If I told you that there’s a crisis in pain management in this country, your thinking would probably go straight to the opioid addiction crisis. And you’d largely be correct. But this crisis is much bigger than opioids and addiction. The reality is that if you suffer from chronic pain and depend on conventional medicine, it’s unlikely you’ll have a positive outcome. That’s the bad news.
The good news is that most people don’t have to suffer from chronic pain. Last week, I told you about four nutrients that can help you treat arthritis pain. This week, I’m going to tell you how well one of those nutrients works. You won’t want to miss these stories.
A recent study showed just how desperate doctors are to find a way to effectively treat pain. The study didn’t pull any punches when it wrote: “Chronic pain and neuropathic pain are indications for which there is high need in the clinic, and as Loeser put it boldly recently, ‘… the lack of evidence for the outcomes of most of the things providers do for patients’ is one of the preeminent crises in pain management today. Indeed, many patients suffering from neuropathic conditions have pain that is refractory to existing treatments.”
Loeser is the author of an article entitled “Five crises in pain management.” He starts his excellent article with the statement: “I believe that there are five preeminent crises in pain management today: (1) the lack of evidence for the outcomes of most of the things providers do for patients, (2) the inadequate education of primary care providers about pain and how to treat it, (3) the largely unknown value of opioid treatment for patients with chronic nonmalignant pain, (4) funding for the providers of pain management, and (5) access to multidisciplinary care.”
I couldn’t have said it better. Pain management today doesn’t serve the patient. It serves the drug companies. And every one of these points is proof of that fact.
Fortunately, because you read this newsletter, you have solved problem #5. You have access to alternatives. And, when it comes to pain, there are some excellent alternatives. I told you about several of them last week. I’ve also told you about CBD, which is a fantastic pain reliever.
Some medical professionals don’t believe natural substances can really offer the pain relief that drugs can. But this small study clearly shows that one of my favorite pain relievers is extremely effective. In this study, the researchers gave PEA (palmitoylethanolamide) to seven patients who were pain treatment-resistant. In other words, pain management had failed to help them. Now watch what happens when the researchers added PEA to their treatment plan.
Note: The study doesn’t give the names of the patients, so I’ve given them a name to humanize them and make it easier to identify them. Also, these accounts are almost verbatim from the study. I’ve edited them a little and added some comments to make them easier to read.
Jack is a 61-year-old Caucasian male who has metastatic prostate cancer. His treatment plan included hormone therapy, estramustine, hyperthermia, and experimental dendritic cell therapy since 1996. In January 2009, Jack’s prostate-specific antigen count went up to 206 ng/mL. The cancer spread to the bones in lumbar and pelvic area. This is bad news, as cancer that has spread to the bones is very difficult to cure. He was subsequently treated with taxotere.
In October 2009, doctors began an experimental protocol with five courses of the new chemotherapy drug sagopilone. The sagopilone resulted in polyneuropathic side effects. This included neuropathic pain in both feet and hands, which increased in intensity. The study said the pain was “characterized by allodynia and hyperalgesia.”
Allodynia is an unusual symptom that causes the patient to feel pain from stimuli that don’t normally cause pain. For example, lightly touching your skin or brushing your hair might feel painful. Hyperalgesia is an abnormally increased sensitivity to pain. And the patient can become hypersensitive to stimulus. Both of these conditions can be miserable.
The doctors treated Jack’s pain with up to 300 mg daily of tramadol (a narcotic-like pain reliever) and pregabalin (an anticonvulsant that decreases the number of pain signals that damaged nerves sent out). Jack’s pain score averaged 7/10 on the numeric rating scale (NRS), with periods of peak pain of 9. Considering he was on pain medication, these numbers are very high and show the utter failure of the pain medications.
At this point, the researchers began treating Jack with PEA. They gave him 600 mgs twice daily away from his meals. Now, this is where it gets good.
Within three weeks, Jack’s pain went from a 7-9 out of 10 on the NRS to a mean NRS of 1-2. Those are absolutely astounding results.
With Jack’s pain now under control, he was able to continue chemotherapy with ongoing PEA administration. His NRS remained low under methotrexate therapy for three months. After about six months, the doctors took him off of the tramadol and pregabalin and he was stable with virtually no pain, occasionally taking 500 mg paracetamol.
Albert was a 62-year-old Caucasian male who had a number of pain-causing issues. He suffered from failed back surgery syndrome and he had three surgeries for a painful hernia (1980, 1991, 2004), plus a neurolysis in 2006 after a skiing injury. Despite these surgical interventions, the patient suffered many years from severe chronic pain with dysesthesia (unpleasant, abnormal sense of touch), burning, and hyperalgesia at the buttocks and right leg.
Treatment with gabapentin (another anti-convulsant) produced intolerable side effects before analgesia could happen. Diclofenac (a nonsteroidal anti-inflammatory drug) did not reduce pain. Albert complained about chronic pain and dysesthesia, scoring 7 on the NRS.
That’s when the researchers began treatment with PEA, giving him 600 mg twice daily. Within three weeks, pain as well as the burning sensations and dysesthesia decreased from NRS 7 to 4 and remained low until the last visit one month later.
Mark was a 54-year-old Caucasian man who had suffered for the past seven years from type-2 diabetes, with a treatment regimen of metformin, glimepirid, and liraglutide. Because of hypertension, hypercholsterolemia, and stomach complaints, the patient also received hydrochlorthiazide, a statin, and losartan (keeps blood vessels from narrowing).
The chronic neuropathic pain, especially prominent at both feet, scored 6 on the Douleur Neuropathique 417 scale and 7 on the NRS. His pain was characterized by burning and lancinating sensations and was largely unresponsive to gabapentin, duloxetine, capsaicine cream, pregabalin, and cannabis (yes, PEA can work when CBD doesn’t). He subsequently stopped all analgesic therapies.
The researchers started treatment with PEA, again giving 600 mg twice daily. In Mark’s case, they also gave R-alpha-lipoic acid (100 mg three times daily, a supplement explored extensively in diabetes mellitus type-2). Mark’s pain dropped to NRS score 3.
After four months, Mark attempted to reduce the dose of PEA to 300 mg twice daily. When he did, his pain rose within a week to an NRS score of 8. He immediately increased his dose of PEA to 600 mg tablets twice daily, and again pain quickly decreased to 3-4.
Four months later, it was possible to decrease PEA dosing again to 300 mg twice daily, without further increase of pain. In the following year, relapses of pain occurred, and treatment with PEA 600 mg twice daily was able to reduce pain to a baseline NRS score of 3 again in about 10 days.
Since then, the patient has been stable and continued taking PEA 300 mg twice daily. It should be noted that PEA has no relevant affinity for either the CB1 or the CB2 receptor, explaining why this patient was a responder on PEA while a non-responder on cannabis. It also should be noted that treating Mark’s diabetes naturally could have completely eliminated his symptoms. This is true for patient #4 as well.
Joe was a 64-year-old Caucasian male suffering from type-2 diabetes for eight years. Doctors had treated him with metformin. Joe suffered from neuropathic pain in both feet. Although the pain was treated with pregabalin (225 mg/day) he still scored NRS 6.
The researchers started prescribing according to their protocol for diabetic pains, consisting of 2000 IE of vitamin D3 (three times daily), 100 mg of R-alpha-lipoic acid (three times daily), and twice daily PEA 600 mg, together with a topical cream twice daily consisting of adelmidrol and capsaicine (Algonerv).
After three weeks, the patient felt much better, pain was reduced from 6 to 4, and only in the morning did some burning pain remain.
After three months of treatment, pain was reduced to 1.5, although the patient forgot to use the alpha-lipoic acid. He was able to resume full activities as an industrial designer and was working with much pleasure on a new machine.
Phil was a 66-year-old Caucasian male suffering from chronic idiopathic axonal polyneuropathy, (neurological disorder that occurs when many peripheral nerves throughout the body malfunction simultaneously). Phil had a mean pain score of 8 on the NRS. The pain included burning and tingling in both feet. Neuropathic pain started after walking 10 miles and more. Being an enthusiastic walker, he started to feel very annoyed by the symptoms.
Phil refused to take analgesics such as amitriptyline and pregabalin because of much-feared side effects. The researchers started treatment with PEA according to their protocol, and month by month his pain decreased.
After two to three months, pain was reduced to NRS 1-2 and Phil was able to start walking long distances again.
Sally was a still-very-active 81-year-old Caucasian female with 25 years’ vaginal complaints from lichen sclerosis. She underwent a partial vulvectomy in 2008 because of a lesion that showed vulvar intraepithelial neoplasia II. Her pain fluctuated from no pain at all to a 7 on the NRS. She also had one or more lesions that came and went and a very fierce itch.
Her family doctor and several gynecologists and dermatologists advised and prescribed petroleum jelly, vitamin E and zinc ointments, triamcinolone acetenoide, several other local corticosteroid ointments, and several local and systemic yeast treatments.
By the end of 2010, passing urine had become very painful and she could not ride her bike anymore. Her gynecologist prescribed a very strong local corticosteroid, clobetasol, after which the pain worsened to 9-10 on the NRS. The patient became desperate and asked for advice.
Sally started with PEA according to the doctors’ protocol. In addition to the oral PEA, they prescribed a twice-daily local vaginal gel containing a precursor of palmitoylethanolamide, adelmidrol (Saginil gel).
The next day, the pain and itching almost disappeared. She started cycling again. She used the gel intermittently during periods of several weeks. The improvements in pain and itching lasted around six months.
Unfortunately, in the second half of 2011, lesions reappeared. Another biopsy was performed, and her lichen sclerosis had progressed to vulva carcinoma. A radical vulvectomy and selective inguinal lymphadenectomy were performed. Histopathologic examination showed no metastasis. All complaints were gone.
Sandra was the only patient who didn’t experience any pain relief from the PEA. She was an 80-year-old Caucasian female with complaints of pain in feet and legs, low-back pain and paresthesia, as well as numbness. Because of her advanced age, the patient did not wish to take amitriptyline and related compounds. Her pain score was 6.5 on the NRS; treatment with topical amitriptyline cream was ineffective. PEA 600 mg twice daily was added; however, no decrease of pain was observed. The addition of other prescribed supplements, such as acetyl-l-carnitine, did not decrease pain either. She is presented as a non-responder. One of the reasons for this might have been advanced age combined with a nonspecific chronic pain.
The study didn’t say whether they tried CBD on Sandra or not. But, as you can see, PEA was extremely effective in six out of seven of the patients. Their pain either went away completely or was so reduced they were able to begin their normal activities again. These are astonishing results, especially given the fact that all of these patients were non-responders to conventional pain relief (other than patient #7 who refused pain medication).
What type of pain does PEA treat? Most types. The researchers said: “Palmitoylethanolamide (PEA), an endogenous fatty acid amide, has been demonstrated to bind to a receptor in the cell nucleus – the peroxisome proliferator–activated receptor – and performs a great variety of biological functions related to chronic and neuropathic pain and inflammation, as has been demonstrated in clinical trials. These include peripheral neuropathies such as diabetic neuropathy, chemotherapy-induced peripheral neuropathy, carpal tunnel syndrome, sciatic pain, osteoarthritis, low-back pain, failed back surgery syndrome, dental pains, neuropathic pain in stroke and multiple sclerosis, chronic pelvic pain, postherpetic neuralgia, and vaginal pains.”
So if you’re looking for pain relief and haven’t found it, give PEA-Min a try. This formulation includes curcumin, which is a fabulous anti-inflammatory. You can order PEA-Min by following this link.