Pain Management a New Approach

PAIN MANAGEMENT – A NEW APPROACH

Sagiv Ben-Yakir DVM, MRCVS, BSc

The Academic College at Wingate Institute, ISRAEL

Netanya, ISRAEL

Pain is often defined as an unpleasant sensory and emotional experience associated with actual or potential tissue damage or described in terms of such damage. Pain produces physical or physiologic changes that are exhibited as mild behavioral discomfort or distress to acute, often unbearable, agony. Pain may be diffused or localized, and usually produces a desire to avoid, escape, or destroy (autonomy) the factors responsible for its production. Untreated or prolonged pain promotes an extended and destructive stress response, characterized by neuroendocrine, dysregulation, fatigue, dysphoria, myalgia, abnormal behavior, and altered physical performance ("Handbook of veterinary pain management" eds. Gaynor J.S and Muir W. 2nd edition, 2009, Mosby Elsevier).

Conventional treatments ensure positive benefits in the short term, but they involve a complex of serious adverse effects. Moreover, many animals cannot use allopathic medicines (as NSAIDs), or face time-limited use of these drugs, as they must not be used for long periods of time. Furthermore, although the main goal is to eliminate the pain, often the causes that determine it are neglected.

Since pain is a multi-factorial condition there is a need to formulate a remedy that will negotiate all the different origins of the pain: a hormonal one, an immune source, a neurological cause, as well as a psychological etiology.

Upon formulation of this kind of remedy we should look for ingredients that –

· Have no local or general allergic reactions

· No adverse side effects in the short and long term

· No contraindications

· Safe to be used during pregnancy

· No interaction with other drugs

We are going to present different remedies to be applied by injections into acupuncture points based on body location as well as body systems involved.

1) Neck ingredients: Cartilago suis 4X 4 parts, Anti interleukin 1 alpha 4C, Anti interleukin 1 beta 4C, Beta-Endorphin 4C, Magnesia phosphorica 8X, Nux vomica 10X, Picricum acidum 10X, Silicea 4X 2 parts, Crotalus horridus 10X, Intervertebral disk of Porcine 4X 1 part all in sterile isotonic sodium chloride solution.

2) Thorax ingredients: Chininum sulphuricum 8X 4 parts, Anti interleukin 1 alpha 4C, Anti interleukin 1 beta 4C, Beta-Endorphin 4C, Calcarea phosphorica 6X, Cimicifuga racemosa 4X, Intervertebral disk of Porcine 4X, Spongia tosta 10X 2 parts, Chelidonium majus 4X, Conium maculatum 6X 1 part all in sterile isotonic sodium chloride solution.

3) Lumbar ingredients: Alumina 8X 4 parts, Anti-interleukin 1 alpha 4C, Beta-Endorphin 4C, Bryonia alba 4X, Hamamelis virginiana 6X, Natrum sulphuricum 8X, Phosphoricum acidum 6X, Sepia 4X 2 parts, Anti-interleukin 1 beta 4C, Intervertebral disk of Porcine 4X 1 part all in sterile isotonic sodium chloride solution.

4) Ischial ingredients: Aconitum napellus 8X, Anti interleukin 1 alpha 4C, Anti interleukin 1 beta 4C, Arsenicum album 6X, Beta-Endorphin 4C, Cimicifuga racemosa 4X, Gnaphalium polycephalum 4X, Lachesis mutus 8X, Rhododendron chrysanthum 6X, Rhus toxicodendron 4X 2 parts all in sterile isotonic sodium chloride solution.

5) Shoulder ingredients: Argentum nitricum 8X 4 parts, Anti interleukin 1 alpha 4C, Anti interleukin 1 beta 4C, Beta-Endorphin 4C, Cartilago suis 4X, Ferrum phosphoricum 8X, Sanguinaria canadensis 8X, Tendon of Porcine 6X 2 parts, Iris versicolor 8X, Ranunculus bulbosus 10X 1 part all in sterile isotonic sodium chloride solution.

6) Hand and foot ingredients: Arnica montana 4X, Viola odorata 6X 4 parts, Anti interleukin 1 alpha 4C, Anti interleukin 1 beta 4C, Beta-Endorphin 4C, Caulophyllum thalictroides 12X 2 parts, Benzoicum acidum 6X, Cimicifuga racemosa 10X, Ledum palustre 6X, Mercurius solubilis 8X 1 part all in sterile isotonic sodium chloride solution.

7) Hip ingredients: Arnica montana 8X 4 parts, Anti interleukin 1 alpha 4C, Anti interleukin 1 beta 4C, Beta-Endorphin 4C, Calcarea fluorica 6X, Cartilago suis 4X, Colocynthis 8X, Rhus toxicodendron 10X 2 parts, Argentum metallicum 6X, Formicum acidum 8X 1 part all in sterile isotonic sodium chloride solution.

8) Polyarthritis ingredients: Salicylicum acidum 2X 4 parts, Aconitum napellus 6X, Anti interleukin 1 alpha 4C, Anti interleukin 1 beta 4C, Beta-Endorphin 4C, Drosera 8X, Ledum palustre 8X, Viscum album 10X 2 parts, Colchicum autumnale 10X, Guaiacum 10X 1 part all in sterile isotonic sodium chloride solution.

9) Muscle ingredients: Arnica montana 4X, Colocynthis 4X 4 parts, Belladonna 6X, Lithium benzoicum 8X, Muscle tissue of Porcine 4C, Procaine chloride 2X 2 parts, Colchicum autumnale 6X, Cuprum sulphuricum 4X, Hypericum perforatum 4X, Interferon gamma 4C 1 part all in sterile isotonic sodium chloride solution.

10) Neural ingredients: Aconitum napellus 8X, Beta-Endorphin 4C, Colocynthis 4X, Ferrum phosphoricum 2X, Formica rufa 8X, Gnaphalium polycephalum 6X, Iris versicolor 8X, Kalmia latifolia 2X, Neurotrophin 4 4C, Paris quadrifolia 6X 2 parts all in sterile isotonic sodium chloride solution.

The remedies ingredients are based according to the different location in the body as well as systems involved –

For #1 = Neck –

· 1st Core – an analgesic core - the concentration of b-Endorphin 4C, corresponding to the physiological concentration of this inhibiting neurotransmitter – both at central and peripheral levels - is capable of sensitizing the cell receptors through up-regulation mechanisms resulting in an enhanced analgesic action of endogenous b-Endorphin.

· 2nd Core – an anti-inflammatory core - the action of Anti IL 1 a and b 4C restrains the onset of inflammatory episodes; these two interleukins representing some of the main factors responsible for the inflammatory process.

· 3rd Core – an homeopathic analgesic core - the four remedies of this core have been selected according to their specific organic tropism for the different anatomical structures of the neck to modulate pain, especially myalgic syndrome (Picricum acidum), spastic and/or congestive (Crotalus horridus and Nux vomica), nerve (Magnesia phos.) pain affecting the neck. Particular attention should be paid to the analgesic action of Picricum acidum and the myo-relaxing action of Nux vomica which work in synergy with each other thus curing acute pain.

· 4th Core – an anti-degenerative core - rheumatic pathologies are accompanied by severe tissue degeneration conditions resulting in a progressive functional handicap. Moreover, as in a vicious circle, degeneration supports inflammation and vice versa. A correct therapeutic rationale should stop this mechanism by acting not only on symptoms but also on the etiological causes. Consider that Cartilago suis, by stimulating protein synthesis (especially glycosaminoglycans) induces restructuring of cartilage matrix, which is usually responsible for cervical spine disorders. Hence, the neck remedy contains Discus intervertebralis disk of Porcine. The anti-degenerative core also contains the remedy Silicea, which performs a dual action. First, it stimulates the osteoblast function for bone matrix metabolism, and secondly it is capable of correcting the constitutional predisposition of certain individuals, as the Fluoric Constitution, according to Constitutional Homeopathy, who are more prone than others to joint degeneration and ligament loosening.

For #2 = Thorax –

· 1st Core – an analgesic core - the concentration of 4C of b-Endorphin, corresponding to the physiological concentration of this inhibiting neurotransmitter – both at a central and peripheral level - is capable of sensitizing the cell receptors through up-regulation mechanisms resulting in an enhanced analgesic action of endogenous b-Endorphin.

· 2nd Core - an anti-inflammatory core - the action of Anti IL 1 a and b restrains the onset of inflammatory episodes, these two interleukins being some of the main factors responsible for the inflammatory process.

· 3rd Core – an homeopathic analgesic core - the five remedies of this core have been selected according to their specific organic tropism for the different anatomical structures of the spinal column to modulate pain especially of nerve-muscle origin (Cimicifuga, Chininum sulphuricum, Conium maculatum), spastic and/or congestive pain (Chelidonium and Spongia tosta). The remedies of this core have also been selected on the basis of the localization of their therapeutic effect: they are all active on the dorsal rachis due to their specific organic tropism, while Chelidonium (specific organic tropism for the right side of the liver) has a reflex analgesic action on rachis.

· 5th Core - a constitutional core- Calcarea phosphorica is capable of correcting the constitutional predispoision of some individuals, the Phosphoric Constitution according to Constitutional Homeopathy, who are more prone than others to structural alterations of the posterior area of the spinal column (scoliosis, kyphosis, lordosis) that may lead to or be the cause of pain related to poor posture.

For #3 = Lumbar –

· 1st Core - an analgesic core - the concentration of 4C of b-Endorphin, corresponding to the physiological concentration of this inhibiting neurotransmitter – both at a central and peripheral level - is capable of sensitizing the cell receptors through up-regulation mechanisms resulting in an enhanced analgesic action of endogenous b-Endorphin.

· 2nd Core – an anti-inflammatory core - the action of Anti IL 1 a and b restrains the onset of inflammatory episodes, these two interleukins being some of the main factors responsible for the inflammatory process.

· 3rd Core – an homeopathic analgesic core - the remedies of this core have been selected according to their different action on pain and especially on the basis of the different origin (neuro-muscular: Bryonia, Alumina, Phosphoricum acidum; joint pain: Natrium sulphuricum), type (cramps: Phosphoricum acidum; as a consequence of muscle paresis: Alumina), localization (lumbosacral rachis: Hamamelis; reflex coming from the abdomen: Sepia).

· 4th Core – an anti-degenerative core - it is well known that the rheumatic pathology is accompanied by serious tissue degenerative conditions leading to a progressive functional handicap. Moreover, like in a vicious circle, degeneration often supports inflammation and vice versa. A correct therapeutic rationale acting on both symptoms and etiological causes is to stop this mechanism. In lumbar pain, an essential role is played by the intervertebral disk: the inflammation of pulp core, and its protruding condition leading to hernia or degenerative conditions are often at the basis of lumbosacral pain. Furthermore, we should consider that the main locus minoris resistentiae of the spine can be localized at the level of L6-L7 and L7-S1 vertebra: the aim of a treatment – acting not only on symptoms - of lumbosacral pain is to protect the disk at this level. Hence, lumbar remedy contains intervertebral disk of Porcine.

For #4 = Ischial –

· 1st Core – an analgesic core - the concentration of 4C of b-Endorphin, corresponding to the physiological concentration of this inhibiting neurotransmitter – both at a central and peripheral level – which is capable of sensitizing the cell receptors through up-regulation mechanisms resulting in an enhanced analgesic action of endogenous b-Endorphin.

· 2nd Core – an anti-inflammatory core - the action of Anti IL 1 a and b restrains the onset of inflammatory episodes; these two interleukins being some of the main factors responsible for inflammatory process.

· 3rd Core – a primary anti-neuralgic core - the five remedies of this core have been selected on the basis of their specific organ tropism for the sciatic nerve (Gnaphalium policephalum, Lachesis muta and Rhododendron chrysantum) and their functional tropism for the neurogenic phase of the inflammatory process (Aconitum and Arsenicum album).

· 4th Core – a secondary anti-neuralgic core - the two remedies of this core can be considered as analgesic “etiological” remedies as they are capable of modulating the sciatica pain by acting on the causes of osteochondritis of the lumbosacral part of the spine (Cimicifuga) and hip arthrosis and lumbar pain (Rhus tox.).

· 5th Core – a reflex anti-neuralgic core - sciatica pain often has a remote cause; either reflex pain that comes from the abdomen (in this case, Lachesis could be helpful) or a lumbosacral-iliac origin (in this case, Cimicifuga could be helpful).

For #5 = Shoulder –

· 2nd Core – an anti-inflammatory core - the action of Anti IL 1 a and b restrains the onset of inflammatory episodes; these two interleukins representing some of the main factors responsible for the inflammatory process.

· 3rd Core – an homeopathic analgesic core - the five remedies of this core have been selected according to their specific organic tropism for the different anatomical structures including shoulder-arm joint to modulate pain, especially of inflammatory origin affecting the whole shoulder. Argentum nitricum, Ferrum phosphoricum, Iris versicolor, Ranunculus bulbosus, Sanguinaria canadensis, act not only on pain but also on the other signs of periarthritis such as arm paresthesia (Argentum nitricum), brachial nerve pains (Ferrum phosphoricum, Ranunculus and Iris), and functional handicap of muscle origin (Sanguinaria).

· 4th Core – an anti-degenerative core - rheumatic pathologies are usually accompanied by severe tissue degeneration conditions resulting in a progressive functional handicap. Moreover, as in a vicious circle, degeneration supports inflammation and vice versa. A correct therapeutic rationale should stop this mechanism by acting not only on symptoms but also on the etiological causes. Cartilago suis, by stimulating protein synthesis (especially glycosaminoglycans), induces restructuring of cartilage matrix and its functional recovery. To heal shoulder pain it is essential to support the tendon-ligament function and structure of the rotator cuff: therefore, shoulder remedy contains Tendon of porcine.

For #6 = Hand & foot –

· 1st Core – an analgesic core - the concentration of 4C of b-Endorphin, corresponding to the physiological concentration of this inhibiting neurotransmitter – both at a central and peripheral level - is capable of sensitizing the cell receptors through up-regulation mechanisms resulting is an enhanced analgesic action of endogenous b-Endorphin.