Participants: Nick Evenson (Host), Dr. James Marcum
Series Code: UP
Program Code: UP000079A
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00:17 Pain, unfortunately, is something that has been
00:19 experienced by every human that has ever lived. 00:22 But do we have to live with pain 00:24 or is there a better way? Stay tuned... 00:27 I'm Dr. James Marcum, are you interested in 00:30 discovering the reason why? 00:32 Do you want solutions to your healthcare problem? 00:35 Are you tired of taking medications? 00:38 Well, you're about to be given "The Ultimate Prescription" 00:44 Whether suffering from a stubbed toe or a sore back, 00:47 just about everyone of us has experienced 00:49 pain to one degree or another. 00:51 Well, what can we do about it? 00:53 Is the pain go away on its own 00:55 or does it need a medical intervention? 00:57 I'm your host Nick Evenson and you're watching 01:00 "The Ultimate Prescription" 01:01 Dr. Marcum, welcome to the program, 01:02 and let's hear a little bit about pain. 01:04 Well thanks Nick and unfortunately, 01:07 everyone usually at some point experiences pain... 01:10 Even though I recently heard a story about a 94-year-old 01:14 that never had pain until she was 94. Wow! 01:17 Well I think that's more of a rarity. 01:20 So we're going to talk about pain today in general, 01:24 but over the next few weeks, we're going to specifically 01:26 talk about pain in different parts of the body. 01:29 We're going to talk about head pain. 01:32 We're going to talk about chest pain, abdominal pain. 01:35 So we're going to learn a lot about pain. 01:37 And sometimes, I found, Nick, when working with patients, 01:41 just understanding pain, knowing what they're 01:44 up against, having more knowledge, 01:46 that helps, to some degree, relieve the pain. 01:50 How it relieves some of the anxiety 01:51 that maybe causes more pain. Yeah 01:53 Now, have you ever had pain before? 01:55 You know, I've had just a little bit, maybe if I cut myself 01:58 and I've had a sore back a few times, 01:59 but nothing too significant. 02:01 Well I've noticed that the older you get, 02:04 the more pain you have and the longer it takes sometimes 02:08 to get over pain. Sure 02:09 But, you know, a lot of people, we need a really good 02:12 definition of pain... 02:13 So, what would you say pain is to you? 02:15 Pain is maybe a really bad headache sometimes 02:20 and can cause pain or a just kind of throbbing 02:24 in my back sometimes. 02:25 Okay, well we're going to give a definition of pain, 02:27 and I'm going to throw this out there because pain 02:29 is basically an unpleasant feeling that is often 02:34 caused by damaging stimuli. Okay 02:37 So unpleasant feelings, 02:39 damaging stimuli results in pain. 02:43 And pain, long-term, is not good. 02:46 You know, God gave us pain to give us a warning. 02:50 When you have pain, you say "something is not right." 02:54 Well we recently went to our good friend Dr. Dennis Ford. 02:57 We went to his clinic for anti-aging and pain management 03:00 to get his thoughts on what kind of pain he sees and treats 03:04 and to get some ideas of how he treated - let's take a look. 03:08 Probably the most common cases I see is like failed back 03:12 surgeries, failed neck surgeries, 03:13 a lot of fibromyalgia-type pain also. 03:17 Some of the common symptoms for neck or back pain is 03:20 a deep aching, throbbing pain that radiates down the arm, 03:23 an arm may being numb or weak and that's the most common. 03:27 And the fibromyalgia pain is they have deep aching pain 03:31 in muscles all over the body, fatigue, brain fog, 03:35 trouble with memory and just don't feel good, no energy. 03:39 If the pain remains more than 2 or 3 months, 03:41 is fairly severe, then it becomes chronic pain, 03:44 usually patients go to their doctors before that. 03:47 They go to their family doctor first and then if they feel 03:50 that the pain is not getting better, 03:52 they work it up or refer to Pain Management 03:55 and we look into it further. 03:56 Usually after several weeks, the patients will look into it 03:58 about that time if they don't get any better. 04:00 My general approach to back pain is to try to get them 04:03 to do physical therapy, try to build up their muscles 04:06 or strengthening where they can become more active. 04:08 Try to use non-narcotic pain medicine if I can. 04:11 If the pain is not getting any better, 04:13 I'll do like an epidural in the cervical spine 04:16 or lumbar spine; sometimes the thoracic spine 04:18 to see if we can get the pain to go away. 04:20 I've had 2 in my neck about 20 years ago, 04:22 it helped the worst of my pain to go away. 04:24 I still have some decreased range of motion, 04:26 but I don't hurt anymore and that's why I do the 04:28 stretching now to see if I can increase my range of motion, 04:31 and keep my youthful feeling. 04:33 And then there are a lot of times when my 04:34 chronic pain patients, especially the males, 04:36 their hormones get low... 04:37 I do check their testosterone, and if it's low, 04:40 we build that level up to the youthful level 04:42 to get them feeling more energetic; 04:44 help their thinking and their muscles, 04:46 and just help their feel younger. 04:48 There are some risks to epidural steroid injections. 04:51 Most of them are minor complications like... 04:54 sometimes the steroid makes them hyper for a day or so 04:57 or they sometimes get a redness in their face we call 04:59 "steroid flare" for up to 24 hours. 05:02 And I've done this for 30 years, the risk of infection, 05:06 I've never seen an infection, thank You God. 05:09 Also risk of bleeding in the area which 05:12 would require surgery, I've never seen that either, 05:14 but it's rare reported cases of infection or bleeding 05:18 where you would have to have surgery. 05:19 I've done probably 50 or 60 thousand epidurals 05:22 including labor epidurals over the years, 05:24 and never seen those being trying to rule out 05:27 patients who would have potential problem. 05:29 We wouldn't do them if they're on blood thinners 05:31 or if they have an infection. 05:33 The benefits are there are a lot of times 05:35 they will get your pain to ease up tremendously 05:36 or maybe even go away. 05:38 Or your quality of life would return where you can become 05:41 more active and have less or no pain, hopefully. 05:47 And we'd like to thank Dr. Ford 05:48 for sharing his expertise with us. 05:50 And Dr. Marcum, Dr. Ford is a personal friend of yours, right? 05:53 Yeah and can you imagine, Nick, treating 05:55 chronic pain for 30 years. Yeah, that's a long time. 05:58 And, you know, the technology over the last 30 years 06:02 in treating chronic pain has changed quite a bit. 06:05 You know, now, you saw him with an epidural, 06:08 that's very useful, especially sometimes if you can get the 06:12 inflammation to settle down... 06:14 that gives the nerves in the back time to heal. 06:16 So sometimes epidurals are very effective, but can you imagine, 06:19 he has said how many he has done through the years 06:22 of putting that medicine in the exact right spot at the 06:25 exact right time and I thought it was very interesting that 06:27 even though he does it, he has really 06:29 not seen a problem with infection. Right 06:31 And, you know, it sounds like he sees a lot of neck pain, 06:34 a lot of back pain, lower back and that type of thing. 06:37 Why can pain be so damaging to us? 06:40 Well if you think about pain, this is God's warning 06:43 system to tell us that something is not right. 06:45 So anytime someone has pain, no matter where it is, 06:49 the first thing they should think is... 06:50 "something is not right." 06:52 And we're going to learn, as time goes on, 06:54 for each part of the body, which type of pain 06:57 deadly and needs attention right away; 07:00 which type we might have a little bit more time with. 07:03 And, fortunately, God has given the body enormous 07:06 abilities to heal itself, but sometimes the pain 07:09 doesn't heal itself and that's bad news. 07:13 But chronic pain in itself is bad and the general 07:17 approach is - if you have pain, you want to sort of find out, 07:19 well, what's causing it? Right 07:21 Because if you can get at the cause, 07:23 a lot of times that will solve the issue 07:25 and the body will heal itself. 07:27 So if I've got a pain and I'm just taking Advil 07:31 or whatever for several weeks, that's maybe not the best idea. 07:34 And that happens quite a bit, we see that with back pain, 07:37 you know, someone will have to work, 07:39 they'll be lifting, they'll have back pain 07:42 and rather than quit lifting or pulling or doing their job 07:45 for a while and letting the back heal, 07:48 they will just take pain medicines or medicines 07:50 so they can keep doing their job and they make it 07:53 worse - so sooner or later they become dependent 07:56 on that pain medicine. 07:58 That's really not very good. 07:59 No it's not and yet I see this happening quite a bit 08:03 in the world we live in. 08:04 You know, a person has a pain 08:06 and rather than get at the cause, 08:08 they take a little medicine, then what's causing the pain 08:11 gets worse or develops more, so they get dependent 08:14 on medicines - they take a little bit more. 08:16 In fact, last year in the state I live in, 08:19 narcotics was one of the leading causes of death. 08:23 People would overdose on narcotics 08:25 that they're taking for chronic pain, 08:27 and that's a travesty, Nick, you know, 08:29 when they take that amount of pain. 08:31 But, not only is that a danger of chronic pain, 08:34 but chronic pain puts stress on the system. Right 08:38 And my definition of stress is anything that really 08:41 goes against our owners template - you know 08:44 how God made us... whether that be not 08:46 drinking enough water, not getting the 08:47 sunshine or not moving. 08:49 Well God did not make us to have pain. Right 08:52 So pain is a warning that something is wrong, 08:53 but when we're under chronic pain, 08:55 it puts stress on the body... 08:57 And our bodies make chemicals like adrenalin and cortisol, 09:01 and inflammatory proteins. 09:03 When we're under chronic pain, guess what happens in our brain? 09:06 Our brain actually doesn't work as good... 09:09 We use the "let's stay alive part of the brain," 09:12 we don't even think as good. 09:13 So when you're in chronic pain, 09:15 you can't do as well on the test, you can't think as well, 09:18 and chronic pain, it's hard to worship as well... Right 09:22 because you brain is inflamed, it just wants to stay alive. 09:24 You're making all these chemicals, 09:26 the brain is inflamed, so you don't even worship as well. 09:29 So pain is a real difficult thing to happen. 09:32 Now Nick, I'm going to quiz you for a second... Okay 09:36 How does your body know you're under pain? 09:38 Did you ever take physiology? 09:40 No, actually I didn't. Okay 09:42 Well, it's the nerves, did you know that? 09:43 Right, yeah... The nerves tell us 09:45 if we're under pain and, you know, 09:47 the brain is sort of like the command of the nerve center, 09:50 and we call that the "central nervous system." 09:54 So all stimuli from pain is going to eventually 09:57 come back to the brain and the 09:58 brain is going to decide what to do with it. 10:00 So just the brain, how it thinks about pain, 10:03 and the knowledge it has about pain, 10:05 could actually help in the treatment of pain. 10:08 So if your brain really has some good stuff 10:10 stored in the hippocampus... think about it. 10:12 Not only do you know whether the pain is dangerous or not, 10:15 but you'll know how to handle it, what to do... 10:17 So that's why we want to talk in general about pain 10:20 to help the brain develop some coping skills, 10:22 to know when things are dangerous. 10:23 So that's why I think this series is very interesting. 10:26 But if we have a stimuli, like if I pinch you, 10:28 if I pinch you right there and it starts hurting... 10:32 you have a nerve - a peripheral nerve that sends a signal 10:36 all the way to the spinal cord and it goes up the spinal cord 10:41 to the brain and your brain interprets that signal. 10:44 And depending about your knowledge base about pain, 10:47 the brain decides what to do. 10:49 Is this a life-threatening pain? Is this allotted? 10:51 You know, should I keep firing this nerve pain 10:54 or is this not so... 10:55 So just your knowledge base 10:57 can affect how much pain you have. 10:58 Now, we talked about pain in different ways... 11:02 Now pain is due to some type of stimuli, peripheral 11:05 like a burn or someone hits you, we call that "nociceptive pain." 11:11 It's not really the nerve doing it, 11:13 the nerve is interpreting the stimuli. Right 11:16 So the nerve says, "Oh, something is wrong, 11:17 I'm going to do something." 11:19 Now the nerve works fine, so the nerve is not the 11:21 problem at all, it's the stimuli. Okay 11:24 So it's important to know that because you want to know 11:26 whether you could help the nerve get better 11:28 or remove the stimuli. 11:30 Now, if the nerve is damaged too, 11:33 we call that "a neuropathy." 11:35 Now you can have both at the same time; you can have a 11:38 bad nerve and it interprets pain badly as well. 11:42 Now nerves need a lot of things to stay healthy. 11:45 Nerves need oxygen, they need a blood supply, 11:48 they need some good nourishment. 11:51 So it's very important to keep nerves healthy, Nick, 11:54 very, very important. 11:55 And, you know, we could talk on and on, 11:57 but I know we're going to talk a whole series about pain, 12:00 so we're going to answer a lot of questions. 12:02 I know that some people have written 12:03 in with their questions about pain. 12:05 That's right - I've got a lot more interesting stuff 12:07 to learn from you about pain. 12:08 But we're going to be back in just a moment. 12:10 We've got to take a quick break, but stay with us 12:12 as Dr. Marcum will be right back to share more about 12:14 understanding and dealing with chronic pain. |
Revised 2016-11-29