Archive for the ‘Pain Management’ Category

High Oxalate Foods & Pain

Are these High Oxalate foods destroying your body?

Are these High Oxalate foods destroying your body?

Our guest poster, Sally Norton, B.S., MPH, is an expert in oxalates, compounds found in many so-called healthy foods that can, in excessive amounts, cause chronic pain and create havoc with your health.

What is oxalate and how can it impact your health?
1. Oxalic acid: What is it?
  1.  A naturally occurring tiny molecule that is a toxic, corrosive acid
  2.  When it has minerals attached to it, it is called Oxalate. (chemically a salt)
    (E.g. sodium oxalate, potassium oxalate, magnesium oxalate, calcium oxalate)
    Oxalate likes to form crystals. Most kidney stones contain calcium oxalate.
  3.  Find additional information here: Oxalates
2. Where does oxalic acid come from?
  1.  Plants make it, possibly for mineral management, seed germination, or self-defense
  2. You eat it, in many foods. It comes in many forms, both dissolved and as crystals, in a variety of shapes and sizes
    1.  Some foods have a lot of it, some have very little 
    2. Examples of High Oxalate Foods: beans, grains, bran, sesame and other seeds, peanuts, almonds, and other nuts, swiss chard, spinach, beets, potatoes, chocolate, rhubarb, figs, kiwi, blackberries, black pepper, cumin, turmeric. 
    3. Examples of Low Oxalate Foods:
      meats, dairy, eggs, fats and oils, and other non-plant foods
      arugula, avocado, Bok Choy, cabbage, cauliflower, cilantro, cucumber, garlic, kohlrabi, lettuce, mustard greens, mushrooms, green peas, watercress
  3.  Your body makes it. Oxalate is a metabolic waste product in mammals with no known function
    1.  Higher amounts are made when:
      1.  Deficient in B6, or
      2.  High doses of vitamin C are taken or injected
  4.  Some fungi make it, possibly for mineral management, especially in soil
    1.  Can be made by Aspergillus fungi living in the body
3. How can oxalate harm you?
  1.  The body has no way to disarm oxalate and must excrete it. When cells are required to handle oxalate they are moving it or “managing” it, not metabolizing it. This is dangerous work for a cell.
  2.  It steals minerals from your diet and your body and makes them useless (it is an “anti-nutrient”)
    1.  Soluble forms of oxalate (sodium oxalate and potassium oxalate) can be picked up by other minerals like magnesium, calcium, iron, zinc, copper, etc. This locks up the mineral. Oxalate may also bind with toxic metals such as lead, mercury, aluminum, or cadmium.
    2.  Mineral deficiency causes growth, reproductive, and other problems
  3.  It is corrosive to the lining of the digestive system, may cause leaky gut or other GI diseases. Some Oxalate crystals have a needle shape known to perforate mucus membrane cells.
  4.  Challenges the kidneys and can overwhelm their capacity to remove oxalates from the blood
  5.  Forms nanocrystals and microcrystals that can collect in the body and irritate tissues
    1.  Oxalate crystals can collect in any body tissue, even the plaque in your arteries
    2.  kidney stones usually contain oxalate crystals
  6.  Soluble forms of oxalate are absorbed from food and trigger inflammation, causing:
    1.  Membrane and mitochondria damage, and cell death (fatigue and energy issues)
    2.  Nerve cell damage, pain, and functional problems associated with the brain and nerves
    3.  Dysfunction of cells, organs, glands
    4.  Depletion of the antioxidant glutathione in cells. Low levels of glutathione can generate superoxide radicals, increasing toxic stress causing early cell death. Glutathione is especially important in the liver for the detoxification of chemicals. It is also important in preserving brain health.
    5.  Cell communication problems (autoimmunity, hormonal issues, neurological issues). For example: Oxalate can confuse and stress the immune system, creating auto-immune symptoms.
  7.  Destroys connective tissue’s key building block (hyaluronic acid)
    1.  makes it much harder to fully recover from injury, even surgery
    2.  can weaken or destabilize joints, bones, skin (skin may be thin or easily damaged)
    3.  can make you injury prone
  8.  May deplete the B-vitamins, B6 and biotin
    1.  Uses up vitamin B6, possibly initiating a vicious cycle. B6 deficiency increases internal production of oxalate, increases oxalate load, further depleting B6, and so on.
    2.  Can alter biotin metabolism, depleting biotin
  9.  Can lead to a wide range of problems, throughout the body
    1.  Kidney damage
    2.  Damage to intestines, may contribute to the development of celiac disease and “leaky gut”
    3.  Breathing problems, mucus production, and congestion
    4.  Brain problems – sleep, mood, behavior, cognition, organizational ability, autism
    5.  Urinary issues and genital pain
    6.  Gum and tooth problems
    7.  Bone and connective tissue instability
    8.  Contributes to aging, and can make you feel old prematurely
  10.  These problems don’t always cause obvious symptoms. Onset may include a generalized malaise, poor concentration, some sort of “-itis” (gastroenteritis, tendonitis), joint stiffness, swelling, muscle pain or weakness.
  11.  Oxalate damage is not a sensitivity or allergy. It is a toxicity problem.
    1.  Reversal of oxalate toxicity is an avoidance and excretion issue. It is not a matter of boosting liver function as is typically addressed in “detox” regimens.

(See link for entire article)

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Sally K. Norton is an expert in oxalates. She has a Bachelor of Science in Nutrtion from Cornell University and a Master of Publich Health Degree from the University of North Carolina. She has been doing health education and research in nutrition for 35 years and provides virtual nutritional coaching and consulting. She became interested in oxalates due to her own personal experience. Her book, Toxic Superfoods: How Oxalate Overload is Making You Sick and How to Get Better was recently published  by Rodale Books.   Learn more at

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Trigeminal Neuralgia: A Scientist Cures Himself of Facial Pain

Trigeminal Neuralgia: A Scientist Cures Himself of Facial Pain

Trigeminal Neuralgia: A Scientist Cures Himself of Facial Pain

Tormented by severe facial pain, Hugh Spencer invented a nonsurgical way to relieve his trigeminal neuralgia. He found the remedy—capsaicin—inside a canister of pepper spray.

Nineteen years ago, in a distant corner of northeast Australia, a scientist named Hugh Spencer started suffering horrible attacks of pain on the left side of his head. It felt as if someone were striking him with an axe. A neurobiologist by training, Spencer—in his 50s at the time—feared that he was experiencing the first foreboding glimmers of an agonizing ailment called trigeminal neuralgia.

It’s a neurological disorder that happens when the trigeminal nerve—a major cranial nerve that affects facial sensations and chewing—goes haywire, often for unknown reasons. It then floods the spinal cord and brain with ferocious pain signals. Typically described as electrical or stabbing, the facial pain can be so unbearable that trigeminal neuralgia has been dubbed “the suicide disease.” And indeed, Spencer—unable to control his escalating pain with medications alone—eventually found himself nearly pushed to the brink.

If his medical ordeal weren’t challenging enough, he also had to deal with one other obstacle: geographic remoteness rivaling that of Gilligan’s Island. Spencer runs an environmental research station at Cape Tribulation. There, scientists from around the world study everything from flying foxes to invasive weed species. Located along a coastline teeming with crocodiles, pythons, and ostrichlike cassowaries, his research station is actually closer to Papua New Guinea than to any major city in Australia. In fact, his nearest neighbor is the oldest tropical rainforest on earth.

When you’re that far off the beaten track, you’re forced to be self-reliant. So Spencer got to work. And through some daunting experiments in which he cast himself in the role of guinea pig, he came up with his own treatment for trigeminal neuralgia that permanently eliminated his pain. What’s more, his treatment is low-tech. It’s low-cost. It’s do-it-yourself. And anatomically, it makes sense, though it hasn’t gone through clinical trials. Hundreds of people with trigeminal neuralgia have now tried his method, and for about half of them, says Spencer, it’s worked. And it involves no pharmaceuticals, no surgery, and—he insists—no long-term side effects.

Conventional treatments for trigeminal neuralgia can’t make that same claim. The problem with medications, aside from possible side effects, is that they may fail to prevent the pain from intensifying over time. And various surgical procedures don’t always work but can lead to scary complications. For example, microvascular decompression surgery (MVD)—a type of brain surgery—is designed to relieve the pain without harming the trigeminal nerve. But here’s the bad news: the procedure involves cutting open the skull and tinkering with what’s inside, which poses a risk of complications, including hearing loss, cerebrospinal-fluid leakage, stroke, and even death.

By contrast, other less-invasive surgical options intentionally damage the trigeminal nerve in hopes of disrupting its ability to transmit pain signals. For example, radiosurgery (a.k.a. Gamma Knife or CyberKnife) uses radiation to do it. Balloon compression rhizotomy uses pressure. Glycerol injection uses a corrosive chemical. And radiofrequency thermal lesioning uses heat.

The problem is, the trigeminal nerve doesn’t just register pain. It also allows you to feel normal facial sensations—everything from the wind on your cheek to a kiss on the lips. So by messing with that nerve, these procedures can sometimes cause troubling facial numbness. What’s more, they aren’t always successful at stopping the pain or preventing it from coming back.

By contrast, Spencer argues that his approach poses no lasting complications. And it uses a chemical so ubiquitous that you probably ate it the last time you dined at a Mexican, Thai, or Indian restaurant. That chemical—called capsaicin—is what gives chili peppers their heat.

For years, a growing body of research has found that capsaicin—when applied topically—can ease certain types of pain, including difficult-to-treat neuropathic pain. But nobody’s used it in the daring way that Spencer advocates for treating trigeminal neuralgia. For starters, he didn’t put the capsaicin on his skin. He put it inside his mouth.

And Spencer didn’t get his first batch of capsaicin from a tangy little jalapeño pepper. He got it from an old canister of pepper spray, like the kind police officers use. Just imagine the burn you’d feel by holding a spoonful of Sriracha sauce in your mouth for 20 minutes. Now multiply that heat by a factor of 300, and you’ll have some inkling of what Spencer’s fiery treatment involves.

But what does superintense spiciness have to do with relieving nerve pain? 

Listen to the full podcast interview HERE  in which Spencer talks about:

•  His desperate battle with trigeminal pain

•  Why he refused to consider surgery

•  His trial-and-error search for a noninvasive remedy

•  The unlikely technique that quickly vanquished his suffering

•  The science behind why capsaicin appears uniquely able to reduce facial pain without hindering normal facial sensations

•  The reason capsaicin works for some patients but not others

•  Why he believes that his approach has important advantages as a first-line treatment over more invasive alternatives.


Hugh Spencer, Ph.D., is the co-founder and director of the Cape Tribulation Tropical Research Station, located in Queensland, Australia.

Hugh Spencer’s Capsaicin Tutorial:

In this video, Hugh Spencer demonstrates how he used capsaicin to vanquish his trigeminal neuralgia and explains the science behind capsaicin’s ability to dial down the pain:

Straight from the Lab:

What’s the evidence for capsaicin’s ability to relieve trigeminal neuralgia and other types of neuropathic pain? And how effective are conventional treatments? Scientists have been asking those same questions. Explore this sampling of their research to date:

• “Fight Fire with Fire: Neurobiology of Capsaicin-Induced Analgesia for Chronic Pain,” Pharmacology & Therapeutics, 2021.

• “8% Capsaicin Patch in Treatment of Peripheral Neuropathic Pain,” Pain Physician, 2020.

• “Capsaicin 8% Patch in Trigeminal Neuralgia: Case Reports,” Australasian Medical Journal, 2019.

•  “Topical Capsaicin (High Concentration) for Chronic Neuropathic Pain in Adults,” Cochrane Library, 2017.

•  “Trigeminal Neuralgia,” American Family Physician, 2016.

•  “Capsaicin: Current Understanding of Its Mechanisms and Therapy of Pain and Other Pre-Clinical and Clinical Uses,” Molecules, 2016.

•  “High-Dose Capsaicin for the Treatment of Neuropathic Pain: What We Know and What We Need to Know,” Pain and Therapy, 2014.

•  “Carbamazepine for Chronic Neuropathic Pain and Fibromyalgia in Adults,” Cochrane Library, 2014.

•  “Capsaicinoids in the Treatment of Neuropathic Pain: A Review,” Therapeutic Advances in Neurological Disorders, 2014.

•  “Natural History and Outcome of 200 Outpatients with Classical Trigeminal Neuralgia Treated with Carbamazepine or Oxcarbazepine in a Tertiary Centre for Neuropathic Pain,” The Journal of Headache and Pain, 2014.

•  “The Capsaicin 8% Patch for Neuropathic Pain in Clinical Practice: A Retrospective Analysis,” Pain Medicine, 2013.

•  “Non-Antiepileptic Drugs for Trigeminal Neuralgia,” Cochrane Library, 2013.

•  “Neurosurgical Interventions for the Treatment of Classical Trigeminal Neuralgia,” Cochrane Library, 2011. 

“The Treatment of Periocular and Facial Pain with Topical Capsaicin,” Journal of Neuro-Opthalmology, 1998.

•  “Topical Application of Capsaicin for Treatment of Oral Neuropathic Pain and Trigeminal Neuralgia,” Oral Surgery, Oral Medicine, Oral Pathology, 1994.

•  “Analgesic Effect of Capsaicin in Idiopathic Trigeminal Neuralgia,” Anesthesia & Analgesia, 1992.


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This article originally appeared on and is being reprinted with the permission of its author.

ABOUT THE AUTHOR: David Sharp is an award-winning journalist, author, and podcaster in Portland, Oregon. He’s a co-host and editor of Painopolis, a podcast for people with chronic pain. His career includes 10 years as a contributing editor at Health and Hippocrates magazines. He’s worked on the editorial staffs of Consumer Reports on Health and Health Digest. His articles have appeared in many national publications, including Sports IllustratedPublishers WeeklyRedbookEating WellReader’s Digest, and USA Today. He coauthored an earlier book, Six Months Off: How to Plan, Negotiate, & Take the Break You Need Without Burning Bridges or Going Broke. Read more of his blogs at

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Lyme Arthritis With Rheumatoid Arthritis Leads to Poor Quality of Life


Man with lyme arthritis rubbing his wrist.

Lyme Arthritis and Rheumatoid Arthritis can greatly impair a person’s quality of life. A recent study examines survey results from 90 patients to assess the levels of impairment for patients with both these conditions.

In the study “Assessment of quality of life in patients with Lyme arthritis and rheumatoid arthritis,” Yuskevych and colleagues surveyed 90 patients with Rheumatoid Arthritis who were treated at their rheumatology clinic.¹

Nearly 50% of the patients with Rheumatoid Arthritis also tested positive for Lyme disease.

Survey results indicated, “The presence of Borrelia burgdorferi [the causative agent of Lyme disease] in patients with arthritis not only significantly reduced the motor activity of patients, but also complicated the mental adaptation to their own disease.”

The patients had high and moderate disease activity, significantly reduced physical activity, and body pain.

The quality of life of patients with Lyme arthritis and Rheumatoid Arthritis was worse due to severe joint pain and a greater degree of functional disorders compared to the patients with only Rheumatoid Arthritis.

The authors considered depression as a cause of the problem with Rheumatoid Arthritis. “Depression imposes a significant burden on the health-related quality of life, disability, and mortality of individuals with arthritis,” wrote the authors.

“Patients with [Lyme arthritis] have significantly lower MCS (mental component score) values, which is explained by the patients’ severe psychological adaptation to their own disease, given the prevalence of [Lyme disease] at the present and its tendency towards chronicity.”

The authors suggested that an active infection might be the cause of the mental health issues in individuals with these conditions. “We can speculate that the conscious that joints disease may be connected with infection not with the autoimmune disease caused a more depressive reaction.”

Editor’s note: I often see patients with both a rheumatologic condition and Lyme disease. I have had patients with Lyme disease whose symptoms were initially thought to be from a flare-up of the rheumatologic condition.

  1. Yuskevych VV, Zhulkevych IV, Makhovska OS, Smiyan SI. Assessment of quality of life in patients with Lyme arthritis and rheumatoid arthritis. Reumatologia. 2022;60(1):35-41. doi:10.5114/reum.2022.114352


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Practical TENS demonstration for RA in the hand

Lyme Meningitis Leading to Low Sodium, Shoulder & Back Pain


Woman rubbing painful shoulder due to Lyme meningitis.

In their article “A Tick-borne Cause of Hyponatremia: SIADH Due to Lyme Meningitis,” Windpessl and colleagues describe a patient who was initially treated for sudden onset of shoulder pain associated with hyponatremia but later diagnosed with Lyme meningitis. [1]

By Dr. Daniel Cameron

There are many causes of hyponatremia. Any disorder of the central nervous system, including infections, can trigger it. However, only a few case reports of Lyme meningitis or Lyme neuroborreliosis have been published with a focus on hyponatremia, according to the authors.

Hyponatremia is a condition that occurs when the level of sodium in the blood is too low. With this condition, the body holds onto too much water. This dilutes the amount of sodium in the blood and causes levels to be low.²

One month prior to being admitted to the hospital, the 83-year-old woman had presented to the emergency department because of stabbing back pain, localized to the left shoulder.

“The shoulder pain gradually subsided but lower back pain ensued, worsening at night,” wrote the authors. “In parallel, she noticed difficulties in concentrating, unsteadiness, and poor appetite.”

The woman was admitted for an evaluation of unspecific gastrointestinal symptoms and weight loss.

Her sodium was low (hyponatremia (125 mmol/L) consistent with Syndrome of Inappropriate Antidiuretic Hormone (SIADH) secretion.

The doctors could not find a cause. Drug-related hyponatremia was suspected in the absence of another diagnosis. And her blood pressure medication was changed.

The antihypertensive held. As sodium levels were slightly higher when controlled 5 days later, amlodipine was prescribed instead.

However, a month later, her sodium levels were still low (126 mmol/L).

“In view of the history, nocturnal back pain and obscure hyponatremia, she was admitted for a lumbar puncture,” wrote the authors.

Her spinal tap was diagnostic for Lyme meningitis.

SIADS resolved after a 3-week course of antibiotics.

“In hindsight, the lancinating shoulder pain prompting the patient’s first hospital visit likely represented Bannwarth syndrome, a radiculoneuritis occurring early in the course of Lyme disease,” the authors pointed out.

  1. Windpessl M, Oel D, Muller P. A Tick-Borne Cause of Hyponatremia: SIADH Due to Lyme Meningitis. Am J Med. May 27 2022;doi:10.1016/j.amjmed.2022.05.013


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Low Dose Naltrexone for Chronic Pain

Low Dose Naltrexone for Chronic Pain

Low Dose Naltrexone for Chronic Pain


Low doses of a drug that is commonly prescribed to recovering alcoholics and narcotic addicts is being used to help chronic pain sufferers find relief from a variety of pain conditions including fibromyalgia, inflammatory bowel, Crohn’s disease, and complex regional pain syndrome.  The drug is called naltrexone.

What is naltrexone?

Naltrexone is a prescription medication used to suppress narcotic and alcohol cravings in recovering addicts. Naltrexone is used as just one part of an addict’s overall treatment plan. It is prescribed only after a person is no longer dependent on drugs or alcohol.

How does Naltrexone work?

Naltrexone blocks the euphoric sensations associated with narcotic and alcohol use. It is non-addictive and produces no narcotic-like effects.

Researchers believe that naltrexone also modulates the release of inflammatory chemicals in the central nervous system. The drug temporarily binds to and blocks the Mu opioid receptors (MORs) which are central to pain control. When these receptors are blocked, the body responds by producing more pain-relieving endorphins.

Dosage of naltrexone for addiction vs for pain relief

When used for the management of addiction, the typical daily dosage of naltrexone is 50–100 mg per day. For chronic pain relief, the dosage is typically less than 8 mg per day. Patients may start off with a dose as low as .01 mg. A more typical starting dose is 1.5 mg. On average, dosages of low-dose naltrexone (LDN) are approximately 1/10th of the typical addiction treatment dosage.

Prescriptions for LDN can be filled by compounding pharmacies that grind up the higher dose tablet into ultra-low doses.

Are there side effects of naltrexone?

Common side effects of naltrexone when used for addiction management include nausea, fatigue, and loss of appetite. While most side effects are mild, serious side effects are possible. The Mayo Clinic provides a comprehensive list of all possible side effects. Side effects are less likely to occur in patients taking low doses of the drug.

A 2014 review found that the use of LDN for pain relief was “well tolerated” by patients and that there was “low reported incidence of adverse side effects.”

Research on low-dose naltrexone for pain relief

  • Results of a review conducted in 2014 indicated that “Low-dose naltrexone (LDN) has been demonstrated to reduce symptom severity in conditions such as fibromyalgia, Crohn’s disease, multiple sclerosis, and complex regional pain syndrome.” The review found Crohn’s disease to be the condition with the most scientific support when it comes to the efficacy of LDN for pain relief.
  •  A 2018 review found that “Clinical reports of LDN have demonstrated possible benefits in diseases such as fibromyalgia, Crohn’s disease, multiple sclerosis, complex-regional pain syndrome, Hailey-Hailey disease, and cancer.”
  • According to a 2020 review, “Low-dose naltrexone (LDN) has shown promise to reduce symptoms related to chronic pain conditions such as fibromyalgia, inflammatory bowel conditions, and multiple sclerosis.”
  • systematic review conducted by the University of Michigan School of Dentistry concluded that “Low-dose naltrexone provides an alternative in medical management of chronic pain disorders as a novel anti-inflammatory and immunomodulator. It can offer additional management options, as orofacial pain conditions share characteristics with other chronic pain disorders.” Authors of the study consider the drug “a good option for patients with orofacial and chronic pain, without the risk of addiction.”

What pain management specialists say about LDN

According to an article published by Weill Cornell Medicine in September 2020, their pain management specialists have had success treating chronic pain patients with low-dose naltrexone. When interviewed, Dr. Neel Mehta, said, “Generally, my patients report pain relief greater than 50 percent, that they’re sleeping better, or can return to work. And some patients end up responding well to doses as low as 0.1 for reasons we don’t yet completely understand. Patients are experiencing good results with low harm in these early studies.”

In an article published by NPR, Dr. Bruce Vroorman, an associate professor at Dartmouth’s Geisel School of Medicine and the author of the above-mentioned 2018 review, was interviewed. According to the article, “Vrooman says that when it comes to treating some patients with complex chronic pain, low-dose naltrexone appears to be more effective and well-tolerated than the big-name opioids that dominated pain management for decades.” He said that LDN is a “game changer” for some chronic pain patients.

In an interview with Michigan News, orofacial pain specialist Elizabeth Hatfield discussed the use of LDN. She said, “We found a reduction in pain intensity and improvement in quality of life, and a reduction in opioid use for patients with chronic pain.” She went on to say that it is best used on centralized pain disorders including fibromyalgia, complex regional pain syndrome, and TMJ.

Low-dose naltrexone may be a possible treatment for long COVID

According to a recent article published by Reuters, Dr. Jack Lambert, an infectious disease expert at University College Dublin School of Medicine, ran a pilot study on the use of LDN for long COVID. Lambert has reported previous success in using LDN to treat pain and fatigue associated with chronic Lyme disease.

After being treated with LDN for two months, the 38 pilot study participants reported improvement in energy, pain, concentration, insomnia and overall recovery from COVID-19.

Lambert is preparing to run a larger trial to confirm the results. He believes it is possible that LDN may work to repair the damage done to the body by the virus. 


Low-dose naltrexone appears to be safer and more effective for chronic pain than widely used opioids. It might be worth a try if you’re in chronic pain and want to avoid, reduce or eliminate the use of opioids. It’s important to find a knowledgeable healthcare provider who can guide you in terms of dosages and how to taper off of opioids safely.

Other options that involve oral administration of a substance in order to avoid, reduce or eliminate the use of opioids while safely improving pain relief include marijuana, CBD, kratom, an anti-inflammatory diet, nutritional supplements including vitamin D and magnesium.

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Christine Graf is a freelance writer who lives in Ballston Lake, New York. She is a regular contributor to several publications and has written extensively about health, mental health, and entrepreneurship.  

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