Pain is a messenger. The pain from a sprained ankle tells you not to put weight on that foot. Toothache is a warning that a visit to the dentist cannot be delayed. An arthritic twinge is telling you to find out what might be causing the inflammation.
　　But the fact that pain may contain an important message does not make the messenger any more welcome, so it is not surprising that the market for painkillers is big business ?worth more than ?70 million per year.

A Health Which? survey found that 56 percent of painkillers were taken to alleviate headaches and migraines, while 18 percent were taken for back, joint and muscle pain.

Not everyone, however, can take over-the-counter (OTC) painkillers. Aspirin can cause gastritis or ulcers. If you are asthmatic, aspirin can trigger an attack, and a recent study concluded that those who take paracetamol once a week increase their risk of developing asthma by 80 percent. Painkillers have also been found to induce ebound?headaches. Prescription steroids, which suppress inflammation, can have far-reaching consequences from long-term use, including osteoporosis.

While OTC painkillers may be useful for the relief of short-term acute pain, they have a disappointing record for long-term management of conditions such as back and neck pain, arthritis and sports injuries.

any patients are disenchanted with the traditional approach and the most enlightened rheumatologists are combining orthodox strategies with complementary therapies,?says Debbie Hardman of the Arthritis Research Campaign (ARC), the fifth-largest medical research charity in the UK, which is bran- ching out to find how diet and nutritional supplements work.

The nutritional and herbal approach may offer long-term relief from pain ?although you should check with your doctor first to ensure that you are not suffering from more serious health problems. Finding the cause of the pain, instead of subduing it, is a guiding principle of nutritional therapy.

There are several important ways in which dietary manipulation and supplements might help. The first is to affect leukotrienes and prostaglandins ?hormone-like chemicals produced in the body that regulate inflammation. The second is to lower levels of histamine ?a chemical that causes irritation and is implicated in inflammation and allergies. Other mechanisms for regulating pain include breaking up fibrin ?a substance that collects in areas of inflammation and contributes to swelling and pain ?and blocking substance P, a neurotransmitter that sends the pain message?

Changing the type of fats a person eats is usually the first step in a nutritional programme. Saturated fats, found in meat and dairy products, are rich in a substance called arachidonic acid which produces leukotrienes, which in their turn promote inflammation. Conversely, unsaturated fats found in oily fish, fresh nuts and seeds are rich in omega-3 and omega-6 fats, which promote anti-inflammatory prostaglandins. ARC-funded research has found that cod liver oil can help to kill joint pain without causing gastrointestinal upset.

Some people find that inflammation is worsened by certain foods to which they are sensitive, such as wheat, dairy products, citrus fruit, coffee, sugar and alcohol. Some substances in foods directly trigger migraines, eg, octopamine in oranges and tyranine in cheese.

Food sensitivities have been associated with headaches, migraines and arthritic pain in many cases. Dr Gail Darlington, consultant rheumatologist and author of Diet and Arthritis, has investigated elimination diets and their role in the management of patients with rheumatoid arthritis. About 36 percent of my patients who have manipulated their diet have done well and some have been able to stop taking drugs for several years,?she says.

Some specific foods might be helpful. One study reported in New Scientist found that 20 cherries contained between 12 to 25mg of anthocyanins, which has more potent painkilling capability than an aspirin tablet: this has to be one of the more pleasant pain-relief options.

The enzymes bromelain, found in pineapple, and papain, from papayas, can also ease pain. These are proteolytic enzymes, which digest proteins and which can be taken in capsule form. High doses of bromelain and papain have been used successfully to treat back problems.

Capsules are normally taken with meals to aid digestion, but when taken away from meals they are thought to remove waste products and fibrin in the area of the injury, reducing swelling and helping to speed up the healing process. Bromelain also seems to block the formation of inflammatory prostaglandins. But do not take enzymes if you have ulcers or gastritis. Vitamin C has a mild histamine-reducing effect and also appears to help to stabilise the structure of cartilage. Another antioxidant, quercitin, found in apples and onions and also available in capsules, blocks histamine release as well as stopping the release of leukotrienes. It is often used alongside vitamin C for pain relief.

The minerals magnesium and calcium help to relax muscles, which can be involved in back spasm. While both minerals are important, it is probably best to have about 400mg of magnesium daily to relax muscle tension.

This has a marked effect on cramped leg muscles, can be effective in treating back pain, and is useful for migraines. Food sources of magnesium include green leafy vegetables, fresh nuts and seeds. Another useful anti-spasmodic and muscle relaxant is the herb cramp bark, which can be taken as a tea or in capsules. Lower-back pain is often related to dehydration, which affects the strength of the muscles. Drinking two or three litres of water daily, while also cutting back on dehydrating caffeine and alcohol, can make a great deal of difference.

Spices have been used through the centuries for their strong pain-relieving qualities. Ginger has a long history as an anti- inflammatory compound and also acts as an antihistamine, but do not use it if you have stomach or duodenal ulcers. Curcumin, the active agent in turmeric, is a potent antioxidant which is said to work as well as the steroid drug cortisone in relieving acute inflammation. Curcumin and ginger also promote the breakdown of fibrin.

(From The Times)