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A T L A N T I C S P I N E & P A I N - C A T H E R I N E D u N C A N , D O

Dr. Catherine Duncan, an expert in the field of acute and chronic pain management and owner of Atlantic

Spine and Pain in Apex, says we may actually be causing more harm than good when we reach for the ibuprofen to manage acute pain.

“Simple, over-the-counter pain medica-tions are among the most frequently used drugs on the market today,” she notes. “Non-steroidal anti-inflammatories, or NSAIDs, are particularly popular for daily pain management, with advertisements touting products like Advil, Motrin, or Aleve as good options for any pain that ails you. However, what are we really doing when we pop an NSAID as the first line of treatment for a pain or injury? It may not be healing.

“Your body is a self-healing mecha-nism,” she explains. “Inflammation may cause temporary discomfort, but it is a vitally important part of the healing process when it comes to acute, musculoskeletal issues. Sup-pressing that inflammatory process makes you feel better in the short run, but, at the same time, it directly interferes with the heal-ing process.”

When an injury occurs—such as a sprained ankle—inflammation is the body’s natural response to protect and begin to heal the injury, explains Dr. Duncan. “Chemicals called prostaglandins are released into the bloodstream, which causes increased blood flow to the area of injury. This increase of blood flow results in the ankle becoming red, warm, and swollen, but also brings with it ex-tra red and white blood cells, as well as other inflammatory mediators that begin the work of repairing the damage that has occurred.”

HEALIng MYtHSNSAIDs, says Dr. Duncan, “work

by inhibiting the release of prostaglandins, which in turn inhibits inflammation from occurring. A common myth is that if it looks better and there is less pain, the injury is healing. People think ‘Oh, the swelling has gone down so the injury is better.’ But this is actually the exact opposite of the truth. When you take these medications in response to injury you are preventing these important chemicals from entering the

bloodstream that are required to allow effec-tive healing. It’s more than just masking pain. It is preventing healing.”

The myth that decreased swelling and pain indicate healing is actually one that can cause more damage to an already injured site, Dr. Duncan explains. “One of the big negatives about pain medication is that it gives you a false sense of security, which can lead to making an injury worse. If you sprain your ankle and then treat it with an NSAID, the pain may stop so you think it’s okay to start walking on it. However, just because the pain medication is blocking the pain and artificially decreasing the swelling doesn’t mean the injury is healed, and you probably still shouldn’t be walking on it.”

LEt YouR PAIn BE YouR guIDE

“While uncomfortable,” Dr. Duncan continues, “pain is really very useful. It’s the body’s guide to helping us know when we are injured, how injured we are, and when we are healing. Pain tells us not to walk on that sprained ankle until it is well enough—indi-cated by the pain decreasing naturally. When we mask the symptom of pain prematurely with NSAIDs, we lose our guide to knowing when we are helping heal and when we are causing further cell or tissue damage.”

nSAIDS oR InfLAMMAtIon? tHE BESt PAtH to HEALIng

Dr. Duncan not only suggests allow-ing the natural inflammatory process to take place in response to injury, she actually employs a highly effective treatment in her practice that causes inflammation in order to stop chronic pain in joints and promote heal-ing. “Prolotherapy,” Dr. Duncan explains, “is an injection of a dextrose solution into a damaged joint—where there is arthritis or a torn ligament, for example—which causes the immune system to respond to the site of injury and to concentrate on healing that particular area.”

NSAIDs are commonly used to manage chronically painful joints, with millions of people taking them on a daily basis just to cope with the discomfort. “This is doing nothing to treat the actual cause of the pain,” Dr. Duncan says. “Prolotherapy is a treat-ment offering the opportunity to heal the joint, it’s addressing the source of the pain, not just the pain itself.”

So if NSAIDs in fact slow down the process of healing, what can you do to help speed it up? Dr. Duncan points out that the body’s natural healing process is the fastest path to healing. “We don’t have any medications that actually speed up the heal-ing process,” she says. “However, physical therapy and movement in general may help by increasing blood flow to the area. Ice and heat may also help depending on the injury. Certainly if someone is in a lot of pain, let’s help get them out of pain to start, but I would prefer to do so with a protocol that does not rely on artificially reducing the inflammation and which supports the body’s natural healing process.”

So when is it appropriate to use an NSAID? Dr. Duncan says these medica-tions are best used for chronic inflammatory processes such as auto-immune diseases, like Crohn disease. “When inflammation is a chronic problem, and is not in response to an injury but rather pathological wherein the body is basically attacking itself, NSAIDs can be profoundly useful in controlling that inflammatory process.” h&h

Will Duncan has found great relief of his back pain over the years, thanks to the knowledge and healing gifts of his wife, Dr. Catherine Duncan. They are both quite familiar with the structure and frailty of the human spine.

nSaiDS: an Epidemic of Misuse“Inflammation . . .

is a vitally important part of the healing

process . . . . Suppressing that

inflammatory process makes you feel better

in the short run, but, at the same time, directly interferes

with the healing process.”

For more information, contact:For more information about resolution

of pain issues, contact:ATLANTIC SPINE AND PAIIN

Catherine A. Duncan, DO1031 West Williams Street, Suite 102

Apex, NC 27502Telephone: (919) 439-7867 www.atlanticspinepain.com

Dr. Duncan offers many ap-proaches to help patients over-

come pain, including:

• Radiofrequency Ablation: An electrical current produced by a radio wave to heat up a small area of nerve tissue, thereby decreasing pain signals from that specific area.

• Botox injections for the treatment and prevention of migraine headaches.

• Electromyography (EMG), to measure muscle response or electrical activity in response to a nerve’s stimulation of the muscle. The test is used to help detect neuromuscular abnormalities.

• Epidural Steroid Injections (ESIs), a common method of treating inflammation associated with low back related leg pain, or neck related arm pain.

• FACET Joint Injections of a steroid medication to reduce inflammation in the small joints at each segment of the spine that provide stability and help guide motion.

• Spinal Cord Stimulation, applying an electrical current to the source of chronic pain. This creates a pleasant sensation that blocks the brain’s ability to sense the previously perceived pain.

• Viscosupplementation: an injection of hyaluronic acid into the knee and into the synovial fluid for the treatment of knee osteoarthritis—to increase lubrication in the joint, making joint movement much easier.

• Prolotherapy: an injection technique that stimulates growth of cells and tissue that stabilize and strengthen weakened joints, cartilage, ligaments and tendons.

• A sacroilliac (SI) joint injection— also called a sacroiliac joint block—primarily used to diagnose or treat low back pain and/or sciatica symptoms associated with sacroiliac joint dysfunction.

RelieVing Pain

Originally published in Health & Healing in the Triangle, Vol. 19, no. 4, health & healing, inc., Chapel hill, nC, publishers. Reprinted with permission.