Pour Some Sugar on Pain

Pour Some Sugar on Pain

  • Using Sugar Water for Chronic Pain

Using Sugar Water for Chronic Pain

Most people with chronic pain have tried multiple modalities to help relieve it. What if the answer could be as simple as sugar water? Two techniques using a diluted solution of dextrose (sugar), have been around for about 15 years, and more studies are showing positive results.

The first technique is called Perineural Injection Therapy, or PIT. This involves several micro-injections of the dextrose solution around the superficial nerves in the area you have pain. For example, there are many different nerve bundles that go into the knee, and depending on where on the knee the pain is located, a simple injection of dextrose of the specific nerve fibers involved can decrease that pain. If the pain is on the inner (medial) part of the knee, the pain could be due to the obturator nerve. Pain within the knee joint itself is usually branches of the genicular nerves. This technique can be used on most other joints, including the shoulders, elbows, ankles, and hips. Unlike steroid injections, which go into the joint itself, these injections go into the skin surrounding the joint.

The other technique is called the Sphenopalantine Ganglion (SPG) block, or “Sweet Nasal”. This involves applying the dextrose solution onto the SPG, which lives right at the base of your brain, deep inside the nose. The SPG is a large group of nerves, which feeds into nerve branches that go into the face, brain, jaw, neck, and back. The unique feature of this ganglion, or bundle, or nerves is that it is the largest grouping of nerves in the head outside of the brain, and that it is easily accessible without a needle or a scalpel. To get the dextrose solution on the SPG, all you would need to do is lay on your back, tilt your nose to the sky, and we would drip the solution into your nose, then you’d lay still for about five minutes to let the solution soak into the ganglion. This technique is especially helpful for pain associated with the nerves of the face (trigeminal neuralgia), brain (migraines), jaw (chronic pain after dental procedures), neck and back. Additionally, there is growing anecdotal evidence showing benefit with SPG treatments for “all-over” pain disorders, such as fibromyalgia, complex regional pain syndrome, and diabetic neuropathy.

So how does sugar water help pain? The answer isn’t entirely clear, but there is a theory that has been shown in studies to be very likely. The thought is, that when nerves are firing, or causing you pain, they are telling you that something is wrong. At the site of injury or inflammation, the area becomes acidic and starved for glucose (sugar). If the issues cannot be corrected quickly, as is the case in arthritis, where the likely end result is a joint replacement, the nerve continuously send the signal that something is wrong, that it is starved for sugar. Applying the diluted sugar solution onto that starved nerve can help the nerve to realize that the injury has subsided, and it suppresses the nerve’s need to tell you something is wrong. The solution is concentrated enough to “feed” the nerve, but is diluted enough to prevent an increase in overall blood sugar.

The technique of using sugar water for chronic pain has been gaining popularity all over the world. PIT and SPG blocks are both extremely safe procedures, with minimal side effects (infection or bruising at the injection site). Sometimes treating pain is as easy as feeding it something sweet.

Resources

Ernest, Edwin A. “Sphenopalatine Ganglion Neuralgia Diagnosis and Treatment.” Practical Pain Management, PracticalPainManagement, 28 Dec. 2011, www.practicalpainmanagement.com/pain/other/sphenopalatine-ganglion-neuralgia-diagnosis-treatment.

“Lyftogt Perineural Injection Treatment™ (LPIT) – Neurofascial Prolotherapy.” Caring Medical Regenerative Medicine Clinics, Barry Weiner,
www.caringmedical.com/prolotherapy-news/lyftogt-perineural-injection-treatment/.

Sanders, Michael, and Wouter W. A. Zuurmond. “Efficacy of Sphenopalatine Ganglion Blockade in 66 Patients Suffering from Cluster Headache: a 12- to 70-Month Follow-up Evaluation in: Journal of Neurosurgery Volume 87 Issue 6 Year 1997.” JNS | Journal of Neurosurgery: Pediatrics, American Association of Neurological Surgeons, 30 Oct. 2018, thejns.org/view/journals/j-neurosurg/87/6/article-p876.xml.

“Scientific Rationale.” Lyftogt Med: Neuropathic Pain Therapies, www.lyftogtmed.com/what-is-lyftogt-perineural-injection-treatment/scientific-rationale/.

Got Pain? Why You Should Try Acupuncture

  • Knee Pain

For many of us, who suffer from injuries or pain, we eventually seek medical help.  According to recent surveys, 80% of Americans will suffer from some pain at some point.  Many of these folks, suffer from chronic pain- defined as pain that has persisted for more than 3 months. Current options to manage pain include a myriad of options from physical therapy, dry needling, anti inflammatory medicines and as a last resort opioids. Given the recent opioid crisis, there has been a substantial push to reconsider options to manage pain.

Acupuncture has been around for thousands of years, some research even theorizing as early as 3300 BCE.  It began in China, using finely sharpened tools, and has since developed into a widely used medical practice.  It’s effectiveness has been appreciated for millenia, however, we have only recently began to understand how it actually works. It is estimated that about 2 billion people a year will get acupuncture treatments annually and it is used for a myriad of different conditions.  There have been multiple research studies, using MRIs, blood tests, and other methods, which have shown some of the amazing results acupuncture can have on a multitude of ailments.

A few studies have had patients receive acupuncture therapy, while a brain MRI was performed.  This testing showed consistent activation of different parts of the brain, which control different functions in the body, including pain perception, and mood.  For instance, studies comparing acupuncture and simple touching of the same areas (tactile stimulation), while an MRI was observing brain function, have shown that the amygdala and the hippocampus are deactivated during acupuncture, but not nearly as much during the tactile stimulation.  These two areas of the brain are activated during stress, hunger, pain, and other negative emotions. De-activating these areas will decrease the body’s perception of these negative emotions, therefore helping to manage depression, over-eating, and chronic pain.

Acupuncture can have chemical impacts as well.  These impacts are due to the effects on neurotransmitters and endorphins, which help with mood and pain.  Acupuncture has been shown to increase the levels neurotransmitters, such as dopamine and seratonin, while decreasing noradrenaline.  Dopamine and seratonin play major roles in feelings of well-being and happiness. Noradrenaline is released during periods of stress, so decreasing the release of this neurotransmitter, can decrease the perception of stress.  Additionally, acupuncture has been shown to increase endogenous opioid peptides, or endorphins, which are the body’s natural pain relievers. These studies answer some of the questions as to how acupuncture can help with depression, anxiety, and pain.  

The Eastern medicine theory on the way acupuncture works, is due to qi (pronounced “chee”), or the body’s energy.  Qi flows through certain pathways, called meridians, and when these meridians are disrupted, the body reacts with pain.  There are twelve different meridians,
each corresponding to a different body system. The acupuncturist would follow the meridian map, according to the patient’s medical concern, and place needles in specific areas along the targeted pathway.  Doing so restores the body’s qi, and helps it flow smoothly through the meridians.

Joanna Wroblewska, MD has a quite unique perspective to this.  She is board certified in anesthesiology and pain management. On a typical day, she will treat patients with headaches, migraines, neck pain, back pain and even musculoskeletal pains such as joint pains.  With over a decade of experience, she has developed an exceptional perspective on how pain affects patients, not just physically, but emotionally, psychologically and socially.

Joanna has studied acupuncture and she integrates components of acupuncture into her daily medical practice. She acknowledges that acupuncture is not for everything or everyone, but it has a role.  When performed well, it has lasting results and can certainly supplement current
westernized approaches. She integrates acupuncture with current western treatments to treat various conditions and her patients are benefiting from this approach.

Acupuncture has various mechanisms of how it works.  The most postulated theory is that it helps stimulate your body’s own neural and hormonal systems to help create a balance within your body’s environment. Acupuncture is no longer an exotic treatment, but rather a very well accepted form of medical treatment.

Speak with our providers- Margaret Truesdell- PA-C and Joanna Wroblewska, MD to understand how acupuncture can have a lasting impression to benefit your health.  We welcome you to experience this unique combination of western medicine and acupuncture!

References

Han, J S. “Acupuncture and Endorphins.” Current Neurology and Neuroscience Reports., U.S. National Library of Medicine, 6 May 2004, www.ncbi.nlm.nih.gov/pubmed/15135942.

Huang, Wenjin, et al. “Characterizing Acupuncture Stimuli Using Brain Imaging …” National Institute of Health, National Center for Biotechnology Information, 9 Apr. 2012, www.ncbi.nlm.nih.gov/pmc/articles/PMC3322129/.

Hui, Kathleen, et al. “Acupuncture, the Limbic System, and the Anticorrelated …” National Institute of Health, National Center for Biotechnology Information, 27 Aug. 2013, www.ncbi.nlm.nih.gov/pmc/articles/PMC3754836/.

Wen, Guoqiang, et al. “Effect of Acupuncture on Neurotransmitters/Modulators.” Journal of Trauma and Acute Care Surgery, Lippincott Williams and Wilkins, 5 Apr. 2016, uthealth.influuent.utsystem.edu/en/publications/effect-of-acupuncture-on-
neurotransmittersmodulators.

Wen, Guoqiang, et al. “Effect of Acupuncture on Neurotransmitters/Modulators.” Journal of Trauma and Acute Care Surgery, Lippincott Williams and Wilkins, 5 Apr. 2016, uthealth.influuent.utsystem.edu/en/publications/effect-of-acupuncture-on-
neurotransmittersmodulators.

Wen, Guoqiang, et al. “Effect of Acupuncture on Neurotransmitters/Modulators.” Journal of Trauma and Acute Care Surgery, Lippincott Williams and Wilkins, 5 Apr. 2016,
uthealth.influuent.utsystem.edu/en/publications/effect-of-acupuncture-on-
neurotransmittersmodulators.

White, A. “A Brief History of Acupuncture.” Rheumatology, vol. 43, no. 5, 2004, pp. 662–663., doi.org/10.1093/rheumatology/keg005.

Superfood: Orange & Banana Oatmeal Parfait

Ingredients:

  • 4 1/2 cups water
  • 1 1/2 cups quick oatmeal
  • 1/2 cup vanilla yogurt
  • 1 1/2 tablespoons honey
  • 1 ea medium banana, sliced
  • 2 ea orange sections
  • 1 tablespoon, 1 teaspoon grated orange peel

Method:

  1. In a medium sauce pan, bring water to rapid boil. Slowly pour oatmeal into boiling water, stirring constantly. Return to a boil. Reduce heat and simmer for 8 to 10 minutes, stirring occasionally. Remove from heat and let cool.
  2. Mix the oatmeal, yogurt and honey together. Chop the orange into small pieces. Divide the mixture into 4 bowls or jars. Top each parfait with 2-1/2 tablespoons each of banana and diced orange and 1 teaspoon orange zest. Serve cold.

Nutrition Facts:

  • Calories: 140
  • Total Fat: 2g
  • Saturated Fat: 0.5g
  • Total Carb: 29g
  • Protein: 5g
  • Dietary Fiber: 3g
  • Sodium: 35mg

Food for Thought…and Pain

  • Anti-Inflammatory Diet

Diet and exercise is well known to keep your heart healthy, but more and more research is showing that what you eat can directly impact your pain levels. The link between food and pain lies in systemic inflammation, and decreasing your inflammation can help to decrease your pain. By eating more foods with anti-inflammatory properties, and avoiding those that increase it, you can add another tool to your pain management belt.

First, what is systemic inflammation? Throughout the body, there are several inflammatory mediators, which are basically the body’s defensive line when injury or ailment occur. These defensemen can be everywhere…in the joints, in the back, in the gut. When inflammatory markers are activated, they stimulate the perception of pain, to tell you that something is wrong. Whenever and wherever there is pain, chances are, there is also inflammation.

Next, how does food affect inflammation? Free radicals and foreign substances cause oxidative stress, which leads to the activation of the inflammatory mediators. Free radicals come from quick and sharp spikes in blood glucose and lipids (or sugars and fats), or processed foods which the body interprets as a foreign substance. The resulting oxidative stress caused by these foods is similar in process to rust on an old metal bicycle, so the body takes this as an injury that needs to be taken care of. The inflammatory markers are sent to take care of the oxidative stress caused by the free radicals, and systemic inflammation occurs.

What kinds of food increase and decrease inflammation? The culprits for increasing inflammation is processed foods, and added sugar. Fats are not so bad on their own, but when paired with sugar, the combination of the two is even more damaging. These are found in high sugar foods, white breads and pastas, soda, alcohol, and processed meats (hot dogs, bologna, etc.).

As far as foods that can help with inflammation and pain, the keyword here is “antioxidant.” These are found in vitamin and mineral-rich fruits and vegetables. The other trick is to avoid that sharp blood sugar and fat spike. Foods that shorten this spike are those that are high in fiber, like beans and whole grains, or good protein, such as chicken, fish and lean beef.

Overall, taking care of chronic pain requires a multi-faceted approach. Physical therapy, procedures, even surgery are all common tools to treat and manage chronic pain. However, there is one more tool to add to the belt, and that is a pain relieving diet.

Good luck and let’s hear back with how you are doing!

For more information, recipes, and meal planning tools, check out these resources!

References

Bonakdar, R., Cotter, N. and Rhodes, C. (2019). Nutrition, Inflammation, and Pain. The Pain Practitioner, (November/December 2017), pp.10-12.

Briggs, M., Givens, D., Schmitt, L. and Taylor, C. (2019). Relations of C-reactive protein and obesity to the prevalence and the odds of reporting low back pain.. [online] Ncbi.nlm.nih.gov. Available at: https://www.ncbi.nlm.nih.gov/pubmed/23187041 [Accessed 23 Jan. 2019].

Stone, A. and Broderick, J. (2019). Obesity and pain are associated in the United States.. [online] Ncbi.nlm.nih.gov. Available at: https://www.ncbi.nlm.nih.gov/pubmed/22262163 [Accessed 23 Jan. 2019].

Thoracic Pain

While chest pain should always be evaluated to eliminate issues involving the heart, many patients exhibiting chest pain find that their pain is due to muscles and nerves in the upper and middle back. The thoracic vertebrae are the narrowest part of the spinal canal, making them the most susceptible to issues of injury. Carolinas Pain Center can evaluate your thoracic pain and begin a course of treatment to help you manage this difficult condition.

Shoulder, Arm, and Hand Pain

Pain in the shoulders and arms can be exhausting in addition to being painful. The act of reaching, typing, or carrying even the smallest object can be excruciating. Pain in the hands is just as debilitating and can affect even the most menial of tasks, like holding a glass, picking up a pen, or manipulating your computer’s mouse. The causes of these types of pain are varied and may include rotator cuff or inflammatory conditions, muscle spasms, or arthritis. Carolinas Pain Center can evaluate your shoulder, arm, or hand pain and get you started on a course of treatment to eliminate this pain from your life.

Pelvic Pain

Pain in the lower abdomen and groin areas can be incapacitating. While this pain can often have a surgical solution, it is not uncommon for the pain to persist even after surgery. It can affect such simple tasks as walking or sitting, making exercise or recreation almost impossible. In some cases, even sexual activity may become affected. The goal of treatment for this kind of pain at Carolinas Pain Center is to determine the cause, whether due to injury, infection, inflammation or nerve trauma, and then to apply a specialized, multidisciplinary approach to pain management that will have you leading a normal life as quickly as possible.

Pain in Children and Adolescents

Pediatric pain management must involve highly specialized and sensitive care for these unique patients. Pain in children is often difficult to assess due to the limited ability of the patient to verbally communicate what he or she is feeling. While an adult may ask for pain relief medication or therapy, a child often does not understand this option and does not ask for help. While an adult may tolerate an aggressive treatment plan, children often do not respond well to this. Adults are often able to continue to function in their daily routines of work and household management, even in social settings, but children are not able to function at this level. Missing school, and not feeling well enough to be with friends can often result in an unhealthy detachment. Their physical pain can lead to anxiety, depression, and even a withdrawal from the family members seeking their well-being. This makes treating pediatric pain even more challenging.

Neck Pain

Neck pain is a difficult condition to bear, both physically and mentally. Carolinas Pain Center understands the devastating impact it has on patients. Our state-of-the-art treatments and multidisciplinary approaches to each individual case will help you manage your neck pain and return you to a normal life as quickly as possible.

Lower Extremity Pain

Pain in legs, hips, knees, ankles, and feet can be life-disrupting. Simple daily tasks become excruciating, and exercise or recreation must take a seat for awhile. Pain in the lower extremities can have causes ranging from wear-and-tear due to normal motion and function, to trauma or infection. This pain is manageable, and the Carolinas Pain Center can help you get it under control.