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Getting Smarter about Pain

A couple weeks ago, I introduced some concepts on the workings of pain that I think are useful for everyone to know. They’re derived from my explorations into Traditional Chinese… Read More

A few decades ago, we knew very little about the chemistry of cannabis. Most of what I encountered in college was low quality, compressed, greenish-grey material with lots of stems and seeds – commonly known as “Mexican brick weed.” It was likely to make you feel passive, immobile, and hungry – a much more benign combination than the various effects you might experience from too much beer or Mad Dog 20/20.

Of the many compounds in the plant, we only heard much about two back then – THC and CBD. At the time, our elementary knowledge could be summed up in a few words: THC is the mood-altering component (what gets you “high”) and CBD is the part that makes you relaxed. We didn’t want to be relaxed, though, so we interpreted this to mean that “good marijuana is high in THC and low in CBD” and bad marijuana is the other way around.

In the years that followed, Mexican brick weed became increasingly scarce as the American cannabis industry bred more potent plants that contained an ever-higher percentage of THC. But for many of us who had dabbled in it in our early 20’s, an intensely altered state was no longer something we desired.

As legal restrictions loosened up, specialists in botanical medicine were eventually able to gain a better understanding of cannabis chemistry (we still have a ways to go) and breeders began to develop strains that produced a more specific effect – calming, stimulating, and so on.

Furthermore, although the market for Mexican brick weed seemed to be long gone, it turned out that there was a high demand, especially among older consumers, for a product with its effects – essentially a breed with a high level of CBD and a very low quantity of THC. Something a connoisseur would have once called low quality cannabis is now sought after. And an increasing number of my patients tell me they use this - or simply CBD alone - not to “get high” but to de-stress, decrease pain, sleep better, manage neurological disorders, and more.

A patient with very stubborn idiopathic nerve pain (meaning, the cause was unknown) came in one day reporting that the pain had been remarkably better since our last visit. “I hate to break it to you, Doc,” he said with a smirk on his face, “but it wasn’t the acupuncture.” He went on to tell me that he had been using a topical CBD lotion, and that it was more effective than anything else he had tried.

Another patient, who had for years experienced an anxious tightness in her chest in social situations, told me that a small amount of oral CBD resolved it without causing any other perceptible effect. She said, “I don’t feel different in any other way. I do my work, I can think clearly. I just don’t have that anxious feeling.”

And several patients who were tired of using pharmaceuticals to treat their insomnia have told me of their success with a variety of CBD products. They generally find them just as effective as sleeping pills, but with the advantage of being natural. Also, unlike the prescription drugs, they don’t worry that the CBD could put them into such a deep slumber that they might not hear a smoke detector or other emergency.

Now, if there’s one thing that rubs me the wrong way, it’s a “cure-all” – and that’s because there aren’t any! There’s no substance out there that’s good for everything or everyone, and I’d be remiss as a healthcare practitioner if I implied otherwise. CBD isn’t going to fix your life, and some people don’t experience any noticeable benefit from it. But I can say that, for many, it’s a useful natural helper with an excellent safety profile. And I’m eager to see what more we learn about this and other remarkable plants.

Be well,

Dr. Peter Borten

P.S. Just as we were publishing this article, I discovered a new study in the journal Nature on the use of CBD in the treatment of pancreatic cancer. Pancreatic cancer has a dismal 5-year survival rate of just 5%. But in this study, mice with pancreatic cancer who were given CBD plus chemotherapy survived THREE TIMES longer than those who were treated with only chemotherapy. While we don't yet know how this will translate to treatments for humans, it's one more way in which this astounding plant is a promising tool for healing.

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[post_title] => CBD vs. THC: A Tale of Two Cannabinoids [post_excerpt] => [post_status] => publish [comment_status] => open [ping_status] => open [post_password] => [post_name] => 7095 [to_ping] => [pinged] => [post_modified] => 2020-07-28 19:43:20 [post_modified_gmt] => 2020-07-28 19:43:20 [post_content_filtered] => [post_parent] => 0 [guid] => http://thedragontree.com/?p=7095 [menu_order] => 0 [post_type] => post [post_mime_type] => [comment_count] => 4 [filter] => raw [webinar_id] => 0 ) [1] => WP_Post Object ( [ID] => 7623 [post_author] => 3 [post_date] => 2019-08-27 18:47:08 [post_date_gmt] => 2019-08-27 18:47:08 [post_content] => Early in my career, I found it gratifying to treat pain and I was pretty good at it. The art of choosing the right acupuncture points is fascinating, creative, and even fun. But then I attended a seminar on marketing where the instructor advised, “Choose a specialty and focus on just treating that one thing,” and a friend suggested I should become a pain specialist. At the time, it felt like someone suggesting to a painter, “You should limit yourself to painting only in yellow from now on.” I was resistant to the idea partly because, like most people, I enjoy variety, and partly because the treatment of pain seemed like superficial work. Fixing sore elbows day in and day out would have been the equivalent of painting only in yellow, so I decided I couldn’t be a fixer of body parts. The only way I could be satisfied – and simultaneously facilitate a deeper level of healing – was to treat whole people. Over the years since, I’ve come to understand that pain encompasses a huge range of health concerns and it’s often broader than we think. Chronic pain is frequently part of a complex pattern where it may be intertwined with depression, anxiety, anger, grief, psychological trauma, and also with digestive disorders, sleep disturbances, and more. So there’s plenty of opportunity for variety and depth, and there’s also a great need for pain treatments that are more intelligent than pills. I’ve felt called to educate people on different ways of understanding pain. It helps more than you might think. In 2014, Lancet published a study on the impact of education on people with neck pain. Participants were divided into two groups: half of them got 20 sessions of physical therapy, lasting an hour each. The other half got 30 minutes of education and two follow up phone calls about pain. Throughout the 12-month study, both groups had equal rates of improvement. Spending a short time learning about pain was as effective as twenty hours of physical therapy! I created an online course to teach people productive ways of understanding pain along with instruction in a wide range of do-it-yourself methods for stopping pain. We also unravel the broader psychological, social, and physiological context that the pain is wrapped up in. I know everybody isn’t going to take this course, though, and there are a few concepts I teach in it that I want to share with the whole world. So I’ll be explaining them in the next couple articles. Even if you’re not in pain now, chances are you’ll experience some in the future, or someone close to you will struggle with it. Knowing what’s going on inside can really help. And as you’ll see, the possible expressions of pain go way beyond our usual definition. I want the world to understand this because it’s simple, it makes sense, and it gives us an intuitive sense of what to do about it. Here it is: all pain is due to some form of stagnation. When things (blood, food, lymph, energy, feelings, etc.) move freely through us we generally feel good, and when they don’t we feel bad. Here are some examples. When we have a traumatic injury, there is damaged skin and nerves, crushed or severed blood vessels, torn muscle and other connective tissue, and perhaps broken bone. The damage means that free flow through the area is impeded. Thus, there is stagnation and it hurts. If we overeat and food is so crammed into our digestive tract that it’s barely moving, this is a form of stagnation and it feels bad. If we have a blood clot that’s blocking the flow, this is stagnation and it’s painful. If blood stops moving through the vessels that serve the heart itself, this is dire stagnation, and it’s intensely painful. If we sleep in a cramped position, are dehydrated, or don’t move much, our muscles can become locked up and irritated – i.e., stagnant – and they hurt. In the same way, if we lose someone we love and we cling to them even though they’re not physically here anymore, this is mental and emotional stagnation, and it makes the process more painful. If we harbor any negative feeling (rather than allowing it to be felt and to move through us freely) this is a form of emotional stagnation, and so we suffer. Aside: all negative emotions are qualitatively different from positive ones in that they have a restrictive or contractive effect on the body-mind. Positive emotions have an opening or expansive effect. I’m not implying that if you’re grieving a loss or have been stuck in a state of anger, you should feel bad or wrong for doing this. In fact, if you do so – i.e., if you resist what’s happening or tell yourself, “I shouldn’t be feeling this way,” – you only compound the stagnation, which makes the pain worse and impedes the healing process. Resistance is a major cause of stagnation. So, looking at this mechanism in the broadest way, when we resist reality – meaning, we don’t accept any aspect of life (either in the outside world or within our own inner experience) – we contract ourselves, we tighten up, and we limit our own freedom. This causes stagnation and stagnation hurts – physically, mentally, and emotionally. Resistance causes stagnation and stagnation causes pain and suffering. If we resist the pain and suffering, we get caught in a vicious circle. Although I learned about the connection between stagnation and pain when I was studying acupuncture, it was only through years of treating people and self-exploration that I came to understand the staggering implications of this mechanism and the role that resistance plays. When I began to see pain in this way – all the different forms and how profoundly it affects the course of our lives – it no longer felt like a limited career path! Before I get into how to use this model to get out of pain, I want to add a few sub-principles. First, all parts of us are interconnected, so stagnation on one level can readily lead to stagnation on another level. For example, if we’re chronically angry, tense, or sad (emotional stagnation) this can eventually show up as, say, a tension headache or lower back pain (physical stagnation). Vice versa, living in a tight and inflexible body (physical stagnation) can contribute to a lack of mental flexibility – rigid thinking, frustration, depression, etc. Second, because of this interconnection, clearing stagnation on any level tends to promote healthy flow on all levels. For instance, physical exercise is beneficial for depression, because moving the body moves the mind. Likewise, using the mind to imagine energy and blood coursing freely through a painful area of the body can often be as effective as painkillers. For the same reason, if we’re in physical pain, it is always worthwhile to look inward and see if there’s some story or emotional pattern we need to let go of. Third, while resistance leads to stagnation, acceptance (feeling willingly, not arguing with reality, surrendering) restores flow. Thus, there is often immediate relief from suffering when we stop resisting it. So, to summarize:

Where there is pain there is stagnation
Resistance promotes stagnation
All levels of our being are interconnected, so
- Stagnation can spread between levels
- Movement on one level can alleviate stagnation on multiple levels
Relinquishing resistance restores the flow

Take some time to think about this and feel into it. And tell me about your experience with it in the comments section below. I’ll explain some ways to utilize this model next week and we’ll also look at an updated Western model of pain. Be well, Peter

Learn more about the Live Pain Free course

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This month’s theme is one of my specialties: pain management. There’s so much I could write about dealing with pain, but the fact is the approaches that are of greatest benefit to most people don’t need much explanation. As with most simple things, they’re easy to dismiss because we put so much value on complexity. Now that we have mapped out the human genome and can control the weather with our iPhones, who’s going to believe that the simple approach is the best?

Interestingly, many of the complex health-related developments don’t entail much involvement by the user. Just swallow this pill, which is the culmination of years of work by people much, much smarter than you. The simple interventions, on the other hand, often represent more work and/or lifestyle change by the user, but by the same token, they stand to heal you in a way that few pills could.

Now, let’s get down to business. I’d like to teach everyone to understand the meaning of pain from the perspective of Chinese Medicine. One of the most fundamental principles of this medical system is that all pain is due to some form of stagnation. When things move freely we feel good, and when they don’t we feel bad.

If we overeat and food is stagnant in our digestive tract, it feels bad. If blood stops moving through the vessels in our heart, it feels bad. If our muscles are irritated and taut (i.e., stagnant), they feel bad. If a joint is damaged and inflamed (stagnation again), it feels bad. If we broke up with someone but we keep fantasizing about them or replaying our conversations, this is mental and emotional stagnation, and it feels bad. If we’re attached to life being a certain way but it’s not that way, and we don’t accept it, it feels bad. Guess why. No matter what kind of pain you’re in, restoring healthy movement or flow will make you feel better.

Now for three important sub-principles. First, all parts of us are interconnected, so stagnation on one level can readily lead to stagnation on another level. For example, if we’re chronically angry, tense, or sad (emotional stagnation) this can eventually show up as, say, a tension headache or lower back pain (physical stagnation). Vice versa, living in a tight and inflexible body (physical stagnation) can contribute to a lack of mental flexibility – rigid thinking, frustration, depression, etc. Physical stagnation is easier to cure in this case, as emotional stagnation needs not just a treatment, but also your willing to get well. There is the natural product that can help to reduce stress and improve your emotional state.

Second, clearing stagnation on any level tends to promote healthy flow on all levels. For instance, physical exercise is beneficial for depression, because moving the body moves the mind. Likewise, using the mind to imagine energy and blood coursing freely through a painful area of the body can often be as effective as painkillers. For the same reason, if we’re in physical pain, it is always worthwhile to look inward and see if there’s some story or emotional pattern we need to let go of.

Third, you can’t argue with reality. Resistance produces stagnation. So, resisting pain doesn’t help. Acceptance does. Accept your pain (and everything else) and let it go.

Almost everything that benefits pain does do by mobilizing stagnation. We’ll explore a handful of the most beneficial interventions this month.

Let’s start by addressing conservative care for injuries. For several decades, the standard has been RICE: Rest, Ice, Compression, and Elevation. All of these tactics are aimed at inhibiting movement, based on the notion that the inflammatory process in injuries is somehow a mistake by the body. We’ve been taught that it’s vital to stop the influx of immune cells that causes swelling. As for Rest, it’s a good idea not to cause more damage, so avoiding activity that could be injurious is smart, but total immobility can slow the healing process. Contracting the muscles around an injured area gets the congested fluid (lymph) moving out of there. Controlled, low impact movement speeds healing.

The use of ice is the subject of fierce debate. In Chinese Medicine (and thermodynamics), cold is considered a contractive force. It inhibits movement. Therefore, if the goal is to get fresh blood into the area and clear out lymph and particles of damaged tissue, we need to keep the vessels in this area open. Cold constricts vessels, while heat opens them. Cold blocks pain signals, but inhibits healing. In fact, emerging research shows it may contribute to increased tissue death and slower healing. If you really love the refreshing feeling of brief cold application after minor strain (like working or exercise), I don’t think it’s a problem. But for healing pain, heat almost always works better.

Compression is meant to keep an area from swelling, but again, the influx of fresh blood to nourish damaged tissue and the immune macrophages, cells that clean up debris, are beneficial. We don’t want to restrict this response; we just need to keep things moving. Although there are some cases in which compression is useful, I generally advise against it for acute traumatic injuries.

Of the four RICE interventions, I find Elevation the least objectionable. It’s meant to reduce gravity’s contribution to swelling and to improve the return of blood to the heart through veins. The thing is, most of the fluid swelling in trauma is lymph, not blood, and lymph moves through lymphatic vessels, not veins. Gravity alone isn’t going to help much in moving that lymph. Instead, the muscles around these lymphatic vessels need to contract to squeeze the fluid along. Again, this is why controlled, low impact movement is vital.

So, next time you get injured, try slow, low impact movement and heat application. Next week I’ll discuss more strategies for alleviating this and other forms of pain. Stay tuned and keep moving.

Be well,

Dr. Peter Borten

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Be well,

Dr. Peter Borten

Click Here to Learn More About Dragontree CBD Infused Body Care Products And Get Free Shipping On Your Next Order

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