Pain, unfortunately,
is something that has been
00:00:17.01\00:00:19.95
experienced by every
human that has ever lived.
00:00:19.98\00:00:22.62
But do we have to live with pain
00:00:22.65\00:00:23.99
or is there a
better way? Stay tuned...
00:00:24.02\00:00:26.09
I'm Dr. James
Marcum, are you interested in
00:00:27.06\00:00:30.43
discovering the reason why?
00:00:30.46\00:00:32.79
Do you want solutions
to your healthcare problem?
00:00:32.83\00:00:35.13
Are you tired of
taking medications?
00:00:35.16\00:00:38.13
Well, you're about to be given
"The Ultimate Prescription"
00:00:38.17\00:00:43.77
Whether suffering from a
stubbed toe or a sore back,
00:00:44.31\00:00:47.51
just about everyone
of us has experienced
00:00:47.54\00:00:49.38
pain to one degree or another.
00:00:49.41\00:00:51.85
Well, what can we do about it?
00:00:51.88\00:00:53.21
Is the pain go away on its own
00:00:53.25\00:00:55.18
or does it need a
medical intervention?
00:00:55.22\00:00:57.59
I'm your host Nick
Evenson and you're watching
00:00:57.62\00:01:00.09
"The Ultimate Prescription"
00:01:00.12\00:01:01.46
Dr. Marcum,
welcome to the program,
00:01:01.49\00:01:02.82
and let's hear a
little bit about pain.
00:01:02.86\00:01:04.79
Well thanks Nick
and unfortunately,
00:01:04.83\00:01:07.10
everyone usually at some
point experiences pain...
00:01:07.13\00:01:10.73
Even though I recently heard
a story about a 94-year-old
00:01:10.77\00:01:14.17
that never had pain
until she was 94. Wow!
00:01:14.20\00:01:17.51
Well I think
that's more of a rarity.
00:01:17.54\00:01:20.11
So we're going to talk
about pain today in general,
00:01:20.14\00:01:24.18
but over the next few weeks,
we're going to specifically
00:01:24.21\00:01:26.72
talk about pain in
different parts of the body.
00:01:26.75\00:01:29.92
We're going to
talk about head pain.
00:01:29.95\00:01:32.35
We're going to talk about
chest pain, abdominal pain.
00:01:32.39\00:01:35.02
So we're going to
learn a lot about pain.
00:01:35.06\00:01:37.56
And sometimes, I found, Nick,
when working with patients,
00:01:37.59\00:01:41.86
just understanding
pain, knowing what they're
00:01:41.90\00:01:44.77
up against,
having more knowledge,
00:01:44.80\00:01:46.87
that helps, to some
degree, relieve the pain.
00:01:46.90\00:01:50.04
How it relieves
some of the anxiety
00:01:50.07\00:01:51.47
that maybe
causes more pain. Yeah
00:01:51.51\00:01:53.17
Now, have you
ever had pain before?
00:01:53.21\00:01:55.14
You know, I've had just a little
bit, maybe if I cut myself
00:01:55.18\00:01:58.01
and I've had a
sore back a few times,
00:01:58.05\00:01:59.85
but nothing too significant.
00:01:59.88\00:02:01.58
Well I've noticed
that the older you get,
00:02:01.62\00:02:04.32
the more pain you have and
the longer it takes sometimes
00:02:04.35\00:02:08.02
to get over pain. Sure
00:02:08.06\00:02:09.92
But, you know, a lot of
people, we need a really good
00:02:09.96\00:02:12.29
definition of pain...
00:02:12.33\00:02:13.66
So, what would you
say pain is to you?
00:02:13.70\00:02:15.73
Pain is maybe a
really bad headache sometimes
00:02:15.76\00:02:20.57
and can cause pain or
a just kind of throbbing
00:02:20.60\00:02:24.07
in my back sometimes.
00:02:24.11\00:02:25.44
Okay, well we're going to
give a definition of pain,
00:02:25.47\00:02:27.28
and I'm going to throw
this out there because pain
00:02:27.31\00:02:29.54
is basically an
unpleasant feeling that is often
00:02:29.58\00:02:34.32
caused by damaging stimuli. Okay
00:02:34.35\00:02:37.59
So unpleasant feelings,
00:02:37.62\00:02:39.62
damaging
stimuli results in pain.
00:02:39.65\00:02:43.79
And pain,
long-term, is not good.
00:02:43.83\00:02:46.73
You know, God gave us
pain to give us a warning.
00:02:46.76\00:02:50.10
When you have pain, you
say "something is not right."
00:02:50.13\00:02:53.54
Well we recently went to
our good friend Dr. Dennis Ford.
00:02:54.67\00:02:57.47
We went to his clinic for
anti-aging and pain management
00:02:57.51\00:03:00.78
to get his thoughts on what
kind of pain he sees and treats
00:03:00.81\00:03:04.11
and to get some ideas of how
he treated - let's take a look.
00:03:04.15\00:03:07.58
Probably the most common
cases I see is like failed back
00:03:08.02\00:03:12.02
surgeries,
failed neck surgeries,
00:03:12.05\00:03:13.69
a lot of
fibromyalgia-type pain also.
00:03:13.72\00:03:17.69
Some of the common symptoms
for neck or back pain is
00:03:17.73\00:03:20.16
a deep aching, throbbing
pain that radiates down the arm,
00:03:20.20\00:03:23.73
an arm may being numb or
weak and that's the most common.
00:03:23.77\00:03:27.37
And the fibromyalgia pain
is they have deep aching pain
00:03:27.40\00:03:31.21
in muscles all over the
body, fatigue, brain fog,
00:03:31.24\00:03:35.74
trouble with memory and
just don't feel good, no energy.
00:03:35.78\00:03:39.78
If the pain remains
more than 2 or 3 months,
00:03:39.81\00:03:41.95
is fairly severe, then
it becomes chronic pain,
00:03:41.98\00:03:44.62
usually patients go to
their doctors before that.
00:03:44.65\00:03:47.86
They go to their family doctor
first and then if they feel
00:03:47.89\00:03:50.73
that the pain is
not getting better,
00:03:50.76\00:03:52.09
they work it up or
refer to Pain Management
00:03:52.13\00:03:55.03
and we look into it further.
00:03:55.06\00:03:56.43
Usually after several weeks,
the patients will look into it
00:03:56.46\00:03:58.83
about that time if
they don't get any better.
00:03:58.87\00:04:00.54
My general approach to
back pain is to try to get them
00:04:00.57\00:04:03.20
to do physical therapy,
try to build up their muscles
00:04:03.24\00:04:06.54
or strengthening where
they can become more active.
00:04:06.57\00:04:08.34
Try to use non-narcotic
pain medicine if I can.
00:04:08.38\00:04:11.78
If the pain is not
getting any better,
00:04:11.81\00:04:13.21
I'll do like an
epidural in the cervical spine
00:04:13.25\00:04:16.18
or lumbar spine;
sometimes the thoracic spine
00:04:16.22\00:04:18.92
to see if we can
get the pain to go away.
00:04:18.95\00:04:20.59
I've had 2 in my
neck about 20 years ago,
00:04:20.62\00:04:22.92
it helped the worst
of my pain to go away.
00:04:22.96\00:04:24.79
I still have some
decreased range of motion,
00:04:24.83\00:04:26.90
but I don't hurt
anymore and that's why I do the
00:04:26.93\00:04:28.40
stretching now to see if I
can increase my range of motion,
00:04:28.43\00:04:31.33
and keep my youthful feeling.
00:04:31.37\00:04:33.17
And then there are
a lot of times when my
00:04:33.20\00:04:34.87
chronic pain
patients, especially the males,
00:04:34.90\00:04:36.50
their hormones get low...
00:04:36.54\00:04:37.94
I do check their
testosterone, and if it's low,
00:04:37.97\00:04:40.84
we build that level
up to the youthful level
00:04:40.88\00:04:42.71
to get them
feeling more energetic;
00:04:42.74\00:04:44.11
help their
thinking and their muscles,
00:04:44.15\00:04:46.88
and just help
their feel younger.
00:04:46.92\00:04:48.72
There are some risks to
epidural steroid injections.
00:04:48.75\00:04:51.82
Most of them are
minor complications like...
00:04:51.85\00:04:54.92
sometimes the steroid
makes them hyper for a day or so
00:04:54.96\00:04:57.66
or they sometimes get a
redness in their face we call
00:04:57.69\00:04:59.79
"steroid flare"
for up to 24 hours.
00:04:59.83\00:05:02.86
And I've done this for 30
years, the risk of infection,
00:05:02.90\00:05:06.33
I've never seen an
infection, thank You God.
00:05:06.37\00:05:09.20
Also risk of
bleeding in the area which
00:05:09.24\00:05:12.31
would require surgery,
I've never seen that either,
00:05:12.34\00:05:14.28
but it's rare reported
cases of infection or bleeding
00:05:14.31\00:05:18.05
where you would
have to have surgery.
00:05:18.08\00:05:19.41
I've done probably 50
or 60 thousand epidurals
00:05:19.45\00:05:22.32
including labor
epidurals over the years,
00:05:22.35\00:05:24.72
and never seen those
being trying to rule out
00:05:24.75\00:05:27.89
patients who would
have potential problem.
00:05:27.92\00:05:29.46
We wouldn't do them if
they're on blood thinners
00:05:29.49\00:05:31.69
or if they have an infection.
00:05:31.73\00:05:33.16
The benefits are
there are a lot of times
00:05:33.19\00:05:35.00
they will get your
pain to ease up tremendously
00:05:35.03\00:05:36.67
or maybe even go away.
00:05:36.70\00:05:38.93
Or your quality of life would
return where you can become
00:05:38.97\00:05:41.77
more active and have
less or no pain, hopefully.
00:05:41.80\00:05:46.24
And we'd like to thank Dr. Ford
00:05:47.14\00:05:48.64
for sharing his
expertise with us.
00:05:48.68\00:05:50.48
And Dr. Marcum, Dr. Ford is a
personal friend of yours, right?
00:05:50.51\00:05:53.58
Yeah and can you
imagine, Nick, treating
00:05:53.62\00:05:55.42
chronic pain for 30
years. Yeah, that's a long time.
00:05:55.45\00:05:58.65
And, you know, the technology
over the last 30 years
00:05:58.75\00:06:01.99
in treating chronic
pain has changed quite a bit.
00:06:02.02\00:06:05.23
You know, now, you
saw him with an epidural,
00:06:05.26\00:06:08.33
that's very useful, especially
sometimes if you can get the
00:06:08.36\00:06:12.13
inflammation to settle down...
00:06:12.17\00:06:14.20
that gives the nerves
in the back time to heal.
00:06:14.24\00:06:16.91
So sometimes epidurals are very
effective, but can you imagine,
00:06:16.94\00:06:19.77
he has said how many he
has done through the years
00:06:19.94\00:06:22.68
of putting that medicine
in the exact right spot at the
00:06:22.71\00:06:25.21
exact right time and I thought
it was very interesting that
00:06:25.25\00:06:27.75
even though he
does it, he has really
00:06:27.78\00:06:29.22
not seen a problem
with infection. Right
00:06:29.25\00:06:31.39
And, you know, it sounds
like he sees a lot of neck pain,
00:06:31.42\00:06:34.19
a lot of back pain, lower
back and that type of thing.
00:06:34.22\00:06:37.09
Why can pain be
so damaging to us?
00:06:37.13\00:06:40.20
Well if you think about
pain, this is God's warning
00:06:40.23\00:06:43.00
system to tell us that
something is not right.
00:06:43.03\00:06:45.77
So anytime someone has
pain, no matter where it is,
00:06:45.80\00:06:49.50
the first thing
they should think is...
00:06:49.54\00:06:50.87
"something is not right."
00:06:50.91\00:06:52.87
And we're going to
learn, as time goes on,
00:06:52.91\00:06:54.71
for each part of the
body, which type of pain
00:06:54.74\00:06:57.41
deadly and needs
attention right away;
00:06:57.45\00:07:00.35
which type we might have
a little bit more time with.
00:07:00.38\00:07:03.25
And, fortunately, God
has given the body enormous
00:07:03.28\00:07:06.49
abilities to heal
itself, but sometimes the pain
00:07:06.52\00:07:09.96
doesn't heal itself
and that's bad news.
00:07:09.99\00:07:13.23
But chronic pain in
itself is bad and the general
00:07:13.26\00:07:17.00
approach is - if you have pain,
you want to sort of find out,
00:07:17.03\00:07:19.37
well, what's causing it? Right
00:07:19.40\00:07:21.24
Because if you
can get at the cause,
00:07:21.27\00:07:23.54
a lot of times that
will solve the issue
00:07:23.57\00:07:25.67
and the body will heal itself.
00:07:25.71\00:07:27.64
So if I've got a pain
and I'm just taking Advil
00:07:27.68\00:07:31.01
or whatever for several weeks,
that's maybe not the best idea.
00:07:31.05\00:07:34.58
And that happens quite a
bit, we see that with back pain,
00:07:34.62\00:07:37.39
you know, someone
will have to work,
00:07:37.42\00:07:39.89
they'll be lifting,
they'll have back pain
00:07:39.92\00:07:42.29
and rather than quit lifting
or pulling or doing their job
00:07:42.32\00:07:45.93
for a while and
letting the back heal,
00:07:45.96\00:07:48.10
they will just take
pain medicines or medicines
00:07:48.13\00:07:50.47
so they can keep doing
their job and they make it
00:07:50.50\00:07:53.23
worse - so sooner or
later they become dependent
00:07:53.27\00:07:56.00
on that pain medicine.
00:07:56.04\00:07:57.97
That's really not very good.
00:07:58.01\00:07:59.81
No it's not and yet I see
this happening quite a bit
00:07:59.84\00:08:03.38
in the world we live in.
00:08:03.41\00:08:04.75
You know, a person has a pain
00:08:04.78\00:08:06.38
and rather than
get at the cause,
00:08:06.41\00:08:08.25
they take a little medicine,
then what's causing the pain
00:08:08.28\00:08:11.49
gets worse or develops
more, so they get dependent
00:08:11.52\00:08:14.29
on medicines - they
take a little bit more.
00:08:14.32\00:08:15.99
In fact, last year
in the state I live in,
00:08:16.02\00:08:19.49
narcotics was one of
the leading causes of death.
00:08:19.53\00:08:23.13
People would
overdose on narcotics
00:08:23.16\00:08:25.07
that they're
taking for chronic pain,
00:08:25.10\00:08:27.04
and that's a
travesty, Nick, you know,
00:08:27.07\00:08:29.20
when they take
that amount of pain.
00:08:29.24\00:08:31.27
But, not only is that
a danger of chronic pain,
00:08:31.31\00:08:34.24
but chronic pain puts
stress on the system. Right
00:08:34.28\00:08:38.38
And my definition of
stress is anything that really
00:08:38.41\00:08:41.55
goes against our
owners template - you know
00:08:41.58\00:08:44.35
how God made us...
whether that be not
00:08:44.39\00:08:46.02
drinking enough
water, not getting the
00:08:46.05\00:08:47.76
sunshine or not moving.
00:08:47.79\00:08:49.12
Well God did not make
us to have pain. Right
00:08:49.16\00:08:52.19
So pain is a warning
that something is wrong,
00:08:52.23\00:08:53.76
but when we're
under chronic pain,
00:08:53.80\00:08:55.63
it puts stress on the body...
00:08:55.66\00:08:57.43
And our bodies make chemicals
like adrenalin and cortisol,
00:08:57.47\00:09:01.67
and inflammatory proteins.
00:09:01.70\00:09:03.41
When we're under chronic pain,
guess what happens in our brain?
00:09:03.44\00:09:06.88
Our brain actually
doesn't work as good...
00:09:06.91\00:09:09.24
We use the "let's stay
alive part of the brain,"
00:09:09.74\00:09:12.45
we don't even think as good.
00:09:12.48\00:09:13.85
So when you're in chronic pain,
00:09:13.88\00:09:15.42
you can't do as well on the
test, you can't think as well,
00:09:15.45\00:09:18.85
and chronic pain, it's
hard to worship as well... Right
00:09:18.89\00:09:21.99
because you brain is inflamed,
it just wants to stay alive.
00:09:22.02\00:09:24.76
You're making
all these chemicals,
00:09:24.79\00:09:26.13
the brain is inflamed, so
you don't even worship as well.
00:09:26.16\00:09:29.26
So pain is a real
difficult thing to happen.
00:09:29.30\00:09:32.73
Now Nick, I'm going to
quiz you for a second... Okay
00:09:32.77\00:09:35.97
How does your body
know you're under pain?
00:09:36.00\00:09:38.74
Did you ever take physiology?
00:09:38.77\00:09:40.64
No, actually I didn't. Okay
00:09:40.68\00:09:42.01
Well, it's the
nerves, did you know that?
00:09:42.04\00:09:43.41
Right, yeah...
The nerves tell us
00:09:43.45\00:09:44.98
if we're under
pain and, you know,
00:09:45.01\00:09:47.32
the brain is sort of like
the command of the nerve center,
00:09:47.35\00:09:50.42
and we call that the
"central nervous system."
00:09:50.45\00:09:54.06
So all stimuli from
pain is going to eventually
00:09:54.09\00:09:57.03
come back to the brain and the
00:09:57.06\00:09:58.43
brain is going to
decide what to do with it.
00:09:58.46\00:10:00.33
So just the brain,
how it thinks about pain,
00:10:00.36\00:10:03.87
and the knowledge
it has about pain,
00:10:03.90\00:10:05.57
could actually help
in the treatment of pain.
00:10:05.60\00:10:08.27
So if your brain
really has some good stuff
00:10:08.30\00:10:10.41
stored in the
hippocampus... think about it.
00:10:10.44\00:10:12.61
Not only do you know whether
the pain is dangerous or not,
00:10:12.64\00:10:15.18
but you'll know how to
handle it, what to do...
00:10:15.21\00:10:17.61
So that's why we want to
talk in general about pain
00:10:17.65\00:10:19.98
to help the brain
develop some coping skills,
00:10:20.02\00:10:22.45
to know when
things are dangerous.
00:10:22.48\00:10:23.82
So that's why I think this
series is very interesting.
00:10:23.85\00:10:26.29
But if we have a
stimuli, like if I pinch you,
00:10:26.32\00:10:28.69
if I pinch you right
there and it starts hurting...
00:10:28.72\00:10:32.16
you have a nerve - a peripheral
nerve that sends a signal
00:10:32.19\00:10:36.90
all the way to the spinal cord
and it goes up the spinal cord
00:10:36.97\00:10:41.27
to the brain and your
brain interprets that signal.
00:10:41.30\00:10:44.41
And depending about your
knowledge base about pain,
00:10:44.44\00:10:47.51
the brain decides what to do.
00:10:47.54\00:10:49.18
Is this a life-threatening
pain? Is this allotted?
00:10:49.21\00:10:51.71
You know, should I
keep firing this nerve pain
00:10:51.75\00:10:54.25
or is this not so...
00:10:54.28\00:10:55.62
So just your knowledge base
00:10:55.65\00:10:56.99
can affect how
much pain you have.
00:10:57.02\00:10:58.69
Now, we talked about
pain in different ways...
00:10:58.72\00:11:02.22
Now pain is due to some
type of stimuli, peripheral
00:11:02.26\00:11:05.89
like a burn or someone hits you,
we call that "nociceptive pain."
00:11:05.96\00:11:11.37
It's not really
the nerve doing it,
00:11:11.40\00:11:13.50
the nerve is
interpreting the stimuli. Right
00:11:13.54\00:11:16.37
So the nerve says,
"Oh, something is wrong,
00:11:16.40\00:11:17.91
I'm going to do something."
00:11:17.94\00:11:19.27
Now the nerve works
fine, so the nerve is not the
00:11:19.31\00:11:21.88
problem at all,
it's the stimuli. Okay
00:11:21.91\00:11:24.38
So it's important to know
that because you want to know
00:11:24.41\00:11:26.28
whether you could
help the nerve get better
00:11:26.31\00:11:28.38
or remove the stimuli.
00:11:28.42\00:11:30.39
Now, if the
nerve is damaged too,
00:11:30.42\00:11:32.89
we call that "a neuropathy."
00:11:33.82\00:11:35.72
Now you can have both at
the same time; you can have a
00:11:35.76\00:11:38.19
bad nerve and it
interprets pain badly as well.
00:11:38.23\00:11:42.23
Now nerves need a lot
of things to stay healthy.
00:11:42.26\00:11:45.67
Nerves need oxygen,
they need a blood supply,
00:11:45.70\00:11:48.90
they need some good nourishment.
00:11:48.94\00:11:51.51
So it's very important to
keep nerves healthy, Nick,
00:11:51.54\00:11:54.34
very, very important.
00:11:54.38\00:11:55.71
And, you know, we
could talk on and on,
00:11:55.74\00:11:57.65
but I know we're going to
talk a whole series about pain,
00:11:57.68\00:12:00.58
so we're going to
answer a lot of questions.
00:12:00.62\00:12:02.52
I know that some
people have written
00:12:02.55\00:12:03.92
in with their
questions about pain.
00:12:03.95\00:12:05.29
That's right - I've got a
lot more interesting stuff
00:12:05.32\00:12:07.42
to learn from you about pain.
00:12:07.46\00:12:08.79
But we're going to be
back in just a moment.
00:12:08.82\00:12:10.16
We've got to take a
quick break, but stay with us
00:12:10.19\00:12:12.03
as Dr. Marcum will be
right back to share more about
00:12:12.06\00:12:14.43
understanding and
dealing with chronic pain.
00:12:14.46\00:12:16.80