Relief with opioid discontinuation

Managing persistent or chronic pain is complex. Frequently there is a lack of objective reason for persistent pain yet it is real, personal and subjective and people with persistent pain are of then desperately seeking effective pain relief. I recently attended an “Explain Pain” course in Cairns (which was lovely and warm), which looks at ways to reconceptualise pain from a modern neuroscience perspective. How does this help? Well knowledge is power. There is a growing body of research showing that we can target our natural analgesic systems with simple but effective education about pain. This is particularly pertinent given the numbers of people suffering with persistent pain and the failure of common pain medications to effectively manage pain.

A high fat diet worsens post-operative pain and inflammation:

Obesity commonly correlates with increased pain. One of the mechanisms for this is relatively straightforward; having central adiposity (fat around the stomach region) or being obese is associated with low-grade chronic inflammation, and this, in turn, is associated with a greater incidence and severity of chronic pain conditions. In the recent study authors (Song. et al, 2018) wanted to study the effects of diet and obesity on postoperative pain. There were 2.7 million surgeries performed in 2016 according to the Australian Institute of Health and Welfare. Each surgery is associated with some degree of acute pain, and the severity and duration of acute pain experienced is a risk factor for the development of chronic pain. So any modifiable factor that increases pain intensity or duration post surgery is worthy of note, as it may help to reduce progression to chronic pain.

Acne is more than skin deep

The burden of acne is more than skin deep. Strongly impacting on negative self-image and perceived stress, acne not only causes stress but is also made worse by stress. It is now well established that stress contributes to the development of acne but until this year there have been no studies looking at stress management as a direct treatment intervention. A report published this year in the International Journal of Dermatology details the methods and results of an 8-week experimental study in 30 women with acne undergoing a specific stress reduction process called the Pythagorean Self-Awareness Intervention (Chatzikonstantinou, et al. 2018)

The gut-skin axis

The health of the gut microbiome and its impact on wider health has seen an explosion of research, and with the advent of DNA sequencing our understanding of the microbiome and its effects on health is growing. We now understand that the influence of the gut microbiome extends beyond the gut, impacting on distant organs and systems either positively or negatively depending on the composition of microbiota. These wider effects are known to influence skin health, and this article will review the specific influence on acne.

Mind over matter

This month I have been delving into New Scientist again and one article in particular really sparked my interest. Called “Mind Over Matter”, the author David Robson outlines and supports the assertion that changing your attitude can have profound benefits on your health (Robson, 2018). In this day and age of metaphysical thinking this may not seem like a mind-blowing-ly new concept, however I often find the mind over matter approach being thrown about without a lot of research to back it up. So when the article outlined studies to support this concept I suddenly got a bit more interested.

The vitamin D and acne connection

Vitamin D deficiency is known to play a role in many inflammatory skin conditions, and certainly is seen to be a contributing factor in acne. Acne is an inflammatory skin condition with both systemic inflammation and local inflammation within the skin, even at the very early micro-comedone stage of development. The causes of local inflammation can be directly linked to the influence of systemic drivers however; local factors play a significant role as well. This article looks at the role of vitamin D as a potential regulator of local immune and inflammation processes that drive acne.

Turmeric, a super spice for pain

If you do a quick search about Turmeric on the Internet you may begin to wonder what it can’t do. The list of benefits reported is extensive and the diseases it is purported to treat are numerous. This super-spice is popping up in all sorts of interesting ways from Turmeric lattes to fermented drinks. It also has a growing body of research to back up some of the widely quoted benefits. However, it is important to note that there is a difference between food ingestion and a standardised supplement and in this article, I specifically look at standardised curcumin, one of the key active components of turmeric, and the role it has to play in pain management.

Dietary relief for arthritis & musculoskeletal pain

There’s a ton of ideas floating around social media about the best diet for chronic health issues. Some have research to back them up, many don’t. So, when I read this recent paper reviewing the studies that found positive effects of dietary changes on pain intensity in musculoskeletal pain (MSK) I was one happy practitioner!

The premise of this review paper was to assess the link between dietary patterns, specific components of a patient’s diets, and chronic MSK pain. Some interesting trends emerged, which I have outlined below.

Podcast - how pain influences the brain

In this podcast with Daniel Roytas I talk about pain management from a holistic perspective and consider the importance of a biopsychosocial approach to pain. We also talk about how the brain plays a major role in pain perception.

Bad, Mad, Sad

Are you feeling bad, mad, or sad?

𝗬𝗼𝘂𝗿 𝗳𝗲𝗲𝗹𝗶𝗻𝗴𝘀 𝗺𝗮𝘁𝘁𝗲𝗿, and just as important is knowing what you are feeling and being able to articulate them.

Not knowing is called alexithymia, which means an inability to describe our own emotions. It can also be associated with difficulty with identifying different types of emotions.

Critically not understanding or being able to describe our own emotions has far-reaching effects. With the appropriate language we can understand and share what we are experiencing. Labelling an emotional experience results in ‘greater emotional regulation and psychological wellbeing’. Without this capacity we may not even know how to make sense of an experience for ourselves. If we can’t understand and share our experience, then how can we ask for help, or get what we need?

Psoriasis risk factors

Written By Ananda Mahony

A review in the International Journal of Environmental Research & Public Health highlights nutrition as a risk factor for psoriasis, suggesting that overall diet, body weight and quality of nutrition are significant triggers of disease development and exacerbating factors, with potential to worsen the disease severity.

Psoriasis a chronic immune-mediated condition associated with significant inflammation. Metabolic risk (characterised by central weight, high blood sugar, blood pressure, triglycerides and cholesterol) is linked with increased severity of psoriasis and the current understanding is that inflammation may be the common link.

Naturopathy and chronic pain

A set of excellent guidelines by NPS MedicineWise includes complementary medicine approaches as part of overall health care planning for those in chronic pain. The specific recommendations also include aspects of life such as physical fitness, mood, sleep, relaxation and overall health. I find these inclusions so positive as they support a holistic approach to pain management and importantly, these aspects fall squarely within the scope of naturopathy, meaning specifically that working with a naturopath can have a health benefit in these areas. I have long held that naturopathy’s holistic approach fits well with the medical biopsychosocial model of chronic pain management and these guidelines further reinforce this approach.

Overcoming psoriasis

In this podcast with Andrew Whitfield-Cook from FX Medicine, I discuss how to overcome psoriasis, a devastating disease not just because of the outward expression of the red rash and silvery scales, but also because of the co-morbidities and frequently unsatisfactory results gained by medical management alone.

Overcoming sleepless nights

For about 5 years insomnia was a regular and generally unwelcome companion of mine. Over this time I managed to function well, most of the time but there was this nagging belief that I ‘should’ be able to heal myself if I just found the right solution. Well that thought wasn’t overly helpful because there wasn’t ‘one’ solution. What did come out of the experience however was a gradual acceptance that some nights I just wouldn’t sleep well and the understanding that there are many, many useful tools to assist with a calm night regardless. I also looked into and tried many different approaches to help improve my sleep, some of which were quite useful, others not so much. However, like most chronic issues, an individual whole body, whole life approach is what was successful for me in the end.

Healing Stewed Apple

Diarrhoea or constipation, abdominal pain and bloating are symptoms commonly associated with irritable bowel syndrome (IBS). This conditions affects up to 15% of individuals at some time in their life and is frequently associated with anxiety, stress and poor emotional well-being. The gut symptoms, emotional impact and inflammation associated with IBS can lead to chronic pain and a poorer quality of life in general. What is surprising is that even the fear of gut symptoms has adverse consequences and can have a significant impact on an individual’s day-to-day life.

A holistic approach to chronic pain

An article in the Australian Pain Newsletter by pain specialist Dr Chris Hayes (2016) really stood out to me recently as it emphasises the necessity for a holistic approach to the management of chronic non-cancer pain. The biopsychosocial model is widely accepted as the predominant framework for understanding the experience of chronic pain and its negative consequences, and is supported by a large body of research. The model takes a broad and holistic view of the factors that contribute to chronic pain and the interaction of biological (genetic, biochemical, trauma), psychological (mood, behaviour) and social factors (familial, medical, work place etc) and was developed to counter the biomedical model, which suggests that disease is the result of only biological factors.

The scaly issue of psoriasis

Psoriasis is a chronic (long-lasting) skin disease of scaling and inflammation that affects about 1 to 5% of the population worldwide. Itching and abnormal flushing are also common features. Primarily affecting adults, psoriasis is caused by an accelerated skin cell turn over and has a strong genetic component.. Those who suffer from this disease often experience physical, social and emotional trauma. The exact cause is unknown; however, researchers believe that heredity, environment, and the immune system may also play a role in psoriasis.

Acne is seen as a condition associated with Western diets that are generally higher in saturated and trans-fats, high in simple carbohydrates and sugars and lower in healthy protein sources.

While topical applications make a difference, a healthy glow is more often a sign of internal health than anything else. There is a growing body of evidence to show that what we eat certainly influences skin ageing and not surprisingly, the dietary correlations that relate to reduced skin ageing also relate to reduced ageing in general.

Insomnia also disrupts the optimal processing of collagen formation, which is essential for skin structure and integrity. The follow on effects from poor collagen formation include the disruption of the acid mantle leading to excessive moisture loss and increased sensitivity and permeability to topical products.