Systemic Inflammation, Pain and Degenerative Disease: Part 2
By Dr. Greg Fors, DC, DIBCN
Board Certified Neurologist
A major factor in the formation of chronic inflammation in your
patients’ tissues is the presence of free radicals occurring in greater
abundance than the body's ability to remove them. This imbalanced
condition is known as oxidative stress. The presence of oxidative stress
in your patients’ myofascial tissues will automatically create an
inflammatory response in their muscles and joints. This inflammatory
response will then cause the release of more free radicals in the
affected tissues, creating greater oxidative stress and causing an
increased inflammatory response. As you can see, this forms a vicious
cycle, but worse yet, this cycle can accelerate, creating what is known
as a feed-forward cycle, thereby making symptoms progressive with
eventual tissue degeneration.
Here is the crucial fact to understand about chronic muscle and joint pain problems, whether secondary to acute or repetitive stress; they develop primarily from improperly managed inflammation and oxidative stress in your patients’ tissues. In chronic muscle and joint disorders, the presence of chronic inflammation and oxidative stress in the myofascial tissues are as inseparable as ‘love and marriage’; you cannot have one without the other. Therefore, to correctly heal chronic muscle and joint problems, you must learn how to manage the metabolic factors of chronic inflammation and oxidative stress. Luckily, there are herbal and nutritional supplements that can assist you in naturally managing these metabolic factors in your patients with chronic pain.
Today, almost everyone is aware of antioxidant supplements such as vitamin A, C, E, beta-carotenes, bioflavonoids, as well as other lesser-known phyto-nutrients. In addition, certain dietary minerals, such as selenium and zinc, are utilized by tissues to produce endogenous antioxidants. Even though many of your patients take antioxidants, many do not realize exactly why they are taking them. Anti-oxidant supplementation is helpful in neutralizing free radicals in myofascial tissues, thereby reducing the presence of systemic inflammation. Besides these nutrients that help to manage your patients' oxidative stress, and subsequently reduce chronic inflammation, there are very specific botanicals available for treating chronic Inflammation.
Botanical Anti-Oxidants and Anti-Inflammatorys
Chinese and Ayurvedic practitioners have relied on Ginger Root's anti-inflammatory properties for at least 3,000 years in the treatment of inflammatory joint diseases, such as arthritis and rheumatism. Ginger Root is an excellent anti-oxidant, helping to scavenge free radicals from multiple sources including drugs and environmental toxins. In a 2005 article published in the Journal of Medical Food, the authors reviewed the past 25 years of research on ginger’s anti-inflammatory properties. Multiple research studies outlined in the review established that ginger helped to manage multiple biochemical pathways activated in chronic inflammation without blocking enzymes vital for maintaining healthy tissues.(1)
What is exciting about standardized extracts of Ginger Root is that it contains (6)-shogaol, in addition to its other active substances such as the gingerols. What is special about (6)-shogaol is that research has shown it to reduce substance P in the spinal cords of rats.(2) This mechanism of action may explain why standardized extracts of powdered ginger have been found to be effective in chronic myofascial pain disorders and fibromyalgia syndrome. Much of the research on standardized Ginger Root extracts for chronic pain disorders utilized anywhere from 1000 mg to 4000 mg per day. Based on my review of the research and my own clinical experience, I find that best results are found by utilizing products that contain as much as 300 to 500 mg of standardized ginger root extract per tablet or capsule. In addition, the ginger root label must state that it is standardized to at least 5% gingerols and shogaols.
As powerful as Ginger extract is, recent studies have shown extracts of Turmeric Root, also referred to as Curcumin, to be the most powerful natural antioxidant and anti-inflammatory agent available. Because Curcumin extract is so clinically impressive, I always combine the herb with Ginger root. For botanical formulations to reduce chronic inflammation, the Curcumin root extract must be standardized to 95% Curcuminoids. An ideal product would be the formulation I created for Biospec NutritionalsTM called Inflam-Rx.
Inflam-Rx contains a guaranteed concentration of 500 mg of the standardized Ginger Root extract, and 300 mg of standardized Curcumin Root extract. With this concentrated dosage per tablet, I would suggest starting your patient out at one tablet twice a day and increasing the dose over the next couple of days to two tablets twice a day, for a total of at least 2000 mg of standardized Ginger Root extract and 1200 mg of standardized Curcumin Root extract. If your patient’s inflammation and pain is not fully controlled, you may try increasing the dose to two tablets three times a day, and even up to two tablets four times a day. At the tablet strength described, this would give you a daily dose of 4000 mg of standardized Ginger root extract and 2000 mg of standardized Curcumin root extract, as found in the research.
In one study, 100% of the muscle pain patients and 75% of the arthritis patients got pain relief from their Ginger Root extract. In this study, many patients took 3000 mg to 4000 mg a day to achieve this reduction in inflammation and pain.(3) In one study on Curcumin Root, individuals were supplemented as much as 8000 mg per day without any side effects.(4) Usually within six weeks of taking this concentrated dosage of Ginger and Curcumin Root extracts you can lower the dosage to the lowest effective amount needed. This approach works extremely well, especially if you utilize a complete program as described in my book Why We Hurt; a healthy Mediterranean-like diet, omega-3 fatty acids, magnesium malate with B vitamins, vitamin D, and of course, Inflam-Rx.
1. Grzanna R, Lindmark L, Frondoza CG. Ginger--an herbal medicinal product with broad anti-inflammatory actions. J Med Food. 2005 summer; 8(2):125-32
2. Onogi T, Minami M, Kuraishi Y, Satoh M. Capsaicin-like effect of (6)-shogaol on substance P-containing primary afferents of rats: a possible mechanism of its analgesic action. Neuropharmacology. 1992 Nov; 31(11):1165-9
3. Srivastava KC, Mustafa T. Ginger (Zingiber officinale) in rheumatism and musculoskeletal disorders. Med Hypotheses. 1992 Dec; 39(4):342-8
4. Chainani-Wu N. Safety and anti-inflammatory activity of curcumin: a component of tumeric (Curcuma longa). J Altern Complement Med. 2003 Feb;9(1):161-8
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