Chronic pain

Common causes of chronic pain include arthritis, back problems, injury, surgery, osteoporosis, and disease states such as cancer or the complications of diabetes (e.g. diabetic neuropathy). Work-related injuries may be responsible for as many as 20% of cases of chronic pain.

In some patients, no cause can be found, despite extensive medical investigation. In other cases, an underlying cause may be identified and rectified, but the pain persists regardless.

• Devil’s claw is traditionally used for its analgesic and anti-inflammatory properties, and may provide temporary relief of symptoms of muscle tension, stiffness and decreased mobility associated with musculoskeletal complaints. Devil’s claw may also aid the management of arthritis pain by helping to reduce the intake of some pain relief medications, and may help to improve spine mobility and flexibility in people with chronic back problems.
• Magnesium may be useful in times of stress and is important for healthy bone strength and bone mineral density. It also helps all the muscles of the body to function optimally and to contract in a normal, healthy way. Taking a magnesium supplement may help prevent muscular cramps and spasms. It is often taken with other nutrients that are also involved in the maintenance and repair of muscle tissue, such as folic acid and vitamins C and B12.
• Herbs that have traditionally been used to promote restful sleep include passionflower, hops and lemon balm, a combination that may be particularly beneficial when mental tension and irritability are contributing to insomnia. 
• Glucosamine helps reduce cartilage wear and slows the progressive deterioration of the joints. It may be beneficial for pain associated with osteoarthritis, as it has been shown to slow the progression of joint damage, decrease joint stiffness, and improve joint mobility and function. It reduces symptoms of pain, swelling and joint inflammation, and has been shown to be as effective as some pain-relieving medications for the long-term relief of osteoarthritis symptoms.
• The omega-3 fatty acids, have anti-inflammatory properties and may help reduce the pain, swelling and joint stiffness of rheumatoid arthritis while supporting optimal joint mobility. They may also be beneficial for other inflammatory conditions.
• Willow bark may provide temporary relief of the pain of osteoarthritis and may relieve lower back pain. Willow bark has a long history of use as an analgesic remedy. Traditionally, it has been prescribed for the relief of many types of pain including gout, toothache and mild headache.
• Corydalis rhizome has been used in Traditional Chinese Medicine (TCM) for its analgesic properties and to promote circulation of blood and Qi
• Experimental in vitro studies suggest both ginger and bromelain may interfere with various aspects of the inflammatory cascade which is responsible for causing pain.

• Work with your healthcare professional to develop a pain management plan that involves pain relief medication (if necessary), appropriate supplementation, a healthy diet, natural therapies (like acupuncture and massage), and appropriate levels and types of activity. This integrated approach ensures that you have tools and techniques at your disposal ready to use when a flare up occurs.
• Your mental outlook has a significant impact on your quality of life, your perception of pain severity, and your ability to cope with it. Ask your healthcare professional about cognitive behavioural therapy, which can teach you valuable and effective coping skills.
• Regular massage may be helpful when the pain is in the soft tissues (muscles, tendons and ligaments), but may aggravate bone and joint pain.
• Stick to a healthy, nutritious diet that includes plenty of fresh fruit and vegetables, whole grains and legumes. Include plenty of omega-3 oils in your diet in order to take advantage of their anti-inflammatory properties. Good sources include fish (and fish oil capsules), flaxseeds (and flaxseed oil capsules), canola oil, and walnuts.
• Regular, restful sleep is important. Don’t try to burn the candle at both ends, as it may reduce your ability to cope and add to your fatigue. 
• If you’re having difficulty coping, talk to a friend or healthcare professional about your frustrations and concerns.
• Don’t let pain rule your life. Where possible, find a way to participate in your favourite activities, even if it’s at a lower intensity than before. Also look for new hobbies and activities that are enjoyable without aggravating your pain levels. 
• In particular, it’s important that remain physically active. Even those with restricted movement need regular exercise of some form, so work with your occupational therapist or physiotherapist to identify an exercise program that’s tailored to your personal circumstances. Regular exercise has benefits for many musculoskeletal problems, and also helps to maintain positive moods.
• Meditation, hypnotherapy, yoga and hydrotherapy may be beneficial for some people.
  

• Adhere carefully to your healthcare professional’s instructions about the use of pain-relieving medication. The aim is to minimise both the impact of the pain on your life, and the risk of adverse effects from medication, so don’t increase the dose except on your doctor’s advice. If you prefer to use natural remedies where possible, discuss your choices openly with your doctor. It is important that any possible interactions between pharmaceutical and natural medicines are monitored closely.