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September 29, 2017

Dealing with Chronic Pain?

Fitness First USA



Dealing with physical pain, whether acute or chronic, has become widespread for many Americans. Approximately 100 million Americans live with daily, chronic pain and another 125 million are affected by a musculoskeletal condition (including joint pain and arthritis). Some of the most common sources of pain include lower back pain, neck pain and headaches (including migraines).

Nearly 20% (1 out of 5) of ALL healthcare visits in the U.S. are for musculoskeletal conditions, and the price tag for pain and musculoskeletal conditions totals over $600 billion a year, or more than $6,000 annually for each American adult living with chronic pain.

Clearly PAIN and musculoskeletal dysfunction are a MAJOR problem in the U.S…


Conventional treatments for pain too often focus on suppression of symptoms (i.e. palliative care), without dealing directly with the cause of the condition. Common examples include the use of NSAIDs, acetaminophen, tramadol (a weak opioid), stronger opioids (like fentanyl, which is blamed for >20,000 overdose deaths in 2016 alone), Try-cyclic anti-depressants (TCAs), SNRIs and corticosteroids (ex. cortisone injections). While there may certainly be a place for these interventions in temporarily alleviating acute pain, their widespread use in treating chronic pain has done little to slow the increase in pain-related conditions in the U.S.


So what’s the solution to America’s pain epidemic? A better understanding of the common root causes of chronic pain and musculoskeletal dysfunction is step #1. What ARE some of the most common root causes of pain you ask?...

  1. Damaged & under-functioning digestive system organs & tissues (includes the esophagus, stomach, intestines (small & large/colon), liver, gall bladder, kidneys & renal system, and pancreas)
  2. Parasites & microbial pathogens (includes worms, flukes, protozoa, bacteria, viruses, fungi [like yeasts & molds] and prions)
  3. Nutrient & chemical imbalances (includes deficiencies & excesses in both macro and micro nutrients)
  4. “Stones” & soft tissue calcification (including gall stones, kidney stones and build-up of calcium in the soft tissue and joints)
  5. Damaged & aggravated nervous system tissue (ex. pinched nerves, sciatica, radiculopathy, etc.)
  6. Damaged, malformed &/or misaligned skeletal tissue (pain may stem from conditions like bone spurs and misalignments (ex. subluxations in the vertebrae))
  7. Damaged, malformed &/or imbalanced muscles, tendons, ligaments & cartilage (Includes chronically inflamed, torn, strained & sprained muscles, tendons, etc.)
  8. Overly rigid &/or inflamed fascia and other connective tissue
  9. Excess adipose tissue (body fat) (can cause undue strain on joints, among other negative bodily effects)
  10. Excessive amounts of metabolic by-products & waste materials (includes excess lactic acid, ammonia, uric acid, carbon dioxide, etc., leading to toxemia-related conditions)
  11. Pharmaceutical irritants & adverse effects of prescription drugs (while some of these don’t directly contribute to immediate pain per se, common offenders here include blood thinning meds, blood sugar meds, antibiotics, corticosteroids, acetaminophen, SSRI’s, NSAIDs, and beta blockers)
  12. Heavy metal toxicity (includes mercury, lead, aluminum and others)
  13. Radiation (includes exposure from medical imaging devices and radiation treatment for cancer)
  14. Excess scar tissue, fibrin, dead tissue, etc. (includes plaque, cysts, fibroids, clots, etc.; often occurs in ducts, tubes and vessels, as well as in other soft tissue)
  15. Damage caused by free radical production & oxidative stress
  16. Excess & chronic inflammation
  17. Abnormal cell & tissue growth (both cancerous & non-cancerous)

You might be thinking “Wow, that’s a lot of underlying causes! That’s all pretty overwhelming…” And that actually highlights part of the problem with treating pain- because there are so many causes of chronic pain, treating the problem with numbing agents and/or medications that temporarily boost “feel good” hormones can usually only serve as stop-gap pain management measures at best. What we need are interventions that correct the underlying cause, while also offering immediate relief from pain.


Therefore, step #2 in effectively dealing with chronic pain involves examining and then implementing those relatively safe, natural, non-toxic interventions that have a strong history of effectiveness, both anecdotally and clinically. To do this, we must consider every major area that influences health, including sleep habits, exercise, nutritional habits, stress & stress management, medical & dental interventions, drug use and sexual health habits (to name a few). With today’s article we’re talking nutrition, specifically, supplementation…


A number of nutritional supplements have gained a solid reputation for reducing (and sometimes eliminating) chronic pain while also improving musculoskeletal and joint functioning. Let’s take a quick look at 10 of them…


proteins/Amino Acids
  • Collagen Types 1 & 3
  • Collagen Type 2 (UC II)
  • Fish Oil (high EPA)
  • Vitamin D3 (fish oil-derived)
  • Magnesium (citrate or glycinate)
  • Glucosamine (vegetarian)
  • Chondroitin (vegetarian)
  • MSM
  • Turmeric Extract (curcumin)
  • Hyaluronic Acid

Detailed View


    Also known as bovine collagen, collagen hydrolysate and collagen peptides, collagen types 1 & 3 (a singular product) most often comes in powder form and has a strong track record of helping to support healthy tendons, ligaments and joints (as well as skin, hair & nails). A highly digestible and bioavailable protein powder, collagen types 1 & 3 helps replenish the body’s natural collagen stores, which are depleted with aging. In addition to its well-established reputation in providing joint support, collagen powder has gained an almost cult-like following as an effective anti-aging supplement.

    One of our favorite products is YouTheory’s Collagen Powder Types 1 & 3…

  2. COLLAGEN TYPE 2 (including UC-II)

    Like collagen types 1 & 3, collagen type 2 also helps support soft tissue and joint health. A patented form of type 2 collagen, UC-II is an undenatured form of type 2 collagen derived from chicken sternum cartilage. Some studies have shown 40mg of UC-II to be more than twice as effective as glucosamine & chondroitin in combating pain and joint immobility.

    One of our favorite products is Myogenix’s Joint & Tissue…

  3. FISH OIL (high EPA)

    There are two essential fatty acids- omega 3 ALA and omega 6 LA. Most of the clinical research has focused on the benefits of omega 3 ALAs. Two ALA derivatives are EPA and DHA, which are naturally found in high amounts in fish oil. Both EPA and DHA play a primary role in joint health (as well as brain, nervous system and skin health). How you ask? In part by decreasing inflammatory markers, such as IL-10 and TGF beta. Research also indicates EPA and DHA’s inhibitory effect on the expression of various proteins that contribute to arthritis. Omega 3s are also incorporated into cartilage cell membranes, thus providing a kind of “lubricant” to the joint.

    While both EPA and DHA are important joint health nutrients, research indicates that EPA may play a more primary role. Therefore, fish oil supplements specifically targeted to help with joint pain often include a higher ratio of EPA to DHA (ex. 700-1000mg of EPA and 100-250mg of DHA per serving).

    One of our favorite products is BlueBonnet’s Omega 3 Joint Formula Fish Oil…


    Vitamin D is a fat-soluble vitamin that plays a major role in bone and tooth health (as well as immune system and endocrine/hormonal health). Vitamin D deficiency in the U.S. is unfortunately common, in part due to people spending more time indoors (thanks Industrial Revolution and Steve Jobs), and in part due to a lack of vitamin D in the diet (food sources are limited to fatty fish). A number of epidemiological studies have linked low levels of vitamin D to chronic pain, and while the exact connection between chronic pain and vitamin D appears to be poorly understood, understanding some of vitamin D’s primary roles in the body offers some explanations. For instance, we know that vitamin D helps increase the skeletal system’s ability to absorb calcium. Low levels of vitamin D could therefore lead to osteopenia and bone pain. Similarly, vitamin D helps maintain healthy calcium levels in the blood and soft tissue. Low levels of vitamin D could, then, lead to elevated levels of blood and soft tissue calcium, which could, over time, lead to soft tissue calcification (and subsequent pain and restricted mobility).

    One of our favorite products is BlueBonnet’s Vitamin A & D3 (one of the few vitamin D products that sources vitamin D from fish oil instead of lanolin or algae)…


    Magnesium is an essential mineral (technically a macro mineral) and plays a vital role in skeletal health, nervous system functioning, cardiovascular health and protein & carbohydrate metabolism. Some experts estimate that 60-70% of the U.S. population is deficient in this important nutrient. So what’s the connection with pain? Like vitamin D, a deficiency in magnesium can have devastating effects on the body’s bones and teeth over time (ex. bone pain, osteomalacia, etc.).

    Magnesium also has a laxative effect on soft tissue that’s well documented. For instance, magnesium sulfate (aka Epsom salts) has been used to help relieve sore muscles (and promote regular bowel movements) since the early 1600s. The relaxing effect that magnesium offers is part of what makes it a popular supplement for those dealing with chronic pain, particularly muscle and bone pain.

    One of our favorite products is BlueBonnet’s Magnesium Plus B6…


    Glucosamine is a compound that’s found within the body’s joints. Made from chains of sugars and proteins, glucosamine plays a central role in the body’s production of cartilage and synovial fluid. In other words, glucosamine effectively acts both as a joint lubricant and shock absorber, thus increasing the body’s ability to move without joint pain.

    In addition to its positive effects on joint health and function, glucosamine has also been clinically proven to help reduce chronic inflammation and support gastrointestinal health.

    Glucosamine sulfate is the recommended form of glucosamine for treating joint pain and arthritis. Glucosamine sulfate is often sourced from shellfish (a common allergen), so in response some manufacturers produce a vegan or non-shellfish derived form of glucosamine sulfate.

    One of our favorite products is BlueBonnet’s Vegetarian Glucosamine & MSM…


    A conversation about glucosamine sulfate commonly leads to a conversation about another joint-friendly, sulfur-containing supplement: chondroitin sulfate. Like glucosamine, chondroitin sulfate functions as a glyco-amino-glycan (a bonded sugar & amino acid compound) to help form proteoglycans. Proteoglycans, along with collagen, are two of the most important components of connective tissue. Proteoglycans also form the structural framework of collagen, and like glucosamine, help promote water retention in the joints, thereby providing a lubricating effect.

    While it’s relatively easy to find a shellfish-free glucosamine, it’s fairly difficult to find the same with chondroitin sulfate. There are, at present, only a handful of companies that provide such a product…

    One of our favorite products is NutraBio’s Extreme Joint Care, which contains 540mg of non-shellfish sourced chondroitin per serving…

  8. MSM

    As you may have picked up on, there’s a connection between sulfur, collagen production and joint health (sulfur ALSO plays a major role in liver health and detoxification). Accordingly, another supplement with a strong reputation for supporting joint health is methyl-sulfonyl-methane or MSM. MSM is roughly 34% sulfur, which is the 4th most abundant mineral in the human body. Functionally, MSM operates in the body in many of the same ways that glucosamine and chondroitin do, where it acts as an anti-inflammatory agent and also assists in collagen and cartilage production.

    Additionally, MSM’s liver supporting properties help the liver more effectively cleanse the blood, which can have a positive impact on inflammation and chronic pain. And lastly, sulfur itself is a potent anti-microbial, and as such is effective at killing a variety of pathogenic microbes that are often an underlying cause of systemic pain (including systemic arthritis and fibromyalgia).

    One of our favorite products is BlueBonnet’s MSM 1000mg…


    Of all the nutritional supplements out there, perhaps none has been as “hot” an item as turmeric the past 5-10 years. An Indian spice, turmeric has been used for centuries to reduce inflammation, improve liver health and treat joint pain, including arthritis. Some of the most active constituents of turmeric include curcuminoids, which have potent antioxidant effects on the body.

    Since turmeric (and curcumin) are poorly absorbed, many turmeric/curcumin manufacturers add a synergist to increase absorption. Common synergists include black pepper extract, ginger and/or a fatty acid.

    One of our favorite products is Oregon Wild Harvest’s Turmeric, which contains both organic turmeric and a curcumin extract, along with Bioperine, a black pepper synergist that helps increase absorption and bioavailability…


    Found naturally throughout the body, HA is a muco-poly-saccharide that can be several thousand sugar molecules long. A water-loving molecule that’s able to hold up to 1000 times its weight in water, HA acts as a lubricant and shock absorber in joints and cartilage. Named because of the hyaluronan that covers the ends of the long bones where articulation (bending) occurs, “hyaline cartilage” (also called “gristle cartilage”) is especially resistant to wear and tear.

    In addition to its primary role in joint health and functioning, HA also plays an important role in skin and eye health.

    One of our favorite products is Hyalogic’s Hyaluronic Acid for Joints (Lozenges)…


Below is a list of 10 additional supplements to consider for treating chronic pain and musculoskeletal dysfunction…

  • Evening Primrose Oil
  • Montmorency Tart Cherry Juice Concentrate
  • White Willow Bark Extract
  • Boswellia Extract
  • Cissus Extract
  • Ginger
  • Cayenne
  • Nattokinase
  • Bromelain
  • CBD Oil

We hope this information helps you in your efforts to live a pain-free, physically-active and vibrant life!