Homecare

Biochemical Recommendations
for People in Prolonged Pain

Deficiencies and insufficiencies of certain metabolites have been seen in many chronic pain conditions and can create a predisposition to the activation of trigger points and subsequent perpetuation of myofascial pain syndromes. Deficiencies are values that fall outside the normal range. Insufficiencies can be found in the low parts of range and can be equally problematic whenever demand is high.

The following table has been compiled according to the recommendations of Robert Gerwin MD, Pain and Rehabilitation Medicine, Bethesda, MD; Tim Taylor, MD and Anna Bittner, MD, of Pain Relief Home, Richmond, VA. Support studies are quoted in the text books ‘Myofascial Pain and Dysfunction’ by Travell & Simons, ‘Trigger Point Therapy for Low Back Pain’ by Sauer & Biancalana and ‘Myofascial Trigger Points’ by Dommerholt & Huijbregts.

Supplement	Normal range for men	Normal range for women	Recommendations
Test results should be *at, or greater* than the following values
Ferritin (the storage form of iron)	50 ng/ml	The same	Eating red meat remains the best delivery system for iron. Spirulina etc. can help vegetarians. Take iron tablets with vitamin C
Vitamin B1 (thiamin)	4.0 mcg/l	The same
Vitamin B6	5.4-6.7 mcg/l	2.0-2.8 mcg/l
Vitamin B12	350 pcg/ml	The same	Found in animal protein
Vitamin D3 (25-OH)	50 ng/ml	The same	Take Vitamin D₃ with fatty food. Drs Taylor & Bittner super-supplement as high as 5,000 IU Vit D3 twice per day for one month, then 5,000 IU once a day until levels normalize. Recheck levels after 6 weeks from onset of supplementation. See also www.vitaminDcouncil.org
Serum Folate	5.4 mg/ml	The same
Test results should fall within the following ranges
Thyroid Stimulating Hormone (TSH)	0.4-2.0 micro IU/ml	The same	Hypothyroidism is mostly a female condition
Serum Calcium	8.5-10.6 mg/dl	The same
Red cell Magnesium	1.7 – 4.5 mg/dl	The same	Magnesium malate has less side-effects
Serum Potassium	3.5-5.2 mmoll	The same

Anti-Inflammatory and
Pro-Inflammatory Foods

Anti-Inflammatory

Foods and ingredients that are
known to be anti-inflammatory.

Fruits

Vegetables

Potatoes

Nuts

Fresh Fish

Wild Game

Omega-3 Eggs

Organic Extra-Virgin Olive Oil

Organic Butter

Dark Chocolate

Stout Beer

Red Wine

Balsamic Vinegar

Spices: ginger, turmeric, garlic, oregano, marjoram, cumin, etc.

Pro-Inflammatory

Foods and ingredients that are
known to be pro-inflammatory.

Refined Grains

Whole Grains

Grain / Flour Products

Grain-Fed Meats / Eggs

Most Packaged Foods

Most Processed Foods

Deep Fried Food

Trans Fats (Margarine, and in most packaged or processed foods)

Oil: corn, safflower, sunflower, soybean

Most Commercial Salad Dressings

Reference: Liebenson C. Rehabilitation of the Spine, 2nd Edition (2007), Chapter 30, page 730 ‘Nutritional Considerations for Inflammation and Pain’by David R. Seaman DC

Unhealthy Sleep Habits

History: Before the light bulb was invented we used to average 9-10 hours of sleep per day. We also worked harder, ate more naturally, and had way less continual stimulation. We slept long and well.

Unhealthy Habits

Unhealthy habits around bedtime
may be affecting your sleep hygiene.

Not really physically tired when going to bed

Overeating or eating and drinking too close to bed-time

Stimulated too close to bedtime by TV, computing, work projects

Over-worry about things: deadlines, finances, family or friends health

Out of sync with diurnal rhythms, especially with shift work

Daytime napping for more than 45 minutes

Medications that interfere with deep sleep

Bedroom Environment

Components of your bedroom environment
may be interfering with sleep.

Room too warm or too cold

Room too bright

An easily visible, or loud alarm clock time

A cordless phone in the bedroom (high electromagnetic forces)

Room too cluttered with stuff

Pets sleeping on the bed

Mattress over 8-10 years old

Pillows over 2 years old

Covers too heavy or restrictive

Spouse or partner that is restless, noisy, or generates too much heat

Medical Conditions

Certain medical conditions
may interfere with sleep.

Respiratory disorders

Cardiovascular disorders

Gastrointestinal disorders

Musculoskeletal pain and dysfunction

Diabetes

Renal disorders

Prostate problems and small bladder causing urinary frequency

Cancer

Dementia

Dental disorders

Restless leg syndrome or Periodic Limb Movement Disorder (PLMD)

Fibromyalgia (alpha wave intrusion)

Medications

The medications you are taking may be
interfering with your sleep.