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Ask Dr. Mike: Foods for Pain Caused by Reflex Sympathetic Dystrophy

Here you'll find the answers to a wealth of health and wellness questions posed by Healthy Talk fans.

Listen in because what you know helps ensure healthy choices you can live with. Today on Healthy Talk, you wanted to know:

I suffer from Reflex Sympathetic Dystrophy (RSD). I take neurontin off and on for some relief, but what about foods for pain (I hate taking pills)?

RSD is a condition that is characterized by symptoms including a burning pain, swelling, tenderness, discoloration, sweating, warmth and/or coolness, flushing, and shiny skin.

Some foods like dark tart cherries, ginger root, omega-3 fatty acids, curcumin, and hot chili peppers can help ease the symptoms.

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RadioMD Presents:Healthy Talk | Original Air Date: May 13, 2015
Host: Michael Smith, MD

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DR MIKE: That's AskDrMikeSmith@RadioMD. Send me your questions. Be as vague or specific as you want. Try to stump me. See if you can send me a question that I just don't have the answer to.

Of course, I'll find the answer. Alright. Let's go to this next one and I think this one's going to take some time.

The question is:
"I suffer from RSD," and that's, for those of you who don't know, that stands for "reflex sympathetic dystrophy".

Sometimes it's called "reflex sympathetic syndrome". And there's a more modern name for this. I just forgot it, it left my mind but there is a common name now, maybe a chronic pain syndrome or something like that. But anyways, the classic reflex sympathetic dystrophy is a type of a pain that is associated with the sympathetic nerves in the body. Sympathetic nerves are ones that kind of drive metabolism, drive motion and activity, that type of thing--the sympathetic nervous system. You have these nerves that come out at certain parts of your spine and they go into the nerve, the muscles, the skin.

They're all over the body and when these nerves -- usually from trauma or surgery-- when they become damaged, inflamed, they produce a lot of pain. The sympathetic nerves, when you stimulate them in the body, they produce burning sensation, tingling, sharp type pains. Have you ever maybe had a walking pneumonia or upper respiratory tract infection and when you take that deep breath you get these real sharp pains that kind of shoots out in your chest and you're like, "Oh, my gosh, what was that?" That sharpness is usually from inflammation of the pleural space which comes from inflammation of the sympathetic nerves.

There are a lot of nerves that innervate the chest cavity and the sympathetic nerves so that type of sharp pain that you might get with those types of congestive type disorders is what we're talking about here. It's very debilitating, very painful. And this person here suffers from that condition, RSD. She says, her name is Anne, she says:

"I take Neurontin off and on with some relief. What about foods for pain? I hate taking pills. Thanks, Anne."
I think this is a great question. So, Neurontin is a nerve drug. I didn't really know they were using that for RSD but I guess they are the user for this. So, any type of nerve pain, the common prescription is Neurontin. It's a rotten drug, Neurontin. Rotten. See how I did that? Doesn't work all that great for nerves and has a lot of side effects. And so, let's see where we're at. I had to do some research on this one.

So, what I found mostly through Life Extension literature, first of all, dark cherries specifically tart cherries--dark tart cherries—are great for neuropathic pain and that one I knew. I often start there with people. Anybody that has that sharp stabbing type pain regardless of what it might be, diabetic, trauma, surgery, whatever. Tart cherries are great for that. Even just post-workout type pains. Tart cherries. This has been confirmed, too. This isn't just anecdotal evidence, historical evidence. John Hopkins, they have a very highly regarded pain treatment center there at John Hopkins and they confirm that bioflavonoids specifically the anthocyanin that produce the deeper hues, deep dark hues, are good for nerve inflammation and nerve damage so they've actually shown this.

They did a study where it wasn't an extract. It was just eating tart cherries and it wasn't even that many. Twenty to forty tart cherries a day helped to relieve some of that type of neuropathic pain. I think you should do a capsule. Eat the cherries but also do the capsule about 1200 milligrams a day, 1500 milligrams a day, really good there. Second that I found was ginger root. Ginger is not just for motion sickness although it works great for that. Ginger has some of these similar compounds. They are bioflavonoids but they're not anthocyanin. They don't have those hues but they have some of the same effects as you see in the dark tart cherries. Ginger root extracts would be something I might suggest for you.

More and more people are using ginger root to make a paste, too, so it's not just the extract. You can make a paste and you can apply that topically to joints and muscles. For most people with RSD, I don't know if this is the case for Anne, but most cases of RSD, it's down on the outside of arms, forearms, thighs, calves, those are common areas for that sharp type sympathetic pain. So, maybe do in a ginger root paste. You know, maybe right over that area when that pain kicks in. Maybe that would be something you could do. Next, I found obviously Omega 3. Maybe that's where I should have started. It's a foundational supplement I include with the multivitamin, probiotic, CoQ10, Omega 3.

Now with something like RSD you probably want to do more than the average daily dose which is one to two grams of Omega 3s. You might want to be in the three to four, maybe even five to six grams. The only downside to that is blood thinning. So, if you notice some bruising you just kind of back off the dose a little bit but higher dose Omega 3s might be helpful.

And now that I think about it, maybe even a combination of Omega 3s from fish and Omega 3s from krill because there's some evidence showing that the type of Omega 3s from krill which are phosphate form, the different type of form basically. The Omega 3 from krill is able to penetrate into cavities better, joints better, muscle fibers better. And the krill form of Omega 3 is a phospholipid form. There are products out there now of fish oil Omega 3s with a combination of krill Omega 3, so that might be something to consider there. So, those are the main ones.

So, you got the Omega3, ginger root, dark cherries. Another one is classic curcumin from turmeric. Obviously, that's important too. That's probably second after the omega 3s. Curcumin is going to inhibit the COX and LOX enzymes which are pro-inflammatory and there is definitely an inflammatory component here to reflex sympathetic dystrophy or reflex sympathetic syndrome. Now, cooking with turmeric is great, though you're not going to get a lot of curcumin from that. So, you'll probably want to do an extract that's standardized to the curcumin by 400 milligrams and do the BCM-95. That's the best form on the market.

So, I think those are the big ones for me. There are some other ones here that I found. Apparently raw probiotic yogurt helps with pain. Good bacteria from the yogurt just overall, it's not just for your gut, it promotes overall better inflammatory response so there may be something there. Hot chili peppers, capsaicin, that's the main extract. Great for metabolism. Great for your heart. Maybe have some benefit for nerve pain.

As a matter of fact there is a substance in your nerves called substance P that has to do with pain and some researchers say capsaicin helps to modulate that a little bit. So, there's just some suggestions there for you and, Anne, I do hope you get better.

This is Healthy Talk on Radio MD. I'm Dr. Mike. Stay well.