There’s nothing more physically debilitating than pain. Being unable to bend your neck, flex your elbow, or turn your head are extremely unwelcomed experiences in life.
Thankfully, at SF Advanced Health we have a multifaceted team that decreases our patient’s pain with a multi-faceted approach. The #1 thing you need to know about pain is that there are a variety of ways to manage or eliminate it entirely without the use of prescription painkillers. My advice is to stick with something you know works well for you.
Consider exercise in pain management, for example. No matter what you do, whether it be swimming or low-impact interval training, it has to be something you’re comfortable with and doesn’t exacerbate your symptoms.
In a systematic review of the literature (the strongest type of evidence we can obtain), Roddy and colleagues (2005) sought to compare the effectiveness of walking and leg-strengthening exercises in geriatric patients with knee osteoarthritis. Treatment intervention and placebo groups’ lengths varied from 8 weeks to 2 years with both approaches demonstrating decreased pain severity and disability for their patients. Neither treatment was statistically different upon indirect comparison.
This means that since both interventions were beneficial, patients have a choice between exercise intervention. This is key because adherence to exercise you like is a major predictor of one's response to physical activity. Patient choice helps impact patient adherence. The clinical usefulness of choice is undeniable. The most appropriate way to perform strengthening exercises remains unclear for older populations at this time. We do know for sure that a sedentary lifestyle should be avoided; any movement is better than no movement.
A reduction in pain would most likely be enhanced if weight loss were also a part of the patients' outcomes. In a study by Messier and colleagues (2013), after 18 months adhering to a weight loss diet and exercise protocol, overweight and obese adults with knee osteoarthritis had less inflammatory markers (IL-6), less pain, quicker walking pace, and better function/physical health-related quality of life.
This begs the question, what if knee osteoarthritis is too painful or limits a patient’s mobility to exercise in ways they love? Practitioners don't want to cause more harm, so modifications have to be made and an interdisciplinary approach has to be taken.
In this instance, alteration of the diet (i.e. an elimination diet I recommend) and inclusion of specific supplements could be important precursors before beginning exercise or a strength-based program. (Of course, including these treatments in a multi-modal treatment plan that includes physical activity and care from other providers—mainly acupuncturists, massage and yoga therapists, osteopaths, chiropractors, and/or physical therapists—is a laudable goal for any pain management case.)
Regardless, permanently eliminating inflammatory foods could point to an underlying cause of inflammation, and supplementation could relieve pain to a greater degree. The best part is that implementation is relatively cheap, all things considered, and worthwhile for those not receiving benefit from conventional medication and/or are limited in their capacity to exercise.
The benefit of these two treatment plans cannot be understated, and in fact may be the catalyst to get physically active again. But sometimes, even this is not enough. At Advanced Health, we go deeper than dietary and lifestyle interventions for treating pain by providing osteopathy, yoga therapy, acupuncture, and massage therapy.
Additionally, Andrew Castellanos, L.Ac., uses MedX Cold Laser Therapy with his patients and top-level athletes. Cold lasers (also called Low Level Lasers (LLL) or soft lasers) are a cutting-edge technology that can be used in 2 distinct ways:
- Targeting acupuncture trigger or pressure points (working on the same area as an acupuncturist would, but without the use of needles)
- Obtaining broad coverage of tissue and bone with IR or Red light photons to reduce pain and stimulate healing
Cold Laser therapy offers a non-invasive option to surgery or drug, and can be used in combination with massage and acupuncture. I like this approach because it eliminates the complications of long-term drug treatment programs (i.e. painkiller addiction). Cold lasers are also FDA cleared, where “the energy emitted provides a temporary increase in microcirculation, temporary relief of minor muscle and joint aches, pains and stiffness, relaxation of muscles/muscle spasms, and minor pain and stiffness associated with arthritis”. Andrew uses cold laser therapy for treatment of:
- Acute and chronic pain
- Ligament sprains
- Muscle strain
- Soft tissue injuries
- Tennis elbow
- Back pain
- Carpal Tunnel Syndrome
How Do Cold Lasers Work?
MedX Cold laser sends an impulse of light at a specific wavelength (usually around 600-980 nm) that minimizes reflection and scattering to deliver maximum absorption of the energy (in photons) at a desired depth.
The aim is to deliver light energy units from red and infrared laser radiation to damaged cells. It’s thought that the photons absorbed by the damaged tissues stimulate the mitochondria to increase production of adenosine triphosphate (ATP), the energy of life. Cellular energy is required to transform unhealthy cells to dynamic ones.
The Benefit of Cold Lasers
- Easy to apply
- Extremely safe
- Non-Toxic and non-Invasive
- No side effects or pain
- Cost effective for both the practitioner and patient
- Highly effective in treating ailments (more than 90% efficacy)
- Superior alternative to analgesics, NSAIDs, and other medications
- Reduces the need for expensive surgeries
- Works synergistically with other modalities previously mentioned
Therapeutic Effects of Cold Laser Application
- Increased Vascular Activity: Laser photons induce vasodilation that appears to increase blood flow to affected areas.
- Enhanced Metabolic Activity: Laser photons enhance the production for the basic food source for cells, ATP.
- Enhanced Cell Growth: Laser photons accelerate cellular growth and reproduction.
- Faster Wound Healing: Laser photons stimulate fibroblast development and accelerate collagen synthesis in damaged tissue
- Anti-Inflammatory Action: Laser photons decrease swelling caused by bruising or inflammation of joints, resulting in enhanced joint mobility.
- Reduced Fibrous Tissue Formation: Laser photons reduce the formation of scar tissue following tissue damage from cuts, scratches, burns, or post surgery.
- Stimulated Nerve Function: Laser photons improve the process of nerve cell function
- Outcome: Pain Reduction
As we age, we begin to see changes in our musculoskeletal system and we may accidently invite pain into our lives. Does this mean we shouldn't exercise or seek effective treatments? Not at all. It's possible to adapt or scale any workout, and if you have limited mobility or pain Dr. Bhandari and her Advanced Health Team Are Here to Support Your Health.
Our expert team helps patients suffering from chronic pain improve their bodies, allowing them to live healthier, fuller lives. We are always ready to share our expertise. To book an appointment, contact Advanced Health or call 1-415-506-9393.
Messier, S. P., Mihalko, S. L., Legault, C., Miller, G. D., Nicklas, B. J., DeVita, P., ... & Williamson, J. D. (2013). Effects of intensive diet and exercise on knee joint loads, inflammation, and clinical outcomes among overweight and obese adults with knee osteoarthritis: the IDEA randomized clinical trial. Jama, 310(12), 1263-1273.
Roddy, E., Zhang, W., & Doherty, M. (2005). Aerobic walking or strengthening exercise for osteoarthritis of the knee? A systematic review. Annals of the rheumatic diseases, 64(4), 544-548.