Holistic Pain Relief: Q & A with Dr. Heather Tick

Dr. Heather Tick is the author of Holistic Pain Relief and has been an integrative medical practitioner for over 20 years.. A sought-after speaker, she lives in Seattle and works at the University of Washington, where she is the first Gunn-Loke Endowed Professor for Integrative Pain Medicine. Visit her online at http://www.heathertickmd.com.

# # #

What got you interested in pain medicine?

I was a family doctor and many of my most puzzling cases involved pain. Most people would recover from injuries quickly but a subset of them would not. That group would have lingering problems. I would send them to physical therapy and specialists like neurologists, rehab doctors and orthopedics and usually there was still no explanation for why these patients were still having trouble. Sometimes it was suggested that the patients did not want to get better. But I knew these people, I had been their family doctor for a while and I knew more about their motivations than the specialists did. So I started to learn more about ways to help them. Then eventually I limited my practice to pain.

Did medical school prepare you to deal with your pain patients?

When I went to medical school there was very little time spent teaching about pain. Even now many schools have only a few hours of teaching about pain even though most medical appointments are made because of pain. I learned about pain in my acupuncture courses, and from Dr Chan Gunn who trained me in a technique to treat muscle pain called intramuscular stimulation.

What is myofascial pain?

I had never even heard about myofascial pain until years after I graduated. Myo means muscle and fascia is the connective tissue that is throughout our body. Myofasical pain is the commonest cause of pain. It is sometimes present on its own and sometimes is there with other problems like broken bones, arthritis of all kinds, fibromyalgia, migraines and other causes of pain. The muscles can heal if treated properly and helping part of the pain to improve often makes the patient comfortable enough to be able to function better.

Why do you focus so much on what people eat?

Well, you change your body chemistry every time you eat. You can either increase the inflammation in your body or decrease it? What does inflammation do? It causes more pain, decreases the body’s ability to heal and it is at the root cause of every chronic disease we know of. Food also gives you the raw materials that your body needs in order to repair itself: the vitamins, minerals, proteins and fats. We always have the ability to heal- right until the end of our lives. We heal slower as adults than we did as children, but we still heal. When I was in medical school we were taught that cartilage cannot heal, but we know now that even that can heal if the body has the right building blocks.

Why is sleep important?

When we sleep our bodies repair themselves. Our brain and body replenish the molecules that we need for all the millions of chemical reactions that go to help us make energy and repair the wear and tear damage that happens daily. We need around 7 hours of sleep each night. If you are not getting sleep it is very difficult to lose weight too. When we sleep in total darkness a little gland called the pineal gland makes melatonin. Melatonin helps us get restful deep sleep and is also a powerful antioxidant that may be cancer fighting.

What is the one most important thing to remember about nutrition?

Eat your veggies. We should be getting 10 handfuls of vegetables and fruits each day. That may seem like a lot but there are tricks to getting enough. Keep cut up raw vegetables like cucumbers, carrots, celery, zucchini, peppers and broccoli in the fridge. That way when you get home from work or school and need to grab a snack they are right there and easy to grab. You can also easily put some in a container to take for snacks when going to work or school. You may eat 4-6 servings a day just that easily. Another good way to increase your veggie intake is to make vegetable soups. They can be either pureed or left with chunks of veggies and beans or lentils can be added. They are easy to make, tasty, and can be made in bulk to freeze for future meals too. Another trick I find helpful when I cook vegetables is to always make much more than we will eat for that meal. Then I snack on them and even enjoy them as part of my breakfast.

What is wrong with sugar?

As long as you are not diabetic, there is nothing wrong with sugar. The problem is that Americans eat way too much of it. Sugar is like a drug and it triggers the same chemical in the brain as cocaine, dopamine. At the beginning of the 20^th century we used to eat an average of 5 pounds of sugar a year and now we eat an average of 150! That is about ½ pound of sugar each day. It is causing obesity, diabetes, heart disease and did you know that cancer cells love sugar and the inflammation it causes. We have been conditioned to sweeter and sweeter food by the restaurant but mostly to processed food manufacturers. The fastest way to get someone hooked on your food it to put sugar in it.

You can kick the sugar habit by coming off sugar for a week. Then your taste buds recover and instead of 5 teaspoons of sugar in your coffee you may be happy with one or less.

Artificial sweeteners are not the answer because they are intensely sweet and some of them turn into harmful chemicals in our bodies. Aspartame turns into methanol and formaldehyde. Sucralose is chlorine attached to a sugar molecule. Some of the chorine is absorbed by the body. The sweeteners still trigger some of the same brain reactions as sugar and the body which is smarter than us is still looking for nutrition and some studies are showing that zero calorie sweet drinks make us overeat.

What is all the concern with pain killers?

The problem is that we don't have any perfect painkiller. Aspirin and ibuprofen and that entire class of drugs causes stomach ulcers, and kidney damage and all of them except aspirin also put you at greater risk of heart attack. Acetaminophen is helpful but there is a very narrow safe range for the drug and overdose causes liver failure. The opioids like morphine and all the synthetic versions give excellent pain relief at first so they are good for acute pain — when you don't have to keep taking them daily for a long time. When you stay on them they become less effective for the vast majority of people. Then the pain comes back and you want to increase the dose. We’ve discovered that chasing the pain with higher doses not really end up giving good pain relief. People often end up on high doses of pain meds, are at risk of accidental overdose, don't function that well in their work or relationships, and still have pain. Everything seems to deteriorate. Their personalities change. When they come off the opioids they actually feel better with the same or often, less pain. The opioids actually cause pain by making the system hypersensitive and coming off of them reverses that. Opioids are best when not taken daily. That way they stay effective.

What is the best thing to do for fibromyalgia?

The best thing you can do for yourself is get healthy. Eat, pray, love, and I might add sleep.

A low glycemic diet is crucial in FM to avoid the increased inflammation that comes from blood sugar that is either too high or too low. Glycemic Index (GI) is a measure of how fast your food turns into sugar. If it turns into sugar quickly then it spikes your blood sugar and causes inflammation. The body does not like that high BS state so it puts out hormones to drop the BS. That causes low blood sugar, more inflammation, makes you tired, cranky, and hungry for a high GI food. And so goes the rollercoaster. Have you ever noticed what kind of foods are around the checkout stands in grocery stores and even in places like gas stations that are not really supposed to be selling food? It is all high GI. It is there to feed our sugar cravings.

By “Pray” I mean have some sort of meditative or spiritual practice that calms you. When you are in a meditative state your system is in a better balance between the sympathetic system, which is the fight or flight system that increases inflammation and the calming parasympathetic system that decreases inflammation. By now you know that inflammation is the “bad guy”.

“Love” – we all need human connection, companionship, social support. Find a support group, a yoga class, a hobby group. Distraction from achiness and fatigue actually makes you feel better. But social support changes your body chemistry in healthy ways.

Also, do not go on regular doses of pain killers. They do not work in FM and make people worse in the long run. It is more work for your organs to detoxify all the chemicals from the drugs. Some of the pain modifying drugs do help about 30% of the time. So they may be worth a try. But in general, FM is not a drug deficiency state. It is a condition where for one reason or another the body has become hypersensitive and experiences normal sensations as being painful.

What are repetitive strain injuries?

Under certain circumstances, muscles can get fatigued from doing repetitive actions especially when we are in static postures. An example of this is using our hands on the keyboard while slouching in a chair for hours on end. It does not happen to everyone doing this kind of work and there are many factors that make some people more susceptible. The main thing to know is that the muscles are weak and get tight hypersensitive bands in them called trigger points and the muscles need treatment before strengthening is done. Stretching works really well and I like to teach people how to treat their own trigger points so they can do that in addition to working with professional therapists. Things like tennis elbow, most cases of carpal tunnel syndrome, trigger fingers, and rotator cuff injuries are caused by 7these muscle problems and do not need surgeries to correct them. Steroid injections into muscles are also not a good idea and have no research to support doing them.

If you could offer just one piece of advice or support to someone who is suffering from chronic pain as advice or comfort what would it be?"

Sometimes people in pain start to focus their entire life around their pain. I find the people who feel better about their situation are the ones who can focus their lives around their activities instead. They gauge how they are by what they can do. We reinforce the nerve connections of the things we focus on. If we focus on pain we makes those connections stronger. If we can shift the focus, we can distract ourselves and reinforce other nerve connections instead.

HOLISTIC PAIN RELIEF by Dr. Heather Tick

November 11, 2013 • Health & Wellness • 304 pages • Trade Paperback

Price: $15.95 • ISBN 978-1-60868-206-5