What could be causing my pain? There are many reasons you experience pain, from joint inflammation tied to arthritis to overdoing it in the garden to body-wide tightening of muscles linked to a common disorder known as fibromyalgia. Here are some common culprits: Arthritis. Arthritis literally means “inflammation of a joint”—the place where two bones connect, according to the American Academy of Orthopaedic Surgeons. There are more than 100 different types of arthritis, but osteoarthritis is the most common, affecting nearly 27 million Americans. In osteoarthritis, cartilage—the slippery tissue that protects the ends of your bones in the joint—gradually wears down. This can make your knees feel achier than usual after you work out or leave you feeling stiff and old lady-ish when you climb out of bed. No one knows exactly what causes this cartilage breakdown, but a combination of factors like aging, joint injuries, genetic tendencies, and obesity, are all thought to play a role, says the Mayo Clinic. Rheumatoid arthritis, known as RA, is the other most common type. The end result is the same—stiff, achy joints—but rheumatoid arthritis is an autoimmune disease. The body’s immune system attacks its own joints, causing their lining to swell and hurt. RA tends to first occur between ages 25 and 50. Osteoarthritis tends to most affect weight-bearing joints, such as the knees and hips; whereas rheumatoid arthritis more often impacts the entire body: both large and small joints as well as other organs. Fibromyalgia. It’s estimated that at least 12 million Americans suffer from fibromyalgia. Though doctors still don’t know exactly what causes fibromyalgia, there’s more and more understanding of what’s happening to trigger the pain, fatigue, and other symptoms. Research suggests that when you have fibro, your central nervous system doesn’t process pain signals normally. In one study, researchers applied heat to the hands of a group of fibro patients and a group of healthy subjects. In the fibro group, the blips of pain from each jolt of heat didn’t subside between applications the way they did in the healthy group; instead, the sensations of pain accumulated, making the fibro patients feel worse. “We’re all constantly exposed to stimuli as we go through our day,” explains fibromyalgia researcher Roland Staud, MD. The inability to let go of this input may contribute to the constant state of pain in people with fibromyalgia. But what causes a person’s nervous system to become so fixated isn’t known. Back Pain. Back pain sends more patients to doctors than any condition other than the common cold. There are many possible causes of back pain, which means there are also many non-invasive solutions, according to Todd Sinett, a chiropractor and coauthor of The Truth about Back Pain. “Back pain is rarely one catastrophic event,” he says in the book, “but several situations combining to create pain.” And it turns out that some seemingly insignificant everyday habits can take a big toll on your back over time, such as wearing high heels, lugging around a heavy purse, and sitting at a desk for long periods of time. Migraines. For the migraine-prone, lots of things can set off an attack–changing hormone levels prior to menstruation or during ovulation, poor eating or sleeping habits, stress, chemicals in food (including additives and preservatives) or low blood sugar. Even changes in the weather or moving to a higher altitude can prompt the onset of migraine. What causes that initial spasm is still a mystery, but the reaction seems to be related to a brain chemical. “We know that the neurotransmitter serotonin plays a large role in triggering migraines,” says Alan Rapoport, M.D., co-founder and co-director of the New England Center for Headache in Stamford, Connecticut, and assistant clinical professor of neurology at Yale University School of Medicine. “In fact, most of the newer migraine medications work primarily by stimulating the brain’s serotonin receptors.” Headaches. Dull, pounding pain on both sides of the skull often indicates a tension headache (of which stress may be the source). A cluster headache (often precipitated by drinking alcohol or smoking) is marked by discomfort near the eye, while a sinus headache generally lays claim to gnawing pain in the sinus region below the eyes, above the nose, and in the forehead. (The latter often increases in severity over the day and may be spurred by a respiratory infection.) Are women and men affected equally? Women may be harder hit: Some research shows women are more susceptible to pain, especially right before their periods when estrogen levels drop. Women are also at greater risk of suffering chronic pain conditions such as fibromyalgia (of the millions of Americans affected by the condition, about 3.4% of women have it, compared with 0.5% of men); osteoarthritis (almost 60% of sufferers are women); RA (it is almost 3 times more likely to strike women than men); and migraines (more than 29 million Americans–nearly 10 percent of the population, and most of them women–suffer from migraines). What are some natural pain relievers? Drugs can help, but they’re by no means a complete solution. “Most studies find that medications offer only a 20 to 30% reduction in pain,” says Andrew Bertagnolli, PhD, a psychologist with the Spine Care Medical Group and a member of the board of directors for the American Chronic Pain Association. Check out these natural remedies to soothe your aches. Arnica. Use this herb to alleviate acute injury or post surgery swelling. It comes from a European flower; although its healing mechanism is still unknown, it does have natural anti-inflammatory properties. Taking oral homeopathic arnica after a tonsillectomy decreases pain, say British researchers, and German doctors found that it reduces surgery-related knee swelling. Use homeopathic arnica as an adjunct to ice, herbs, or conventional pain meds. Rub arnica ointment on bruises or strained muscles, or take it in the form of two lactose pellets under the tongue up to six times per day. Boiron (boironusa.com) is among the most reputable arnica manufacturers. Capsaicin. Use it to reduce pain from arthritis, shingles, or neuropathy. An active component of chile pepper, capsaicin temporarily desensitizes pain-prone skin nerve receptors called C-fibers; soreness is diminished for 3 to 5 weeks while they regain sensation. Nearly 40% of arthritis patients reduced their pain by half after using a topical capsaicin cream for a month, and 60% of neuropathy patients achieved the same after 2 months, according to a University of Oxford study. Patients at the New England Center for Headache decreased their migraine and cluster headache intensity after applying capsaicin cream inside their nostrils. Acupuncture. Relieve arthritis, migraines, low-back, menstrual, or post-operative pain with this alternative therapy. When pricked with the tiny, essentially painless needles, your body releases endogenous opioids, its natural painkillers—but for reasons scientists are still figuring out, the benefits from acupuncture last longer than the chemicals’ analgesic effect. Recent research has yielded stunning results: people with knee arthritis reduced pain by 40% after 6 months of acupuncture that began as twice weekly sessions and was gradually reduced to once a month, according to researchers at the University of Maryland School of Medicine, who also found it can relieve low-back pain. Overseas, scientists in Europe used acupuncture to cut medication use in half among migraine sufferers—and, in another study, ease menstrual pain. Post-surgery patients needed less morphine after receiving the needle pricks, a Duke University Medical Center review found. Glucosamine & Chondroitin. Use it to protect cartilage from osteoarthritis. Glucosamine is a natural compound used in the formation and repair of cartilage, according to the Mayo Clinic. Chondroitin is made from shark and cow cartilage. Both are thought to help build or protect joint-cushioning cartilage—the same material that breaks down in osteoarthritis. The combination can help people with moderate to severe knee osteoarthritis, according to NCCAM and the National Institute of Arthritis and Musculoskeletal and Skin Diseases. The Glucosamine/Chondroitin Arthritis Intervention Trial was a long term trial that found that taking the supplements was as effective as taking a prescription NSAID. Take 500 mg of glucosamine three times a day alone or with 400 mg of chondroitin sulfate. The Natural Medicines Comprehensive Database suggests glucosamine sulfate over glucosamine hydrochloride, though many brands contain both. Massage. New research shows that massage therapy may be more effective than commonly used treatments such as drugs for short-term relief from soreness in your lower back, according to the Annals of Internal Medicine. After 10 weeks, study participants who received either a 1-hour relaxing Swedish massage or a form of massage focused on treating the tissues of the back were twice as likely to have spent fewer days in bed, taken fewer meds, and continued everyday activities (think: walking up stairs or having sex) compared with those who got usual care, such as painkillers, anti-inflammatory drugs, or muscle relaxants. Moreover, benefits lasted more than 6 months. “This study showed that massage is not only helpful in relieving lower-back pain, but you can get the same benefits with the more commonly available relaxing massage as you can with a more targeted massage,” says Daniel Cherkin, PhD, senior scientific investigator with the Group Health Research Institute. Should I exercise if I’m in pain? Though it may seem counterintuitive, doing regular exercise such as walking can actually help soothe arthritis and muscle pain because it strengthens muscles and tendons that support the joint and improves blood flow to the area for faster healing. “If you avoid walking because, say, your knee hurts, then you’ll lessen your range of motion so it’ll hurt even more later on,” says Teitelbaum.“Try using a heating pad on your knees for 10 minutes before walking to help muscles relax so you’ll get a better range of motion as well as pain relief.” If you find walking too uncomfortable, another good option is swimming because it doesn’t put as much pressure on your joints. In fact, people with arthritis in their knees or hips who did water exercises for 6 weeks reported less joint pain and better overall quality of life, according to the journal Physical Therapy. Can diet affect the amount of pain I’m in? Yes, research shows that picking certain foods—and avoiding others—may ease pain. Talk to your doctor about these diet tweaks based on various causes of pain: Arthritis. Eating foods known to fight inflammation, a symptom of both rheumatoid arthritis (RA) and osteoarthritis, may ease pain. Eat several servings each week of anti-inflammatory omega-3 fatty acids such as wild Alaskan salmon and other cold-water fish, freshly ground flaxseed, omega-3-fortified eggs, and walnuts. Season meals with ginger and turmeric as often as possible; these spices appear to possess anti-inflammatory properties. Eating five to nine daily servings of fresh fruits and vegetables from across the color spectrum can ease arthritis discomfort. Certain vegetables, such as tomatoes, potatoes, peppers, and eggplant, can worsen arthritis pain, but there is little good scientific evidence to support this theory. You’ll also want to limit foods that cause inflammation. Polyunsaturated vegetable oils (such as corn and soy oils) and the partially hydrogenated oils found in many margarines, vegetable shortenings, and processed foods contain fats that promote inflammation. If you have rheumatoid arthritis, try eating fewer animal products: According to a small study, RA sufferers who followed a vegan diet had modest improvement in joint swelling. Of course, if you suspect a particular food is exacerbating your symptoms, there’s no harm in avoiding it for a few weeks and then reevaluating how you feel. Fibromyalgia.“Fibromyalgia symptoms are only about 30% amenable to current pharmaceutical strategies on the market,” says Kathleen Holton, PhD, MPH, lead author of Potential Dietary Links in Central Sensitization in Fibromyalgia. That’s why many patients are taking matters into their own hands and experimenting with alternative treatments, including dietary changes. Forty-two percent of fibro patients reported that symptoms worsened after eating certain foods, and though much of the research is in its preliminary phases, there’s some evidence that these simple diet tweaks may ease fibro pain:
Load up on D. A 2008 study found that pain patients with low levels of vitamin D required almost double the dose of painkillers as those with adequate levels.Avoid additives. Common food additives, like monosodium glutamate (MSG) and aspartame, can act as excitotoxin molecules, a chemical group that has the ability to activate neurons that increase sensitivity to pain.Pile healthy-fat foods such as walnuts, salmon, and flaxseed onto your plate. A 2007 study found that after just 3 months of supplementing omega-3 fatty acids, symptoms such as morning stiffness and painful, tender joints decreased.Go veggie. Some researchers speculate that oxidative stress may be a cause of fibro symptoms. Oxidative stress occurs when the body doesn’t produce enough antioxidants to battle cell-damaging free radicals in the body. Most fruits and veggies are packed with important antioxidants, like vitamins A, C, and E, which fight free radicals to keep your body normalized. Certain studies also show a raw, vegan diet can improve symptoms, but that’s difficult for most people to follow.
Headaches. It’s long been thought that certain foods and food additives may trigger a headache – though recently it’s been theorized that cravings for these foods may actually signal the onset of a migraine. Chocolate, for example, contains phenylethylamine, which can provoke a headache by dilating blood vessels. You may also have a headache associated with foods such as processed meats that contain additives called nitrites. Like phenylethylamine, they cause blood vessels to swell, provoking headaches in migraine-susceptible people. Other common food triggers include aged cheese; alcohol; pickled and marinated foods; citrus fruits; bananas; onions; monosodium glutamate (MSG), a food preservative; and aspartame/phenylalanine-containing foods and beverages. Can I prevent—or at least reduce—pain? Arthritis. Because there’s no cure for arthritis, prevention is your best bet. The three big things you can do are 1) work out regularly and stay active; 2) maintain a healthy weight; and 3) prevent injuries to your joints. “We tend to think of heart health as the main reason to keep physically fit and keep our weight down. But we need to consider another good reason—preventing arthritis,” says John H. Klippel, MD, president and CEO of the Arthritis Foundation. Slimming down can also help if you already suffer from arthritis, and you don’t have to lose a lot of weight to make a difference. When you walk, your knees absorb a force equal to about 3 times your body weight. So losing just 10 pounds actually relieves each knee of about a 30-pound load with every stride you take. Fibromyalgia. “Exercise–including yoga, tai chi, and walking–has been shown over and over again to reduce fibromyalgia pain,” says Dr. Teitelbaum. In fact, a study in the New England Journal of Medicine found that fibromyalgia patients who participated in a twice-weekly hour-long tai chi classes (a combination of slow movements, breathing, and meditation) for 12 weeks reported significant pain improvement. “Factors such as stress trigger adrenaline, which signals your body to tighten up and results in pain. Yoga and tai chi practices help stretch and relax your muscles and soothe soreness,” Teitelbaum says. Even just 10 to 15 seconds of stretching can help. Start by stretching wherever you feel pain (such as a seated forward bend for lower-back problems), hold for 10 seconds or until you feel the muscle release, and gradually work up to 1 minute. Back pain. There are many possible causes of back pain, which means there are also many non-invasive solutions, according to Todd Sinett, a chiropractor and coauthor of The Truth about Back Pain. “Back pain is rarely one catastrophic event,” he says in the book, “but several situations combining to create pain.” Here are some tricks to prevent back pain:
Step away from your desk. Sitting at a 135-degree angle can reduce compression of the discs in the spine, so lean back slightly every now and then. Do it when you take a phone call or a coworker stops by to chat, Sinett recommends. Make sure your office chair supports the curve of your spine, he says: Your lower back should be supported, and your head should be straight—not lurching forward—when you look at your computer screen. Get up and walk around for a couple of minutes every half hour—take trips to get water, use the bathroom, or grab papers off the printer.Lighten your load. When you tote a heavy bag, your shoulders become imbalanced, says Sinett. Your body elevates the shoulder carrying the bag, which throws your spine off-kilter. Doing this every day can cause back muscles to ache over time. To fix it, first carry the lightest bag possible. (Some of today’s styles—with chains, studs, and other hardware—are heavy even when empty!) The American Chiropractic Association recommends that your bag—when fully loaded—weigh no more than 10% of your body weight. Alternate which shoulder you carry the bag with from day to day, and consider splitting your stuff between two bags (one for each arm), which will painproof your load by distributing it more evenly.Don’t resist your feelings. Holding in anger can be a pain in your back–literally. In one study, people with chronic lower-back pain were harassed and then asked to either verbally express their anger or hold it in. Those who kept tight-lipped experienced more tension in the muscles along their spine, according to Psychosomatic Medicine. Tight muscles hurt whether you have ongoing back pain or aches from lifting too much, so follow the old adage and blow off some steam. One trick to minimize or prevent back pain is to allow yourself to fully feel what you’re feeling, says Dr. Teitelbaum. If you try to suppress anger, you’ll only store hostile feelings in your muscles as tension and increase the hurt. And focusing your attention on trying to understand or justify feelings shifts you out of your feelings and into your mind so you never really release anger.
The next time you see red, pay attention to whether your jaw is tightening or your breathing is getting shallower. These are signs that you’re resisting your feelings, so do the opposite and let your jaw go slack or take deep breaths. Find a private place where you can allow yourself to really feel your anger and have a good hissy fit to release your emotions—and ward off tension in your back. Headaches. The best way to prevent migraine is to find out what triggers your attacks and avoid or limit these triggers. Since migraine headaches are more common during times of stress, finding healthy ways to cut down on and cope with stress might help. Stress can signal the body to release adrenaline, which can cause shallow breathing and those neck muscles to tighten that result in headaches, says Dr. Teitelbaum. Practicing relaxation techniques, such as deep breathing, can also help signal your body to release less adrenaline and alleviate tense muscles. The next time you feel a tension headache coming on, mindfully slow your breathing by inhaling for a count of four. Then exhale for a count of four as you focus on a word, such as peace, to help distract yourself from your worries. Repeat for about a minute to feel calmer. Also, boring though it may sound, sticking to a routine helps prevent a migraine. That’s because changes in your daily schedule—sleeping in late on the weekends, blowing off breakfast, or skipping your daily bike ride—can trigger a migraine, says neurologist David M. Biondi, DO. “The brain of a person with a migraine likes to have consistency. When you get off schedule, the brain may respond by triggering a headache. So a person with a migraine should stay on as regimented a program as possible,” advises Dr. Biondi. Keep to a regular bedtime schedule, don’t skip meals, and try to eat at the same time of day every day. If your blood sugar falls too quickly, it can trigger a migraine. Where can I get more information? Arthritis Foundation American Chronic Pain Association National Pain Foundation
