Pain is something that everyone will experience. This can be due to medical conditions, procedures, or injury. Generally, with medical care, this pain will reduce and fade. However, unfortunately for some, pain can be chronic or intractable. This article will explore what exactly intractable pain is, who is at risk, and what you can do if you are currently experiencing it.
Before describing what intractable pain is, it is important to note that there are different types of pain that you may experience in your lifetime. These are:
Acute pain is short-term pain that comes on suddenly, such as with a sprained ankle, and will fade over a relatively short period.
Chronic pain is pain that lasts for at least three months and can't be completely reduced. This type of pain is generally experienced in medical conditions such as arthritis.
The third type is intractable pain, which is defined as pain that cannot be improved with medical care.
Intractable pain can be severe and can leave individuals bedridden or in hospital. This pain can last for specific periods, such as in the case of intractable migraine headaches, or it can be chronic intractable pain. There are many theories about what causes this type of pain, but the main theory is that the brain processes these pain signals differently than the other pain signals.
While anyone can experience it, some groups of individuals may be more at risk. These include people who are:
Many different conditions and factors can cause intractable pain. These conditions include:
Sometimes, the cause of your intractable pain may be unknown. This can lead you to think that you're making it up. However, intractable pain is a real condition that many experience.
Adrenal Fatigue is one condition brought on by long-term stress and can cause intractable pain. Individuals may not even be aware that they are experiencing adrenal fatigue. Adrenal Fatigue is a condition where the body cannot keep up with long-term stress, resulting in various nonspecific symptoms such as tiredness, sleep disturbances, joint aching, migrating muscle pains, and weight gain.
During short-term stress, your body releases hormones such as cortisol from your adrenal glands. The NeuroEndoMetabolic (NEM) Stress Response System, a six-circuit system of related organs, helps support your body. When stress remains ongoing, your adrenal glands become depleted. This results in low cortisol levels and imbalances within the NEM system can start occurring.
The symptoms of Adrenal Fatigue will depend on where the imbalance is occurring. One circuit that can be affected is the Inflammation circuit. As its name suggests, this circuit regulates inflammation in the body. Your immune system, gastrointestinal tract, and gut microbiome are responsible for this circuit and keeping inflammation in check.
An imbalance in this circuit can cause inflammation to increase in your body. This can result in various symptoms, including aches and pains that move throughout your body with no specific pattern. This type of pain can turn into intractable pain. Addressing the root cause of your stress can help reduce intractable pain.
Identifying this type of pain can be tricky, as there is no specific test that can measure your pain. It is generally determined when various medical interventions have been used and the pain continues.
If you are currently experiencing pain, it is important to see your healthcare provider. During this session, your healthcare provider will take a comprehensive history and ask where your pain is. Next, your healthcare provider will try to determine the cause of your pain and whether it is linked to a medical condition you currently have or if there is an underlying one. If the underlying cause of the intractable pain is addressed in some conditions, such as adrenal fatigue, it can reduce the pain. However, this depends on what is causing it.
Pain can have many different effects on your health and greatly affect your quality of life. Some complications of intractable pain include:
Additionally, not only can stress cause intractable pain but experiencing chronic pain can put extra stress on your body. This can cause high blood pressure and/or a high pulse rate. Over a long period, this can contribute to adrenal fatigue and can then worsen your pain, potentially resulting in intractable pain.
There are various interventions for intractable pain, including conventional medical interventions, natural remedies, physical therapy, and rehabilitation in the case of intractable pain in the back and/or neck. Natural remedies can help to reduce pain and, in some cases, can help to address the underlying cause, such as by reducing stress on the body, reducing inflammation, and improving gut health.
Nutrition can help regulate inflammation in your body, which can contribute to pain. Certain foods and drinks to AVOID that can increase inflammation in your body include:
Good quality nutrition, therefore, may help manage pain. Foods to INCLUDE are the following:
While overall adequate nutrition can help with intractable pain, there are specific nutrients that may also assist. These nutrients include:
Many of these nutrients work to reduce pain by reducing inflammation. The exception is magnesium and vitamin C, which work at blocking receptors and preventing pain (1,2).
Additionally, some of these nutrients, including B vitamins and magnesium, can help to improve mood and increase relaxation. During pain, your body can tense up, and your mood can decline, potentially increasing pain perception. These nutrients can also help indirectly reduce pain perception by improving your mood and relaxing your muscles.
Deficiencies in nutrients such as vitamin B5 (pantothenic acid), zinc, and vitamin D can also cause pain. Replenishing these levels may then help to reduce feelings of pain.
While high-quality nutrition can help supply nutrients to your body, sometimes, due to factors such as intolerances/allergies, lack of food availability, and conditions where inflammation is high, supplementation may be needed to assist. Supplementation helps provide larger amounts of nutrients in a controlled dose. This can help ensure that you receive the nutrients you may be lacking.
It can also help your body with herbs or other compounds you may not receive through your diet that may help with intractable pain.
Joint Formula by Dr. Lam is a supplement that provides a range of vitamins and minerals that may help lubricate the joints. In addition, it also provides a range of herbs and compounds you may not receive through nutrition that may help with aches.
These herbs and compounds include glucosamine HCL, Boswellin, sea cucumber, bromelain, and alfalfa juice. These act as antioxidants. Glucosamine helps to increase cartilage and fluid around your joints. This supplement is available in capsule form.
While some remedies will work directly to reduce pain, others will indirectly. The health of your gut will not only affect digestion and absorption of nutrients but also can play a role in pain. This is because of the gut-brain axis, a connection that, in simple terms, allows your gut and brain to talk to one another. Poor gut health can cause dysregulation of this axis. This can result in inflammatory pain (3). Additionally, poor gut health will affect the absorption of nutrients from food, which may then contribute to pain.
Restoring gut health can help restore the gut-brain axis and improve absorption, which can then help reduce pain. Focusing on probiotics and prebiotics can assist. These can be found in foods including:
Supplementation of pro and prebiotics is also available. Fermplex P by Dr. Lam consists of herbs infused with microorganisms during fermentation. This increases the bioavailability of the herbs and provides pro and prebiotics, helping to improve gut health. The herbs found in this supplement include turmeric, ginger, and lavender, which may help to reduce pain. Fermplex P is liquid; the recommended dose is one teaspoon per day.
During meditation, the orbitofrontal cortex (OFC) and anterior cingulate cortex are activated in two different parts of your brain. These parts of your brain are responsible for pain self-control. Additionally, two brain hormones, serotonin and norepinephrine, are released. This can help boost your mood and provide pain relief.
Meditation can also help your body reduce its inflammatory response and can help to reduce stress. If Adrenal Fatigue is one of the causes of your intractable pain, meditation can help not only reduce your pain but may help to address the root cause (4).
If meditation is not your first choice, yoga can help. When you are experiencing pain, physical movement can be reduced, resulting in stiff joints and muscles, ultimately exacerbating the pain. Yoga, specifically gentle yoga, can help to increase exercise, improve flexibility, release helpful brain hormones, and reduce stress. These all work together to help improve pain.
While this may not be a direct remedy, support is important. Pain, especially intractable pain, can make you feel isolated and alone. Getting support from a healthcare provider or support group can help remind you that you aren't alone. This can help boost your mood and reduce feelings of pain.
Intractable pain can be a lonely journey and may seem to be a never-ending one. However, some remedies may help support you during this time. These include:
While there is promising evidence on the use of supplementation for intractable pain, it can be confusing to choose the supplement that will best support your body. If you would like more information or guidance on whether you would benefit from supplementation, our team at Dr. Lam can help. Call us at +1 (626) 571-1234 for a free initial call.
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Na, Hyo-Seok, et al. “The Role of Magnesium in Pain.” Magnesium in the Central Nervous System - NCBI Bookshelf, 2011, www.ncbi.nlm.nih.gov/books/NBK507245.
Daoust, Raoul, et al. “Impact of Vitamin C on the Reduction of Opioid Consumption After an Emergency Department Visit for Acute Musculoskeletal Pain: A Double-blind Randomised Control Trial Protocol.” BMJ Open, vol. 13, no. 5, May 2023, p. e069230, https://doi.org/10.1136/bmjopen-2022-069230.
Morreale, Chiara, et al. “Microbiota and Pain: Save Your Gut Feeling.” Cells, vol. 11, no. 6, Mar. 2022, p. 971, https://doi.org/10.3390/cells11060971.
Dubey, Akshay, and Parikshit A. Muley. “Meditation: A Promising Approach for Alleviating Chronic Pain.” Curēus, Nov. 2023, https://doi.org/10.7759/cureus.49244.
The length that intractable pain continues for will depend on what is causing it. In the case of intractable migraine headaches, the pain will last for as long as the migraine headaches last. If the cause is a joint condition, it may last for longer.
