review, which is known as a meta-analysis, looked for high-quality studies that compared opioids to placebo treatment, or to other active treatments including tricyclic anti-depressants (TCAs) and non-steroidal anti-inflammatory drugs (NSAIDs). Opioids are either derived naturally from opium or synthesized in the lab. Researchers used studies of patients with chronic, non-cancer pain, because concerns about addiction are not as relevant in patients with terminal cancer or with short-term acute pain that occurs, for example, after surgery. There was not enough information in the studies to answer questions about addiction or impotence. The two most significant side effects were constipation and nausea. "There is a common perception that addiction doesn't exist in chronic pain patients because it's believed that the best studies – randomized, controlled trials – do not find it," said co-author Dr. Angela Mailis-Gagnon, director of the Comprehensive Pain Program at Toronto Western Hospital. "This is misleading, because the trials weren't designed to look for addiction, and at an average of five weeks, they didn't last long enough for an addiction to develop," she said. "It must be stressed that the results from this review cannot be easily applied to real-life chronic pain patients, particularly those attending pain clinics," said Mailis-Gagnon. "These patients are on much higher doses than the doses used in the studies. Their cases are also more complex, because they may be taking other drugs, have a higher risk of abusing drugs and have other psychiatric issues." SOURCE: Institute for Work & Health. May 23, 2006 issue of the Canadian Medical Association Journal.

Pain medication
There are dozens of pain medications and combinations available. The most frequently used pain medications are aspirin, acetaminophen, and NSAIDs such as ibuprofen. There are also pain medications available as cream and gel. The product name for acetaminophen is Tylenol.

Danger of pain medication by cream
People who use large amounts of skin-numbing creams and lotions for pain relief, often in conjunction with cosmetic procedures, are at risk of irregular heartbeats, seizures and even death. Topical pain creams can be applied in amounts so large that a lethal dose of the chemicals can enter the bloodstream. A 22-year-old woman and a 25-year-old woman who applied pain numbing creams after laser hair removal on their legs later died. After the procedure, the women then wrapped their legs in plastic wrap, as they were instructed, to increase the creams' numbing effect. Both women had seizures, fell into comas, and subsequently died from the toxic effects of the pain drugs. Pain numbing creams and lotions, available both by prescription and over the counter, are approved to soothe burning or itching skin as well as pain before, during and after various procedures. They contain numbing drugs that can include lidocaine, tetracaine, benzocaine and prilocaine. Leaving the creams on the skin for long periods of time or on large portions of the skin can increase the risk.
 

New Pain Medication
Lonsys (fentanyl iontophoretic transdermal system, Ortho-McNeil) A needle-free, patient-activated analgesic system has been approved by the FDA for the short-term management of acute post-operative pain in adult patients requiring opioid analgesia during hospitalization. Ionsys is expected to be available sometime in 2007.

   Cephalon Inc. is marketing a pain medication Fentora to treat pain in certain cancer patients. Fentora, a dissolving narcotic that aims to treat intense, rapid-onset pain in cases where other opioid-based pain medications no longer work, won conditional approval from the FDA in June, 2006.
Cephalon also makes Actiq, another product approved to treat such pain also termed breakthrough pain. Actiq brought in $172 million in second quarter sales, but it may soon face generic competition. Under a previously announced deal with Barr Pharmaceuticals Inc, Cephalon agreed to provide the generic drugmaker rights to make a cheaper version of Actiq.

Pain Pill warning

Sterner warning labels for the pain pills acetaminophen, aspirin and ibuprofen are being advised cautioning millions of Americans who take the nonprescription pain pills regularly of potentially serious side effects. The over-the-counter pain pills remain safe and effective when used as directed, says the Food and Drug Administration, even though with aspirin, ibuprofen and other nonsteroidal anti-inflammatory pain pills, there is a risk of gastrointestinal bleeding and kidney injury even when patients take the correct dose. Overdoses of acetaminophen can cause serious liver damage, even death. These pain pills are linked to thousands of deaths a year. The drugs are found in hundreds of products sold to treat pain, headache and fever. The wide availability of those combination products allows patients to unwittingly overdose.

Pain Medicine Overdose

The most common drugs involved in fatal pain medicine overdoses listed on death certificates are prescription opioid painkillers, often obtained illicitly. The worsening abuse of potent opioid drugs, such as oxycodone or fentanyl, coincides with an increase in the prescribing of these pain drugs by doctors, who have been encouraged to treat chronic pain more aggressively by pharmaceutical companies.

Methadone Pain Drug danger

There are reports of death and life-threatening respiratory and cardiac events with the pain drug Dolophine (methadone HCl). These deaths and life-threatening side effects have occurred in patients newly starting methadone for pain control and in patients who have switched to methadone after being treated for pain with other strong narcotic pain relievers. Methadone can cause slow or shallow breathing and dangerous changes in heart beat that may not be felt by the patient. Prescribing methadone is complex. Methadone should only be prescribed for patients with moderate to severe pain when their pain is not improved with other non-narcotic pain relievers. Pain relief from a dose of methadone lasts about 4 to 8 hours. However methadone stays in the body much longer -- from 8 to 59 hours after it is taken. As a result, patients may feel the need for more pain relief before methadone is gone from the body. Methadone may build up in the body to a toxic level if it is taken too often, if the amount taken is too high, or if it is taken with certain other medicines or supplements.

Pain Relief
Q. First I wish to express my appreciation for the newsletters. They are the best I have seen. I have arthritis and fell the other day. It caused some pain from muscle cramps and burses. After a week I seem to be having a lot of "cramping" pain from my back; making me think it could be a slipped disc. What puzzles me is that it seems as if I have the "best" pain relief when I have some wine. Is the acid in the alcohol causing the calcium to be more available to the nerves and muscles?
   A. It is difficult to say how wine provides pain relief in your case. Perhaps it is the alcohol itself which has a numbing effect, or perhaps something else is going on to provide the pain relief that you are experiencing.
 

Pain doctor
 

Pain meds and Pregnancy
Women who take common pain meds known as non-steroidal anti-inflammatory drugs (NSAIDS) during the first trimester of pregnancy run an increased risk of having a baby with a congenital anomaly

There are a number of causes for pain, I will address these in more detail with time:

Abdominal pain
Treatment with the probiotic Lactobacillus acidophilus, a beneficial type of microbe, produces changes in the intestinal tract that help reduce abdominal pain related to irritable bowel syndrome. In fact, the effect of the treatment in reducing pain is on par with that of pain killer morphine. Probiotics help regularize the population of microbes normally found in the intestines.
 

Anal pain

Pain in your bottomside can mean that you simply have a bruise from a nasty fall or that a hemorrhoid has become clotted with blood. Fissures (cracks in the skin surrounding the anus) are another common cause of anal pain. In addition, some people have occasional muscle spasms in their rectums. These spasms, called proctalgia fugax, usually occur at night. Common among teenagers, the painful spasms tend to subside as a person ages.

Ankle pain
MR imaging can make a difference in the management of patients with ankle pain, changing treatment in about one-third of the patients. A study, of 91 patients, found that MRI changed the management plans of 35% of patients, said Philip W.P. Bearcroft, MD, of Cambridge University Hospitals in England. "This is itself is significant, but more significant is the fact that before an MRI was done, 65 of the 91 patients were scheduled to undergo surgery. After an MRI was done, nine of those patients were treated nonsurgically," Dr. Bearcroft said. Dr. Bearcroft and his colleagues conducted the study in conjunction with an orthopedic foot and ankle surgeon at a regional teaching hospital. The surgeon noted his proposed treatment plan for each patient before and after an MR examination. The surgeon also noted the potential diagnoses for each injury. Before an MR examination was done, the surgeon indicated an average 2.3 possible diagnoses per patient. "After MRI was performed, the number of diagnoses per patient was reduced to 1.2," said Dr. Bearcroft. MRI increased the referring physician's confidence in his diagnoses, Dr. Bearcroft said. "In 66% of the MRI examinations performed, the referring surgeon felt that his understanding of the patient's disease had either depended upon or had been substantially improved by MRI," he added. American Roentgen Ray Society
 

Chest pain

Chest pain is one of the most frightening symptoms you can have. It is sometimes difficult even for a doctor or other medical professional to tell what is causing chest pain and whether it is life threatening. Any part of the chest can cause pain in the chest, including the heart, lungs, esophagus, muscle, bone, and skin. Because of the complex nerve distribution in the body, chest pain may come from another part of the body. The stomach or other organs in the belly (abdomen), for example, can cause chest pain.
 

Elbow pain

Tennis elbow pain afflicts about 1 to 2 percent of the population. For more information, see tennis elbow pain.

Foot pain
Pain and stiffness due to plantar fasciitis, an inflammatory condition involving the sole of the foot, is relieved by "iontophoresis" treatment with acetic acid. Iontophoresis refers to the use of a small electric current to move ionized substances through the skin into tissues.
 

Gallbladder pain
The gallbladder is a digestive organ located on the right side of the abdomen, just under the edge of the ribcage. Gallbladder problems, including gallstones, will typically cause pain on the right side, though gallstones may be present without pain for a long time.

Heel pain and plantar fasciitis
Dr. Joseph Fox, podiatric surgeon with Gramercy Surgery center in New York, says: "If you experience nagging heel pain when you wake up in the morning or after spending a significant time on your feet, you're not alone. Heel pain is the most common complaint among podiatric patients, affecting more than one million Americans each year. The cause of the pain, most often, is plantar fasciitis -- an inflammation of the tendon that runs along the arch of the foot from the heel to the toes. Fortunately, about 90 percent of all plantar fasciitis cases resolve with conservative treatment. However, up to 10 percent of cases, or 100,000 annually, may become chronic, excruciating and debilitating. While invasive surgery has been the primary option to treat chronic plantar fasciitis, a new, minimally invasive technique called Coblation therapy promises pain relief and resumption of normal activities with fewer side effects."

Jaw pain
People who suffer from chronic jaw pain may be able to help themselves by learning how to manage the body's response to pain and stress. Disorders of the temporomandibular joint, commonly called TMJ, involve pain in the jaw, joint and surrounding facial muscles. Treatment may include pain medication, physical therapy and, in some advanced cases, surgery. A form of treatment called biopsychosocial therapy helps patients with TMJ disorder manage their pain. The treatment is a combination of cognitive-behavioral therapy and biofeedback; the behavioral therapy aims to help patients cope with their jaw pain, while biofeedback can help them learn how to recognize and control any bodily sensations that arise with stress -- such as muscle tension and jaw clenching. The therapy not only reduces patients' jaw pain, but also improves their emotional distress. Journal of the American Dental Association, online February 5, 2007.

Joint pain
Joint pain is often caused by osteoarthritis or rheumatoid arthritis. For more details on joint pain, see the web page.

Knee pain
Older adults with knee arthritis or other chronic knee pain may be at heightened risk of breaking a hip. The risk does not stem from the higher rate of falls among people with knee problems. Instead, they may suffer more fractures because they tend to have more-severe falls or due to their reduced physical activity, they may have more brittle bones.
     For controlling pain after after knee surgery to reconstruct the anterior cruciate ligament (ACL), continuous nerve blocks offer no advantage over conventional painkilling injections.
 

Q. Is there a natural knee pain supplement that works?
   A. Knee pain has many causes. If the knee pain is due to osteoarthritis, it is possible that glucosamine, chondroitin, or a joint formula called Joint Power Rx could be helpful.

Q. Just thought I'd relate my experience. I was a runner for over twenty years before slowing down and mostly walking. About three years ago I developed severe right knee pain where I couldn't walk a quarter mile without pain. Ibuprofen didn't help my knee pain much either. I self-diagnosed arthritis and found suggested treatments on the web. I chose Cosamin DS and began with three capsules a day for the first month then two a day. In three days my knee pain was substantially gone during normal activity including some walking. Over time I increased my exercise and activity. After several months taking Cosamin DS I could even run a little if I was careful. I'm now sixty-five years old and have started a more vigorous running routine after finding that my knee(s) have benefited from this Cosamin DS supplement which I continue to take. I know some arthritis is present and feel it on occasion but I'm really pleased to be able to actually run again even if at a reduced pace and intensity.
   A. Cosamin DS has Sodium Chondroitin Sulfate, Vitamin C (as Manganese Ascorbate), Glucosamine HCl, and Sodium Chondroitin Sulfate. Glucosamine and chondroitin have helped many people with knee pain due to osteoarthritis.

Lower back pain relief
Back pain is a leading cause of workplace disability.
     Water aerobics can help ease the pelvic and back pain that plague many women during pregnancy. Among healthy pregnant women, those who do water aerobics report less low back pain and less work missed due to back pain than those who perform land-based exercise. More than one third of women experience low back pain during pregnancy, which can increase the risk of suffering this type of pain later on.

Neck pain
Neck and shoulder pain commonly stems from the upper trapezius muscle, which spans the upper back and shoulders, and helps move the neck. Repeatedly performing "monotonous" tasks, such as computer operations or assembly-line work, can cause the muscle to become tight and tender.
   Sleeping with a neck support pillow and doing neck exercises can help ease chronic neck pain. Some people who have neck pain, particularly in the morning due to a pillow that does not support the neck may find pain relief from a Tempur-Pedic foam pillow. Before taking long term pain relief medications, consider the use of a Tempur-Pedic foam pillow, it may provide a great deal of pain relief.
   Whiplash injury can cause neck pain. See whiplash for more info.
   For those with chronic pain in the trapezius muscle, the muscle that extends along the back of the neck, high-intensity strength training targeting the neck and shoulder muscles provides long-lasting pain relief.
   Strength training eases chronic neck and shoulder pain, a problem that has grown increasingly common as people spend more time on computers. Strength-training by working out neck and shoulder muscles using hand weights, three times per week for 20 minutes can provide good relief for neck pain.

Arm pain
Arthritis pain relief
Breast pain
Chronic pain
Chronic fibromyalgia pain syndrome
Ear pain
Eye pain
Groin pain
Hip pain
Kidney pain
Left side pain

Leg pain
Liver pain
Muscle pain

Sciatic nerve pain
Sex pain

Stomach Pain
Stomach pain could be a minor, temporary symptom, or It could point to serious underlying health trouble. Concern arises when the stomach pain contains over days and weeks.

Tennis elbow pain
Tennis elbow is an overuse injury to tendons around the outer side of the elbow.

Testicle pain
Tooth pain
 

Trigeminal neuralgia pain
For more information on trigeminal neuralgia.
 

Wrist pain
One cause of wrist pain is carpal tunnel syndrome which is painful compression of the median nerve that extends from the forearm into the wrist.
 

Nerve pain
Cephalon Inc. says its painkiller Fentora, which is currently approved to treat breakthrough pain in cancer patients, also works more broadly as a treatment for nerve pain. The biotechnology company said Fentora helps relieve pain in patients with a variety of chronic conditions associated with nerve, or neuropathic, pain.
 

Q. The use of alpha lipoic acid for nerve pain as a result of diabetic neuropathy, does this apply to nerve pain resulting from surgery. My wife had open heart bypass surgery and they harvested veins from the calf of one leg. Immediately after the surgery, she started having nerve pain from the knee to the foot in that leg. The nerve pain ranges from a kneading type pain to burning to sticking and never seems to let up very much. It has been almost two years since the surgery and , if anything, the pain has gotten worse. Doctors only seem to recommend various drugs such as Neurontin and she is highly allergic to every drug they have recommended.
   A. We have not seen research on nerve pain after surgery and alpha lipoic acid.

Pelvic pain
In women with chronic pelvic pain due to pelvic floor spasms, Botox injections seem to reduce pressure and relieve some of the pain. Pelvic floor spasms occur when muscles in the pelvis contract tightly and unexpectedly. In addition to the distressing pain that typically occurs, affected women can experience urinary problems, pain during intercourse, and sensations of pressure or heaviness in the lower abdomen.

Shoulder Pain

Shoulder pain is an extremely common complaint. Some common causes of shoulder pain include: Bursitis or rotator cuff tendonitis are the most common diagnoses in patients with shoulder pain. Additional causes of shoulder pain include rotator cuff tear, frozen shoulder, calcific tendonitis, shoulder dislocation or shoulder instability, labral tear, arthritis pain, and biceps tendon rupture.
 

Natural Pain reliever
The human body produces a painkiller that, at least in rats, can be several times more powerful than morphine. Researchers extracted from human saliva a natural pain reliever, called opiorphin, which has similar characteristics to sialorphin, a natural painkiller they had earlier detected in rats. They injected the rats with opiorphin to suppress the pain of chemically induced inflammation and acute physical pain and found that in both cases the administered dose of 1 milligram of opiorphin provided the same painkilling power as 3 to 6 mg of morphine. The researchers at the Institut Pasteur said in a statement they hope to identify which physiological conditions trigger the natural release of opiorphin and to further explore possibilities for opiorphin as a painkiller.
 

Pain Medicine from a Snail

A new pain drug based on the venom of a deadly sea snail was launched in Britain in July, 2006, offering hope to patients with chronic pain who do not respond to or cannot tolerate treatments like morphine. Japanese drugmaker Eisai Co Ltd, which acquired European rights to Prialt from Ireland's Elan Corp Plc, is marketing the medicine first in Britain before rolling it out in other European markets. The drug is the synthetic equivalent of a substance produced by the predatory cone snail Conus magus, found off the Philippines, which uses it in a venomous "harpoon" to paralyze fish. In humans, it shuts down pain pathways by stopping nerve cells from sending signals to the brain. The drug is extremely potent and can cause side effects including dizziness, nausea and blurred vision. The pain drug is only designed for a small group of patients with cancer and other serious conditions linked to severe pain and is delivered through a tiny pump directly into fluid surrounding the spinal cord.

Pain Questions
Q. I am looking for an alternative to western medical advice and treatment, 'pop this pill', for the extremely painful joint and muscle pain I experience daily. After my return from the Gulf War, 1991, I have experience multiple symptoms of 'unexplained etemology'. Currently I take 1 X 6 hours 50mg Tramadol; it does help with the pain, I elected to so low a dose to prevent addiction problems, yet I am looking for a more natural and potent herbs or alternative to ingesting the synthetic opium. I look forward to your response, thank you much. As well I have been diagnosed with Fibromyalsia and Chronic Fatigue Syndrome.
   A. Unfortunately, we are not in a position to make an individual diagnosis or treatment.

Q. I am presently taking oxycontin prescribed by my doctor for leg pain and back pain from failed back surgery and nerve damage. Can I take the Kava while taking the Oxycontin pain medicine or can I take the Kava to help with withdrawals or withdrawal pain while I try to cut back on the Oxycontin?
   A. If musculoskeletal pain is due to tense muscle or spasm of muscles, then perhaps kava, by relaxing muscles, could help the back pain. Kava has mild analgesic properties, but it is not considered a true pain killer. We don't suggest the daily use of kava for more than 1 or 2 weeks at a time without taking a break.

Q. I have a rather odd condition it seems. I have developed a pain in my face that I can only describe as if the bone in my face is being eaten. With that pain comes a horrible taste in the right side of my mouth. When I use T Bomb II from MHP the pain and taste go away. Upon cycling off T Bomb II the pain and taste return after about 3 days. I cycle back on it and the pain and taste go away. I have discussed this with two doctors and other health professionals and none of them can give me an answer to why this is happening. Is this a problem you have heard of?
   A. It is difficult to make a diagnosis without a full history and physical exam.

Q. Do you know about the pain relieving gel Blue Ease?
   A. We are not familiar with Blue Ease.