Hidden Causes of Chronic Pain

Pain is one of the top reasons a patient seeks medical help. Pain is a protective reaction of the body that alerts us when something is not right. Pain is one of the manifestations of inflammation, along with redness, heat, and swelling. Causes of acute pain are usually diagnosed more easily and managed more effectively by conventional medicine. In contrast, chronic non-cancer pain, one that lasts longer than 3 months, is more complex, can have multiple causes, and does not always respond fully to conventional care and drugs.

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As a functional medicine and internal medicine doctor, I have found that most of my patients have chronic issues, and chronic pain is usually one of them. This can be in the form of back pain, joint pain and degeneration, muscle aches and spasms, headaches, undiagnosed recurrent abdominal pain, etc. Furthermore, these are also commonly associated with fatigue, depression, anxiety, insomnia, eczema, brain fog, allergies, and other non-specific symptoms. All these symptoms are indications of persistent and chronic inflammation, of which there are usually many causes. This presents a difficulty in completely resolving the symptoms. Finding these root causes of persistent inflammation and chronic pains is my focus in my functional medicine consultation practice. In conventional medicine, the approach is usually finding the right drug or procedure to alleviate the pain. That approach is, of course, important, but unfortunately, the drugs commonly used, like acetaminophen, ibuprofen, steroids, and the expensive biologics (like Humira, Enbrel, Remicade, and others), have significant side effects especially if used long-term. They also do not address the underlying cause of persistent inflammation, and the degenerative inflammatory processes continue and eventually cause other diseases.

What are the common causes of chronic inflammation that I search for? Here is a short list:
1. Nutritional deficiencies and excesses. The standard American diet is commonly loaded with
refined carbohydrates and unhealthy fats, yet lacking in important nutrients like zinc, magnesium, omega-3 fatty acids, vitamin A and K, etc. This imbalance of nutrients promotes inflammation.
2. Infections/Microbes. Subtle infections in the intestines, gums, teeth, skin can cause chronic inflammation. At the same time, inadequate levels of good bacteria in our gut lining weaken our immunity and change our metabolism.
3. Food sensitivities. Gluten (protein present in wheat and other grains), dairy, and soy are among the most common foods that can induce low-grade chronic inflammation. These sensitivities are common and can result from poor diet and other environmental triggers. Unfortunately, conventional medicine does not usually test for these sensitivities.
4. Toxicities. Pesticides in our foods and environment, mercury from dental amalgam fillings, lead from multiple sources, are some of the most common causes of neurological deterioration and painful neuropathies. Tests for your body’s load of these toxins are available, and there are many ways to safely assist the body in removing these toxins.
5. Stress and poor lifestyle choices. Emotional and physical trauma, daily life stressors, smoking, lack of exercise, and inadequate relaxation, promote inflammation and thus contribute to pain.
6. Hormone imbalances. All the above causes can also negatively affect our organs that
secrete hormones, like the thyroid, adrenal, ovaries, testicles, pancreas, and others, leading to poor hormone production or action. Hormone imbalances further promote difficulties in our body functions, leading to more inflammation and pain.
7. Genetic susceptibilities. Some of us have genetic variations that allow build-up of toxins that cause inflammation and slow tissue repair. The good news is that some of these genetic weaknesses can be tested for and overcome through improved nutrition and high-quality supervised nutrient supplementation.

If you suffer from any chronic pains, there are things that you can do to help lower the inflammation and reduce your pains. Start by eating a healthier diet, with a lot more vegetables, fruits, healthy fats, and adequate but not excessive protein. Minimize consumption of refined starches and sugar, like sodas, packaged juices, cookies, donuts, and other unhealthy carbohydrates. Aim for ideal body weight, focusing on reduction of inches around the waist, as this excess abdominal fat produces pro-inflammatory chemicals. Find out what your nutritional deficiencies are and correct them. Avoid harmful chemicals that are commonly found in products that we use daily, like household cleaners, cosmetics, plastic containers, etc. The website of the Environmental Working Group, www.ewg.com, is an excellent source of information on these harmful chemicals.

As you can see, merely taking pain pills for an indefinite period of time without finding and addressing the factors that promote your inflammation and pain, is an incomplete approach to pain management. Working with a functional medicine practitioner, whose focus is to help you find the root causes of your chronic pain, will likely produce better long-term results that can benefit your overall health.

Zorayda “Jiji” Torres, MD, ABIHM, IFMCP