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Interview: Heal Your Pain Now + the fear-pain connection

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If you struggle with chronic pain from an injury, autoimmune disease, fibromyalgia, joint pain, arthritis, anxiety, depression or have tried everything without success, Heal Your Pain Now provides natural solutions to eliminate pain and return you to a life worth living.

I recently had the pleasure of interviewing Dr. Joe Tatta, physical therapist and nutritionist, author of this wonderful new book and a dear friend!

You can watch the interview here:

 

And here is a summary from our great interview:

What is chronic pain – it’s about protection. Acute pain like an ankle sprain tells you to rest and heal; chronic pain – persists beyond 3 months and is less about protection and more about the brain being in a hyper-sensitive state.

The human body has innate ability to heal i.e. the body has a natural anti-inflammatory process and tissue will heal in 3 months. After those 3 months it becomes less about the actual tissue and more about what is going on centrally in the brain and nervous system.

Central sensitization or the hyper-sensitive brain: we have a neural signature specific to you and your pain experience.

It’s based on what you believe about pain, are told about pain, your memories, your emotions, input from body (such as tightness), your thoughts, touch and sound.

With central sensitization pathways light up in the brain causing pain and in some instances those pathways never quiet down. The more we can be educated about pain the faster we can release this central sensitization and the pain.

An example: You and I had backpain – my life: mom is a nurse, my backpain comes and goes, I can move a little, I go to work, do some chores and basic exercise; in your life your grandmother had really bad back pain, was in a wheelchair and said back pain is the worst pain you could ever have. This may make your pain persist. Fear causes pain to persist over a long period of time.

Fear and pain: it can be actual fear or perceived; fight or flight – muscles tense around the spinal column; blood is shunted away from the spinal muscles because you’re getting ready to run or fight; when it’s persistent there is no blood flow and no healthy nutrients going to the spinal muscles; cortisol levels become elevated – they are inflammatory and very powerful at laying down memory patterns (which can make pain persist).

When you lessen fear you promote relaxation and in general pain disappears very fast.

When you hear all this the brain repatterns – you’re doing a mini cognitive behavior session just listening to and watching the video of us interacting! (I love this!)

Myth: chronic pain has to be chronic – no! Replace the word chronic with persistent because language is really important for creating these pain memories.

Myth: imaging studies like xrays and MRIs are correlated with pain. Often we see intense pain with normal xrays, sometimes no pain with awful rays.

There is also the emotional aspect – when someone in a white coat holds up that xray and says you have this issue it can start that fear response and the pain can be worse.

This fear pain connection is fascinating and I asked if it common knowledge

  • The average physician only receives 4 hours of pain science education in 12 -16 years of education – most of what they learn focused on medications, injections and surgery. We currently have a biomedical model (xray and injection or surgery, injections or medications) but we are moving to a biopsychosocial model (movement, nutrition, mindset, the brain)
  • The book has 40 pages of evidence based research (if you’re a practitioner and would like access to the papers let me know in the comments and Dr. Joe can get them to you)
  • I suggest using the book to educate yourself and your doctor

Medications prescribed for pain: Opioids (oxycontin, codeine, morphine) #1 drug prescribed for pain. CDC and NIH: You should not prescribe opioids as first line of treatment for chronic pain. They are highly addictive – 3 million addicted to them; 2 million die each year; opioid-induced hyperalgesia – the more you take the more pain sensitivity you have and the more medication is needed.

Side effects: constipation caused by opioids and you’re prescribed medications for the constipation; called OIC (opioid induced constipation) – changes the microbiome, fecal matter is bound up, you get leaky gut, inflammation starts in gut and there are impacts on neurotransmitter production like GABA and serotonin (and then increased anxiety and depression).

Other medications used are SSRIs – depression looks very similar to pain in the brain – when you heal the gut you can balance serotonin

Gabapentin and NSAIDs and benzodiazepines are also prescribed.

The book covers ALL pain – any chronic (or persistent) pain that has been around for 3 months or longer

Nutrition: diet is the #1 way to reduce inflammation – food is medicine approach; 100% whole food (if it comes in a box or a can or is made by man it has no place in your diet especially if you have chronic pain); farm-raised beef, wild fish, fruit and vegetables, healthy fats i.e. a modified Mediterranean diet.

Then use a gut-healing protocol for removing inflammation and addressing autoimmunity – remove gluten, dairy and sugar. In 3-7 days people see their pain decrease from 8/10 to 2/10.

“I don’t think I have arthritis and I don’t think I need this Aleve – I think it was the gluten I was eating”

If you slip a little and have some gluten then you realize you can’t even have any and you’re educating yourself that food is medicine. It’s very powerful

With gut healing, if you have autoimmunity take out eggs and GMOs (soy and corn) too; there is more clinical evidence around nightshades – if you can heal the gut you can often tolerate small amounts.

The ketogenic diet is last phase: 65% – 75% fat, 5% carbs (from fibrous vegetables) and the rest is protein. It’s awesome to regulate blood sugar, helps central sensitization (we know because those with seizures do really well on a ketogenic diet). With seizures glutamate is high and GABA low and the ketogenic diet helps balance out these in your brain and calms the nervous system and decreases pain; upregulates ATP (energy molecule) which helps with pain. Brain fogs goes away.

The ketogenic diet is not for someone with type 1 diabetes, who is pregnant or in acute adrenal fatigue

Do a trial of 3-4 weeks and cycle into ketosis every 4-6 months.

Intermittent fasting tricks body into thinking body is starving.

A big plane flies over at the 41 minute mark! Enjoy the laugh with us!

With intermittent fasting do a 14-16 hour fast overnight, say 6pm to 9am the next day

Mini-fasts: protein shake in the morning or evening – the meal is smaller; or use bone broth – healing for gut and collagen for your joints!

Supplements: omega-3s (2000 to 4000mg); curcumin (in oil – really important to help absorption); vitamin D 5000-10,000 IU; some kind of proteolytic enzymes; GABA for pain and anxiety and central sensitization.

If this feels overwhelming and you feel you need more support (in addition to reading the book) Dr. Joe does have a group program

It’s called Heal your Pain Heal your Life  – 6 week process, a Facebook group group, Q and A calls, and social support (which is huge if you have pain and can’t get out of house, or if others can’t relate to your pain, plus for the community support)

Movement, sedentary syndrome, sit rise test: movement is medicine and has to be in your life in some form. Even 5 minutes twice a day can help. It sends signal to your brain “I can move a bit and I’m safe”, you build confidence and fear decreases, releases endorphins, quiets down the nervous system

Sit rise test – cross your legs and lower yourself down to the floor without your hands and then stand back up. It indicates a long life-expectancy; they are not sure why – cardio effects? Balance? It tests strength and vitality; if you can’t do it – practice each day. Third world cultures sit on the floor to communicate – when you move joints in full range it lubricates them.

I’m a climber, skier, mountain biker, windsurfer and have had many injuries and worked with wonderful physical therapist and yet I have learned so much from Dr. Joe and this book! I will use it for prevention of injuries and pain and for the next time I am injured and in pain.

Dr. Joe ended by saying

Keep moving forward, we’re going to change the pain paradigm and give people their lives back!

This is the book summary:

In Heal Your Pain Now, Dr. Joe Tatta teaches you how to regain control of your life by breaking the cycle of persistent pain. Following Dr. Tatta’s program, you learn the role of the brain in pain–and how to use your brain to STOP your pain; how nutrition can eliminate the inflammation in your body, which is exacerbating your pain; and how to overcome Sedentary Syndrome and choose the best movement strategy. Dr. Tatta provides quizzes, self-assessments, meal plans, shopping lists, recipes, and exercises to support you throughout the program.

As I mentioned in the interview I really appreciate the very unique perspective Dr. Joe brings to healing from pain. His expertise from the physical therapy and movement world is so beautifully meshed with the power of nutrition! He covers the foundational information for eating an anti-inflammatory diet, an excellent gut healing protocol, healing supplements and with much fascinating reading on intermittent fasting and the ketogenic diet.

Dr. Joe explains these concepts brilliantly: the brain in pain, central sensitization, myths around pain and the biospychosocial model of pain. With the work that I do with anxious women like you (and men too), the pain connection to fear is very relevant; and the fact that stress, anxiety, post-traumatic stress disorder (PTSD), or depression are danger signals that can actually make the pain worse depending on how “sensitive” your nervous system has become.

Also, since many of the same pain medications are also often prescribed for anxiety, this book is a wonderful resource for someone with both pain and anxiety. But best of all, this book offers real solutions for everyone suffering from any kind of pain, and a solid understanding of the mechanisms.

I’m sure you’d like access to what we talked about during the interview:

 

Please let us know which parts of this really resonated with you and what you’re looking forward to implementing for your pain.

 

Fibromyalgia: tryptophan or 5-HTP for anxiety, depression, pain and insomnia

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fibro

Fibromyalgia syndrome is a musculoskeletal pain and fatigue disorder manifested by diffuse myalgia, localized areas of tenderness, fatigue, lowered pain thresholds, and nonrestorative sleep.

This description comes from a paper titled: Fibromyalgia and the serotonin pathway

The paper discusses how low serotonin is often a contributing factor with fibromyalgia and how beneficial tryptophan and/or 5-HTP can be for the anxiety, depression, pain and insomnia we often see in those with classic fibromyalgia:

Evidence from multiple sources support the concept of decreased flux through the serotonin pathway in fibromyalgia patients.

Serotonin substrate supplementation, via L-tryptophan or 5-hydroxytryptophan (5-HTP), has been shown to improve symptoms of depression, anxiety, insomnia and somatic pains in a variety of patient cohorts.

I recently blogged about the effectiveness of 5-HTP being a clinically-effective serotonin precursor and how it improves many of these same symptoms:

Therapeutic administration of 5-HTP has been shown to be effective in treating a wide variety of conditions, including depression, fibromyalgia, binge eating associated with obesity, chronic headaches, and insomnia.

An open 90-day study in 50 patients affected by fibromyalgia found benefits with the use of 5-HTP:

When all the clinical variables studied throughout the trial (number of tender points, anxiety, pain intensity, quality of sleep, fatigue) were compared with baseline results, they all showed a significant improvement.

It is concluded that 5-HTP is effective in improving the symptoms of primary fibromyalgia syndrome and that it maintains its efficacy throughout the 90-day period of treatment.

If we suspect low serotonin may be a factor, I have my clients do the following (whether or not they have a fibromyalgia diagnosis):

  • complete the Amino Acids Mood Questionnaire from The Antianxiety Food Solution and check off their symptoms on the low serotonin section.  The rating uses scale of 1-10 with 10 being worst.
  • review the Amino Acids Precautions and figure out if we can do a trial of 5-HTP or tryptophan
  • do a trial of the amino acid 5-HTP or tryptophan and observe for improvements in anxiety, depression, pain, insomnia and the other low serotonin symptoms

We are all unique and some people do better on 5-HTP and some do better on tryptophan. I typically start with a tryptophan trial since I’ve seen such great benefits with this amino acid. If that’s not working, we’ll do a 5-HTP trial, always watching for high cortisol as 5-HTP can raise cortisol if it’s already high. In this instance 5-HTP may be too stimulating.

Quality is an important issue when it comes to the amino acids and this is especially the case with tryptophan. I find that the Lidtke brand is the most superior. You can see my amino acid product recommendations here.

Do you have a diagnosis of fibromyalgia and have you found benefits with 5-HTP or tryptophan? For your pain? For your sleep? For your anxiety and/or depression?

I’d love to also hear what else has helped with your symptoms?

The Anxiety Summit – Nutritional Influences on Anxiety and Musculoskeletal Pain

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Joe Tatta DPT, CCN, Musculoskeletal Pain Expert, was interviewed by host of the Anxiety Summit, Trudy Scott, Food Mood Expert and Nutritionist, author of The Antianxiety Food Solution.

Nutritional Influences on Anxiety and Musculoskeletal Pain

  • Link between anxiety and chronic musculoskeletal problems
  • Fear avoidance behaviors and pain
  • Headaches, back pain, joint pain and nutritional influences
  • An exercise prescription for anxiety

Here are some snippets from our interview:

People used to think depression was more linked to chronic pain but we are learning its more anxiety driven

The chronic anxiety that people have on a daily basis kicks off the pain process

Negative thoughts, worry, doom-and-gloom about the future all come in to play, with fear being the most common emotion leading to pain

Here is the very recent 2015 paper that discusses this – Psychological functioning of people living with chronic pain: A meta-analytic review.

Joe tied fear and anxiety to adrenalin release and the effects on the muscles, specifically how the smaller muscles around the spine and in the neck are turned off. You then have less blood flow, less oxygen and less nutrients going to those muscles and that’s when the pain starts.

Joe shared the staggering number of people who suffer from chronic pain:

more than those who suffer from heart disease, diabetes and cancer combined!

We also discussed migraines and magnesium, and this paper: Why all migraine patients should be treated with magnesium

Magnesium, the second most abundant intracellular cation, is essential in many intracellular processes and appears to play an important role in migraine pathogenesis. Routine blood tests do not reflect true body magnesium stores since <2% is in the measurable, extracellular space, 67% is in the bone and 31% is located intracellularly. Lack of magnesium may promote cortical spreading depression, hyperaggregation of platelets, affect serotonin receptor function, and influence synthesis and release of a variety of neurotransmitters.

There is strong evidence that magnesium deficiency is much more prevalent in migraine sufferers than in healthy controls.

Considering these features of magnesium, the fact that magnesium deficiency may be present in up to half of migraine patients, and that routine blood tests are not indicative of magnesium status, empiric treatment with at least oral magnesium is warranted in all migraine sufferers.

He also shared great tips for when you’re sitting at your desk. Watch this excellent video on how to: Sit Less & Heal Your Back

 

Free Gift – Opt in to receive Joe Tatta’s free training video series on back pain: “The Backpain Breakthrough”

Once you’ve signed up you’ll receive information about his actual “Backpain Breakthrough” program.

If you are not already registered for the Anxiety Summit you can get live access to the speakers of the day here: www.theAnxietySummit.com

Missed this interview or can’t listen live? Or want this and the other great interviews for your learning library? Purchase the MP3s or MP3s + transcripts and listen when it suits you.

You can find your purchasing options here: Anxiety Summit Season 1, Anxiety Summit Season 2, and Anxiety Summit Season 3.

Smile and laugh to de-stress, calm down and boost your mood

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 laughter

My biggest stress-relief and mood-boosting tip is to smile and laugh! It is one of the many things I encourage my clients to do! And I personally love a good comedy and opportunity to smile and laugh! I almost feel like I need my “fix” of laughter by the end of the day. It really relaxes me, boosts my mood and helps me sleep better.

I was further inspired to make a commitment to laugh each day when I read all the research supporting the many and varied health benefits. Many days I’ll just take a break and engage in spontaneous laughter for no reason at all – just the act of laughing leaves me feeling SO good. I do food-mood presentations around the country and typically end my talks with a laugher session with the audience! It’s a great hit and they leave my talk feeling great!

A 2012 research paper in Physiological Science actually showed that if you smile, you feel less stressed. Also in a 1999 study, “Personality traits such as warmth, calmness, extroversion, and low anxiety were closely related to an attractive smile.”

Laughter falls into a similar category as smiling and is wonderful for improving mood and reducing anxiety and stress and pain. This 2012 paper. showed that laughter “is associated with feelings of wellbeing” and improved mood, likely related to “the release of endorphins.” The release of endorphins also reduced pain levels.

Recent research also shows that the “combination of a laughter and exercise program might have physiological and psychological health benefits for the elderly”. Laughter may also “be an effective strategy to motivate the elderly to participate in physical activity.”

Laughter is actually good for the heart as indicated by the title of a 2009 paper: “The effect of mirthful laughter on the human cardiovascular system.”

Here are some things to make you chuckle: a fun post I did awhile ago about a wonderfully funny and romantic blog called The Musings of a Romantic Comedy Girl and a video of a laughing baby. Enjoy!

And of course, the added bonus: if you eat foods that raise serotonin (like grass-fed read meat and wild fish like salmon), you’ll be happier and more inclined to smile too – and feel even less anxious and less stressed. Tryptophan or 5-HTP will help boost your serotonin levels and are wonderful if you do have low serotonin. You can check for low serotonin levels using this Amino Acids Mood Questionnaire from The Antianxiety Food Solution. 

YOU’RE WELCOME TO INCLUDE THIS ARTICLE IN YOUR EZINE OR WEBSITE AS LONG AS YOU INCLUDE THIS COMPLETE BLURB WITH IT:

Trudy Scott (CN), Certified Nutritionist is the founder of www.everywomanover29.com, a thriving nutrition practice with a focus on food, mood and women’s health. Trudy educates women about the amazing healing powers of food and nutrients and helps them find natural solutions for anxiety and other mood problems. Trudy’s goal for all her clients (and all women): “You can be your healthiest, look your best and feel on-top-of-the-world emotionally!”

Gluten, leaky gut, LPS, anxiety and Dr. Tom O’Bryan at NANP

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Spaghetti and Elbow Macaroni

I’m just back from a great few days at THE best nutrition conference – the annual conference of the National Association of Nutrition Professionals http://www.nanp.org/conference/speakers-sessions/

Dr. Tom O’ Bryan, DC, an expert on gluten, presented the following in his very interesting talk:

  • “One particularly detrimental consequence of increased intestinal permeability” (or leaky gut) caused by gluten sensitivity or celiac disease “is the translocation of bacteria (e.g., E. Coli) and bacterial products (lipopolysaccharides or LPS) also known as endotoxin which creates a proinflammatory environment and increases the oxidative stress burden in the enteric nervous system”
  • “Even minute doses of microbes within the gastrointestinal tract, levels that do not trigger an immune response, are capable of influencing neurotransmission in the paraventricular hypothalamus, the central nucleus of the amygdala and the bed nucleus of the stria terminalis. All three of these regions are involved in the processing of emotions related to anxiety and mood.”
  • “It is suggested that patients with” depression “should be checked for leaky gut by means of the IgM and IgA panel used in the present study and accordingly should be treated for leaky gut”.

In summary, gluten sensitivity or celiac disease can lead to leaky gut which can in turn allow endotoxins called lipopolysaccharides/LPS to relocate into the blood stream. This causes inflammation, oxidative damage, neurotransmitter deficiencies and depression and anxiety.

The study above, refers to depression, however, research also shows that LPS plays a role in stress and anxiety too.

Dr. O’Bryan also discussed the role that LPS plays in rheumatoid arthritis and other autoimmune and musculoskeletal disorders.

Dr. O’Bryan recommends IgG food intolerance testing to identify leaky gut (if you show up with food intolerances to many foods then leaky gut may be an issue) and then to first heal the gut.

These foods will need to be eliminated for at least 3 months and then added back slowly and one at a time.  Many people are surprised to find out that they have issues with seemingly healthy foods like salmon, green beans, peas, strawberries, almonds etc.  Of course, eliminating gluten goes without saying. This is the approach that I use with my clients and is part of the holistic approach that must be used when someone has any mood or physical health problem.

He also talked about LPS antibody testing from Cyrex labs and I look forward to learning more about this.

It was a really great conference, with locally sourced gluten-free meals included in registration! I am gluten-sensitive and it was such a pleasant change to be able to attend a conference and know that what I’m eating won’t affect me!

All the presentations were recorded and will be available for purchase from NANP next month.

YOU’RE WELCOME TO INCLUDE THIS ARTICLE IN YOUR EZINE OR WEBSITE AS LONG AS YOU INCLUDE THIS COMPLETE BLURB WITH IT:

Trudy Scott (CN), Certified Nutritionist is the founder of www.everywomanover29.com, a thriving nutrition practice with a focus on food, mood and women’s health. Trudy educates women about the amazing healing powers of food and nutrients and helps them find natural solutions for anxiety and other mood problems. Trudy’s goal for all her clients (and all women): “You can be your healthiest, look your best and feel on-top-of-the-world emotionally!”

GABA and more for pain relief and anxiety

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Low levels of some neurotransmitters, which are made by the body from amino acids, can contribute to chronic pain. Low gamma-aminobutyric acid (GABA) levels can result in stiff/tense and painful muscles, anxiety and feelings of being overwhelmed. Other neurotransmitters related to pain are low serotonin and low endorphins.

I have many clients who see major improvements in pain levels – when they address low neurotransmitters. In fact one client was able to stop two pain medications when he added GABA and so many people benefit from DPA (d-phenylalanine).  And the added bonus is that GABA also helps with anxiety and overwhelm and DPA helps with sadness and comfort eating.

This and much more can be found in a great article called NATURAL WAYS OF DEALING WITH CHRONIC PAIN and written by Lisa Moretti.  She featured my tips on neurotransmitters and some other wonderful resources from other experts. It was published in the October issue of Max Sports and Fitness.

In her introduction, Lisa reminds us that “According to a 2011report by the Institutes of Medicine of the National Academies, 116 million Americans live with chronic pain – more than diabetes, heart disease and cancer combined. But many of us aren’t looking to just mask the pain by interfering pharmaceutically with our body’s pain signaling system. We want to get to the bottom of it and fix it!

Continuing “We asked experts, athletes and those who have experienced personal, pain-alleviating success for their advice about natural fixes for chronic pain. They have a myriad of suggestions for you.”

You can read about these approaches and more: gluten, acupuncture, eating real food (yay!), meditation, rolfing, proteolytic enzymes, the herbs White Willow and Devil’s Claw, MSM and arnica – all of which I have seen work with different people over the years. We are all unique and have to figure out what the root cause of our pain is and address it.

You can read the full article here

http://www.maxsportsandfitness.com/article/2011/9/natural-ways-of-dealing-with-chronic-pain.html

YOU’RE WELCOME TO INCLUDE THIS ARTICLE IN YOUR EZINE OR WEBSITE AS LONG AS YOU INCLUDE THIS COMPLETE BLURB WITH IT:

Trudy Scott (CN), Certified Nutritionist is the founder of www.everywomanover29.com, a thriving nutrition practice with a focus on food, mood and women’s health. Trudy educates women about the amazing healing powers of food and nutrients and helps them find natural solutions for anxiety and other mood problems. Trudy’s goal for all her clients (and all women): “You can be your healthiest, look your best and feel on-top-of-the-world emotionally!”