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Pain

Think of a toothache and many would empathise with the borrowed saying: “Pain, pain, go away! Please do not come back another day!” Pain motivates us to seek medical care yet non-painful health issues are often treated with less urgency — and sometimes the cause of pain is not easily recognisable.

Let’s take diabetes, for example. Few diabetics sense any pain with their blood sugar disorder and yet, if left poorly controlled, it will eventually lead to serious medical complications. The Australian Diabetes Council lists heart disease, blindness and even limb amputation as possible complications. Given the serious impact on the quality of life, most sufferers would be motivated to take action to control their diabetes.

What about snorers? Being socially embarrassed and not being able to share the same bed with a loved one is bad enough, and it is often the long-suffering partner who pushes the snorer to their doctor or dentist for treatment. Acknowledgement and acceptance of the sufferer’s medical problem is the first step to health; actually desiring better health is another issue.

Yet there is a third kind of pathology that is not broadly acknowledged or well understood by the medical and dental profession. This pathology is classified as disorders of the nervous system. A dysfunctional nervous system is notorious for giving both patients and the healthcare system a conflicting picture of the true nature of their disease.

Meet the homunculus

For starters, our brains receive a much bigger sensory input from our hands, mouth and tongue. Canadian neurosurgeon Dr Wilder Penfield was the first to map this, in the 1940s. A 3-D representation of how our brains map our sensory body is called a homunculus and is shown in the image on the left.

So what causes our nervous system to dysfunction? The reasons can be broadly divided into postural issues, nutritional deficiencies and past traumas (both physical and emotional).

When nerves are distorted or compressed, from poor posture, for example, then the organs that receive these nerve inputs can start to malfunction. Bladder problems, for instance, are frequently observed by chiropractors who find lumbar spine compression. The lumbar spine is where the bladder nerves become compressed and dysfunctional.

The nervous system also requires adequate nutrients to function properly. A sufficient intake of healthy fats, vitamin D and vitamin B12 are all essential for normal nerve function. Adequate vitamin B12 levels also needs an assessment of folate intake, which was the subject of one of my previous blogs. Complicating things further is the presence of heavy metals, which are known to block the nutrients we do absorb from being used by our bodies.

The final cause of nervous system dysfunction are past traumas, whether physical or emotional. Old scars or previous surgery, on the one hand, or strong emotional events, on the other, are all known to permanently alter the way are nervous system responds in the future. Readers interested in learning more about this can read the work of Dr Robert Kidd, a Canadian doctor whom I had the privilege of meeting a few years ago.

My dream is that medical and health professionals desire to collaborate in understanding and treating more nervous system disorders. Not only would this provide better health outcomes for our patients but reduce the ballooning healthcare budget in Australia.

Dr Nader Malik

Dr Nader Malik

Dr Nader Malik is a cosmetic and integrative dentist whose core treatment philosophy is to make a visible difference to the lives of his patients so that they can be inspired to laugh, smile and share the same experience with others! As a whole-body dentist, he focuses on understanding and treating the strong links between the teeth and the rest of the body. He also enjoys working with medical doctors and allied health professionals to ensure the best outcomes for his patients. Dr Malik practises at Our Medical Dental in Penrith, NSW Australia.

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Antiox_nerve_pain_web

Pain, pain, go away

Any sort of pain is uncomfortable, that is its nature. When pain becomes prolonged and removed from an immediate cause however, that takes things to a whole new level. Neuropathic pain is an example of this long term pain and according to a new study, the good news is that antioxidants might offer some help.

The sort of pain that you feel from a cut, burn, or injury, is called nociceptive pain. The reason you feel pain in these situations is because tiny nerve endings become activated or damaged by the injury, and this sends pain messages to the brain via nerves. Nociceptive pain tends to be sharp or aching. It also tends to be eased well by traditional painkillers such as paracetamol, antiinflammatory medications, codeine, and morphine. Neuropathic pain is a quite different beast.

Neuropathic pain is a pain that comes from problems with signals from the nerves. So the problem is with the nerves themselves. Neuropathic pain is often described as burning, stabbing, shooting, aching, or like an electric shock. It is less likely than nociceptive pain to be helped by traditional painkillers. Examples of causes of neuropathic pain are postherpetic neuralgia (pain following shingles), diabetic neuropathy, phantom limb pain following an amputation, multiple sclerosis, chemotherapy, and alcoholism. Conventional treatment for neuropathic pain includes antidepressants, anticonvlusants, and opiates.

It is believed that part of the answer to neuropathic pain lies in spinal neurons that release a neurotransmitter known as GABA (gamma amino butyric acid). These GABA neurons act as a brake on pain impulses and the theory is that when they die or are disabled the pain system gets out of control and neuropathic pain can result. So if you can protect those neurons after injury then neuropathic pain might be averted.

GABA neurons are very susceptible to oxidative stress so researchers wanted to see of antioxidants might protect them and so reduce neuropathic pain. They did this by treating some mice with neuropathic pain with an antioxidant compound for a week while other mice with neuropathic pain received no antioxidants.

The mice given antioxidants showed less pain behaviour and also had far more GABA neurons than the untreated mice. Interestingly, the improvements in pain behaviour were not proportional to the increase in GABA neurons. It is possible that the surviving neurons were somehow impaired in function but if antioxidants were to be shown to have similar effects in humans the kind of results shown here would be good news for a condition that is otherwise difficult to treat.

Terry Robson

Terry Robson

Terry Robson is the Editor-in-Chief of WellBeing and the Editor of EatWell.

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