Treating pain by treating inflammation

People wonder what weight has to do with experiencing pain and its treatment. I am an interventional pain physician, and sometimes I get the question, “Why are you so worried about a patient’s metabolic function? Why worry about their weight? Just treat the pain.”

However, almost all of the patients in our clinics are overweight, and when we evaluate their biochemical markers, they have prediabetes and metabolic inflammation. Even the ones who aren’t overweight have elevated GGT and evidence of fatty liver and insulin resistance. Clinical studies in Europe have found that “increased risk of adverse cardiovascular outcomes associated with type 2 diabetes does not begin at the diagnostic cutoff for plasma glucose (or HbA1c) at which the condition is diagnosed. Rather, there appears to be a continuum of increased microvascular and macrovascular risk that extends to levels of glycemia well below these cutoffs.”

Therefore, treating metabolic inflammation is treating the pain. and treating metabolic inflammation early, before the patient requires insulin, is the key to treating and managing chronic pain. The omega-6 pro-inflammatory pathway is the common link.

Hopper I, Billah B, Skiba M, Krum H. Prevention of diabetes and reduction in major cardiovascular events in studies of subjects with prediabetes: a meta-analysis of randomized controlled clinical trials. Eur J Cardiovasc Prev Rehabil. 2011;18:813–823.

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