The ABC's of Pain Management

The ABC's of Pain Management

May is Pelvic Pain Awareness Month! 

Our resident Pelvic Floor Physiotherapist (Julie Bagshaw, Toronto) treats her fair share of patients that suffer from conditions like generalized pelvic pain, endometriosis, dysmenorrhea (painful menses), dyspareunia (pain with intercourse), etc. These conditions are important to manage, especially with regards to diagnosing the root cause of pain, and managing that pain. 

More generally, I want to talk about pain management for all conditions in the body and their presenting symptoms. Pain is most often linked to inflammation, when it comes to any type of injury or nerve issue. Our bodies send inflammatory cytokines to the site of injury in order to healing and repair damaged tissues. Long term pain issues can arise from 1) an injury not healing properly, or, 2) the body not being able to clear the inflammation. Here are my recommendations to manage pain (anti-nociceptive) and inflammation (anti-inflammatory).

  • Musculoskeletal Assessment
  • The first step to pain management is meeting with a professional that can assess the injury or issue accurately. This is where a collaborative clinic like ours is extremely helpful – practitioners can help triage conditions based on the type of injury and treatment needed. Please don’t Google your symptoms - see a professional!

  • Hot and Cold Therapy
  • This form of hydrotherapy is extremely beneficial with regards to healing injuries and areas of inflammation. Depending on the location of the pain/injury, you can immerse in an ice bath and follow with a hot/warm bath (or shower). Ideally, alternating immersion in hot/warm for 2mins and in cold/ice for 1min is repeated 4 times, and ends with cold.

  • Fish Oil
  • A good, high dose fish oil (rich in omega-3 essential fatty acids) will have strong anti-inflammatory properties that down-regulate pain messaging in the body. Fish oils are safe to take and have added anti-inflammatory & anti-nociceptive benefits such as improving heart health and decreasing cholesterols. Dosing for pain and inflammation should be between 1000-2000mg/day depending on symptom severity. Fish Oils have shown great pain reduction results specifically for joints.

  • Support Your Gut
  • The health of your gut microbiome dictates your body’s ability to respond to inflammation in the body. A healthy microbiome will be able to moderate inflammation and therefore your body’s pain response. The best way to a healthy gut is to supplement with a full spectrum probiotic, to aid the body in recolonizing healthy bacteria. My favorite line of probiotics is HMF by Seroyal as it has prebiotics and probiotics in the same convenient capsule.

  • Inflammatory Herbs
  • This is my sweet spot! I love prescribing anti-inflammatory herbs as they pack such a punch for pain and inflammation. Herbs can down-regulate inflammation so well and have lasting effects, making them a great option for pain management. My favorites are Curcumin (+bioperine for absorption), Boswellia, Devil’s Claw, PEA (palmitoylethanolamide) and white willow. All can be found in capsule or tincture form.

    Again, proper assessment of the nature and root cause of the pain is step one. Wishing you all a beautiful, pain-free month ahead!

    Be well,

    Dr. Kate