Pain and painkillers – the painful truth

Pain and Painkillers

First, a joke. Pressing his index finger against his knee, a patient says to his doctor: “Doctor, every time I touch here I feel pain.” Then, touching his chest he tells the doctor, “Every time I touch here I feel pain.” He then tells the doctor, “And when I touch here (touching his arm) I feel pain.”

The doctor is baffled and asks, “When did this begin?” To which the patient replied, “Since I got a splinter in my finger.”

painkillers analgesics asthma ADHD

Paracetamol/Tylenol/Panadol

Painkillers “Ineffective and Dangerous”

Critics and sceptics of homeopathy are quick to point out an Australian study claiming homeopathy is ineffective for any condition (even though most medicines work homeopathically). A group of doctors, vets and scientists at the HRI, among others, have addressed this study.

What is of note is that the critics have been very quiet about other Australian studies. One study published in the BMJ(“Efficacy and safety of paracetamol for spinal pain and osteoarthritis: systematic review and meta-analysis of randomised placebo controlled trials”) found paracetamol ineffective for back pain, concluding:

Paracetamol is ineffective in the treatment of low back pain and provides minimal short term benefit for people with osteoarthritis. These results support the reconsideration of recommendations to use paracetamol for patients with low back pain and osteoarthritis of the hip or knee in clinical practice guidelines.

This is on the back of an Australian study, published the previous year, in The Lancet, which concluded:

In the world’s first large placebo-controlled trial, we have demonstrated that taking paracetamol does not speed recovery or reduce pain compared to placebo. The effect is the same whether paracetamol is taken regularly or as required.

Because low-back pain is the leading cause of disability worldwide, this study shows that improved focus on development of new, effective treatments is warranted.

That’s according to Christine Lin, Associate Professor, The George Institute for Global Health, The Sydney Medical School, who is a senior author of the paper.

Another critical Australian study that has been conveniently overlooked is one on opioid drugs: “Efficacy, Tolerability, and Dose-Dependent Effects of Opioid Analgesics for Low Back Pain: A Systematic Review and Meta-analysis”, published in 2016, in JAMA – that’s three in a row!

It’s one thing when painkillers don’t work – it’s just that everyone has been deceived – but it’s another when we read headlines such as The Trouble with Tylenol and Pregnancy, in the New York Times, and “Ibuprofen link to heart failure: Over-the-counter painkillers raise risk by almost 20%”, in the Daily Express; two studies into painkillers within the last month, both with negative conclusions.

Some of the issues raised by these critical studies are worth commenting on. Giles Sheldrick, for the Daily Express, quotes Dr Tim Chico, a reader in Cardiovascular Medicine at the University of Sheffield, who said, “It seems unlikely that NSAIDs…” “Seems,” he says! Is this the language of science? Hardly.

Dr Chico also misses the point when he says NSAIDs are unlikely to cause problems in people with a healthy heart. The problem is not whether your heart is healthy or not, it’s the effect of suppressing the joint inflammation that can damage the heart – as Dr James Tyler Kent warned in his lectures at the end of the 19th century and as was the hard lesson shown with Vioxx. To quote Dr Kent in his lecture on Kalmia latifolia (in his Lectures on Homeopathic Materia Medica, pp. 625-626, also available here and here), beginning with a couple of clinical confirmations, he says:

“When articular rheumatism has been treated externally and cardiac symptoms ensue.” Rheumatism that goes from the lower to the upper limbs. Not uncommonly you will meet such things. These “rubbers” that go around the streets with a strong liniment and considerable magnetism frequently do cause a rheumatism to leave the knee joint, and, when it does that, the heart is likely to be the organ that suffers. Then Kalmia, Aurum, Bryonia, Rhus tox, Ledum, Calc.c., Abrotanum and sometimes Cactus, are remedies that prove suitable for such cardiac affections. Rheumatic affections that are driven away in this manner are changed without being cured. The people cannot realize the danger of merely removing symptoms. Every removal that is not in accordance with cure affects the centres of man, that is the heart and brain. Rubbing is a dangerous thing. When you are importuned with the question, “Doctor, will it hurt me to have this rubbed?” you reply, “If rubbing does not affect any change in the symptoms, it will do no harm.” In proportion as it mitigates the symptoms or relieves, just in that proportion it does the patient harm, for the whole vital economy is weakened. There are instances where rubbing is of benefit, but not in rheumatism. In paralyzed muscles it is a beneficial exercise, for then rubbing can take the place of exercise of the patient himself, of the muscles. But rubbing is not admissible if it is used to reduce pain. The more agreeable it is, the worse it is for the patient.

In the report on Tylenol, a brand name for acetaminophen (also known as paracetamol), we are told, “… Acetaminophen may increase the risk that children will develop asthma or attention deficit hyperactivity disorder… It may undercut the brain’s ability to detect errors. When taken after a vaccine, it may suppress the immune system (emphasis mine).” That’s a lot of “mays.” Not what we’d call hard science.

We are then told, “… Even after decades of widespread use, no one knows precisely how it blunts pain.” Amazing! The author then says: “Why might the drug affect both asthma and A.D.H.D. rates? Scientists have variously speculated that it could tweak the immune system during pregnancy, or disrupt hormones, or change growth factors in the developing brain. In short, no one knows.” No one knows! They call it “evidence-based medicine”, “science” and “pharmacology” etc.

But researchers might never know. Unlike homeopathy, which is safe in pregnancy, a definitive study to ascertain whether taking acetaminophen in pregnancy causes asthma and ADHD would be unethical as it means doing trials on pregnant women. (Yet, pregnant women are now targeted for flu vaccines.)

An interesting comment is from Augusto Litonjua, a pulmonologist at Harvard Medical School who said: “… Women should consider non-pharmacological approaches to pain management, like acupuncture or meditation.”

Wrong Kind of Pain

So why don’t painkillers work? Perhaps, like the London Transport official who explained that the trains couldn’t operate in the snow because it was the “wrong kind of snow,” painkillers may not be treating the right kind of pain.

What does “pain” mean? Pain varies for each individual even when people suffer from the same disease, their pain varies and the factors (modalities) which modify the pain; making it better or worse, also vary. So, for example, one person with a migraine might have the pain on the left side of the head at four in the morning. Another may have it on the back of the head after a particular food. One has a sharp pain, the other a shooting pain or a stitching, cutting, digging, boring, bruised, knife-like pain, etc., etc. The permutations of pains and modalities are multifarious.

Sensations and Subjectivity

Pain is a subjective experience. No one else can feels another’s pain. Hahnemann rarely used the word “pain” preferring the word “sensation” instead. This makes sense as not every pain can be described; patients frequently talk in terms of sensation, using analogies: “It’s like cold water trickling down my back”; “It’s like a lump of ice”; “It feels like a hot coal on my skin”; “My head feels like it’s getting larger”; “I feel as if…”; “I feel like I’m…” etc. So, how can a doctor prescribe for such abstract metaphysical descriptions? The reality is that this is exactly what the doctor must prescribe for because it is what the patient is complaining of. Conventional medicine is now in a bind as it limits itself to the physical and to what can be explained – two reasons it’s painkillers and other treatments are unlikely to cure.

Homeopathy and Painpain types painkillers sensation

In contrast, homeopathy offers a better option. It treats these peculiar and strange sensations in their various and numerous ways. Homeopathic remedies can be matched specifically to the individual’s own pain or sensation, no matter how unique. Homeopathy doesn’t simply give something to subdue pain, it treats the specific pain and sensations as well as the totality of symptoms – the only way to remove disease in its entirety.

For an example of remedies for different types of pain, the locality of the pain and its modalities, take a look at the Extremities section of an old repertory here (or scroll down here). Much has been added to the repertories since. That was put together in the 1890s, so you see how advanced and well thought-out homeopathy was even then. There’s nothing to compare in medicine today.

Further Information
For information on painkillers, NSAIDs and opioids visit e.g. Patient.info

Picture: Wikimedia

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