Pain Management
Pain is a very common symptom with ME. There is a list of ways listed below that might help with these pain conditions. We also include a list that patients have suggested along with some medical videos.
- “Headaches: e.g. chronic, generalized headaches often involve aching of the eyes, behind the eyes or back of the head that may be associated with cervical muscle tension; migraine; tension headaches.”
- “Significant pain can be experienced in muscles, muscle-tendon junctions, joints, abdomen or chest. It is noninflammatory in nature and often migrates. e.g. generalized hyperalgesia, widespread pain (may meet fibromyalgia criteria), myofascial or radiating pain.”
Possible pathological types/components:
- altered sensory information and pain processing in the brain that is perceived as pain
- peripheral neuropathies
- decreased pain threshold
- dysregulation of sodium channels & ion transport
- magnesium deficiency
- inflammatory conditions
- muscle pain generated by movement: paretic (decrease in muscle bulk/tone), spastic – (increase in muscle bulk/tone)
- structural pain: failure of supportive structures
Methods to combat these symptoms include:
Non-pharmaceutical:
- avoid pain exacerbators
- pacing
- local heat or cold
- gentle stretching; manipulative body therapy
- massage
- physiotherapy
- chiropractic
- myofascial release techniques
- relaxation techniques
- biofeedback
- ultrasound
- meditation
- TENS (Transcutaneous Electrical Nerve Stimulation)
- acupuncture
- magnesium sulfate (for muscle spasm)
- hydrotherapy
- Synaptic® Electronic Activation
Pharmaceutical:
- topical ointments
- anti-inflammatory/degenerate/neuropathies
- NSAIDs
- ibuprofen
- naproxen
- COX-2 inhibitors
- Celecoxib
- anticonvulsants
- Gabapentin
- Pregabalin
- TCA [tricyclic antidepressants] – low dose for short time
- Amitriptyline
- Nortriptyline
- Doxepin
- muscle relaxants
- Baclofen
- Cyclobenzaprine
- migraines
- Sumatriptan Succinate
- narcotic/opiates: only if severe – requires rationale & documentation
Please note: All of these should be done with medical guidance and approval. There is potential for harm from any medicine. For instance, if you have low kidney function, NSAIDs could cause severe harm. Some patients don’t tolerate anticonvulsants, or antidepressants so it is important to seek medical advice when taking any of these approaches to be sure it is safe for you.
Suggestions from our members:
- Avoid MSG (monosodium glutamate)
- Cannabis: Cannabis and Inflammation: Everything You Need to Know
- Acupuncture from one trained in traditional Chinese medicine
- Distraction is a powerful coping technique
- Epsom salt bath
- Magnesium spray
- Lavender oil
- Peppermint oil
- Foods with salicylate (almonds) (*unless you get kidney stones)
- Antioxidants
- Lots of fluids to flush out toxins
- Food symptom diary to find pain triggers (beef triples my pain levels)
How to Use Ginger for Pain Relief
Pain From Vitamin D Deficiency – And What To Do
How to Use Fish Oil for Pain Relief
How to Use Coconut Oil for Pain Relief
How to Use Tart Cherries for Pain Relief
Homemade Muscle Rub Recipe with Cayenne Pepper for Quick Pain Relief
And, of course, activity level that avoids crashing (rest as much as needed to avoid exacerbation of symptoms)
Caffeine – My favorite way to start each day is with a great cup of coffee! I also will enjoy a cup of tea or perhaps a drink with caffeine in it. If you take it early enough, you could really ease your headache pain. It also will help acetaminophen (Tylenol) to work better. Drinking too much could be a problem and cause caffeine withdrawal. It is my favorite way to help with a headache!
A Cold Pack can work wonders. – If you have a migraine headache, place a cold pack on your forehead. Ice cubes wrapped in a towel, a bag of frozen peas, or even a cold shower may lessen the pain. Keep the compress on your head for 15 minutes, then take a break for 15 minutes.
A Hot Compress or a Heating Pad – If you have a tension headache, place a heating pad on your neck or the back of your head. If you have a sinus headache, hold a warm cloth to the area that hurts. A warm shower might also do the trick.
VIDEOS
Stanford Hospital's Dr. Ian Carroll on Nerve Pain (1:39:10) 28 Oct 2013
An informative presentation by Dr. Ian Carroll of Stanford (California, US) explaining what nerve pain is, as well as information about how various medications work. Posted in 2013, this presentation does not include the more recent information about the effectiveness of low dose naltrexone.
Unraveling the Complexity of Chronic Pain and Fatigue (Part 1 of 3) (53:05) 06 Sept 2020
Part 1: Dr. Lucinda Bateman, internist and Medical Director at the Bateman Horne Center, teaches about strategies and tools for systematically approaching complex chronic illness presentations. This presentation contains the following: • Case presentations • Tools for measuring and tracking severity of pain and fatigue • Tools for efficiently measuring and tracking impaired function