Increasingly the scientific and medical community is becoming cognizant of the tremendous impact diet and lifestyle can have on inflammatory conditions such as heart disease, arthritis, autoimmune conditions and inflammatory bowel disease. For example, the American Heart Association (AHA) and the National Heart, Lung, and Blood Institute (NHLBI) have stated emphatically that the metabolic syndrome in adults should be treated first with diet and lifestyle therapy, rather than medications. The metabolic syndrome comprises a group of metabolic risk factors occurring in one person, including abdominal obesity, hypercholesterolemia, hypertension, insulin resistance, and pro-thrombotic and pro-inflammatory states.
Conventionally, pain syndromes have been treated in a reactionary manner. In other words, a patient first experiences pain and is then treated with an analgesic or anti-inflammatory medication. When treating pain from a prevention-based mindset, however, treatment is proactive and requires knowledge of the patient in order to address the underlying cause of the painful symptoms. Proactive treatment also requires the clinician to adopt a mindset of early detection.. In addition to a detailed physical and medical history, non-standard lab work may be necessary. Examples include measuring cytokine levels, urine neurotransmitter metabolites, C-reactive protein, red blood cell fatty acids, and markers of gut inflammation, such as eosinophil protein X.
In chronic pain, the goal is to bring cytokines under control, modify the eicosanoid cascade, and reestablish normal sleep and hormone secretion patterns. Herbal, vitamin and nutraceutical treatments for pain include agents that work as cyclooxygenase (COX), nuclear factor kappa beta (NF-Kb), or lipoxygenase (LOX) inhibitors. High doses must be given to achieve results comparable to conventional non-steroidal anti-inflammatory drugs (NSAIDS). In addition, there are few natural substances, other than morphine derivatives, that are powerful analgesics. It is relatively impractical to attempt to treat acute pain in this way because nutritional or herbal interventions take time to begin to work and must be dosed fairly high. For instance, the herbal COX and NF-Kb inhibitors take approximately three days to show effects. In chronic pain, however, immune, neurologic, and endocrine mechanisms are often perturbed, and these imbalances, whichfeed into and exacerbate the chronic pain cycle, may be responsive to nutritional interventions.
When tackling the problem of chronic pain a functional approach is clinically useful. The term “functional medicine” refers to more than “holistic” or “alternative” medicine and has been defined as a science-based field of health care that “is anchored by an examination of the core clinical imbalances that underlie various disease conditions. Those imbalances arise as environmental inputs such as diet, nutrients (including air and water), exercise, and trauma are processed by one’s body, mind, and spirit through a unique set of genetic predispositions, attitudes, and beliefs.
The fundamental physiological processes include communication, both outside and inside the cell; bioenergetics, or the transformation of food into energy; replication, repair, and maintenance of structural integrity, from the cellular to the whole body level; elimination of waste; protection and defense; and transport and circulation.” Most naturopathic physicians practice functional medicine because it is a core part of their training and philosophy.