NATURAL PAIN RELIEVERS
Ross Hauser, M.D.

Bruising and swelling typically occur after a soft tissue injury of a ligament or tissue depending on the significance of the injury. The amount of pain is typically proportional to the severity of injury and swelling. The best way to control the pain is by controlling the swelling. This is one of the reasons for the wide-spread of the use of the Rest, Ice, Compression, and Elevation (RICE) treatment. The problem is that pain control is obtained but healing is sacrificed. 

There have been over 20 reports on the use of natural analgesics called proteases and their usefulness in recovery after injury. Proteases are natural enzymes that are needed for any living organism to survive. They encourage soft tissue healing by reducing the viscosity of extracellular fluid. This increases nutrient and waste transport from the injured site, reducing swelling or edema.

Protease administration offers a much safer option than NSAIDs for the pain of acute soft tissue injuries. It can reduce most of the symptoms of the injury while promoting healing. If taken in sufficient quantities, proteases can: Rapidly decrease swelling, Can result in a 50 percent quicker healing time with proper administration, Symptoms of inflammation (pain, swelling, heat, and redness) are usually much reduced. 

These results, however, can only be achieved if certain criteria are met. First, and foremost, supplementation must be initiated as soon as possible after an injury occurs. The protease supplements must be ingested on an empty stomach; otherwise they will be used for digesting food, if taken with food. Using multiple proteases at one time seems to increase the effect. An increase in the typical dose is given after an injury and is continued until the injury is healed. 

If pain medication is needed, generally Tylenol or Ultram is given. These do not affect inflammation like the anti-inflammatories. If the pain is unbearable, a short course of narcotic medication, such as codeine, is given. 

Other Treatment Modalities: These other treatments all increase blood flow to the injured area by various means, just as Prolotherapy does, but not to the same degree. 

Heat Treatments: Heat, along with exercise, has a significant effect on increasing blood flow to the treated area. Heat can be in the form of exercise, hot packs, ultrasound, or whirlpools. It does not matter which one you choose, they all increase blood flow. Heat is also a wonderful analgesic. It helps relax muscles, yet increases nerve conduction to an injured area. Applying heat to an area also helps prevent the formation of scar tissue by helping the collagen tissue become more pliable. Heat can also help break up any congealed blood that may have coagulated after an injury. 

More Treatments: Treatments such as magnetic therapy, acupuncture, chiropractic, electrical muscle stimulation, massage, physical therapy, and a host of other treatments are all beneficial and help healing. All of these treatments should be individualized for a patient's specific problem. Since Prolotherapy depends upon blood flow to help heal the area, all of the treatments can aid the Prolotherapy. The RICE protocol, cortisone shots, and anti-inflammatories have the opposite physiological action and cannot be done in conjunction with the Prolotherapy. High-velocity chiropractic treatments in an area treated by Prolotherapy are also prohibited. This is because the high-velocity techniques could theoretically tear some of the newly formed tissue. Other chiropractic techniques are extremely helpful such as soft tissue massage, myofascial release, and strain-counterstrain.