The Roots of Pain

By Sean Moloughney
Published October 1, 2010

As a warning signal following injury, inflammation and pain are normal. However, EuroPharma’s Ms. Myers said more consumers are realizing that chronic inflammation is not only a cause of pain and discomfort, but also a “root cause” of many serious, life-threatening illnesses, including cancer, heart disease, obesity, diabetes and arthritis. “Therefore, many individuals are looking for healthy alternatives to manage inflammation in their lives every day, whether they have pain or not.”

Inflammation is caused by the release of a hormone-like compound called prostaglandin (PGE1) and is sustained by the enzyme cyclooxygenase 2 (COX-2). Ideally, anti-inflammatory products would inhibit COX-2 without inhibiting COX-1, a good prostaglandin that protects blood vessels and the lining of the digestive tract.

Traditionally, non-steroidal anti-inflammatory drugs (NSAIDs) like aspirin and ibuprofen have dominated the pain management category. However, while NSAIDs effectively inhibit COX-2, many also inhibit COX-1. So while they may offer an effective solution with short-term use, they may also cause serious side effects with prolonged use.

Alongside NSAIDs, acetaminophen is one of the most commonly used drugs in the U.S. for treating pain and fever. According to FDA, in 2005, consumers purchased more than 28 billion doses of products containing acetaminophen, and the hydrocodone–acetaminophen combination product has been the most frequently prescribed drug since 1997.

Acknowledging risks of liver damage and death from high doses of acetaminophen, the FDA’s Drug Safety and Risk Management Advisory Committee voted in June of 2009 to recommend a ban on two of the most popular prescription painkillers, Vicodin (hydrocodone and acetaminophen) and Percocet (oxycodone and acetaminophen). Vicodin and its generic equivalents are prescribed more than 100 million times a year in the U.S. The problem is, patients taking opioids over a long period of time typically build a tolerance, requiring higher doses to achieve the same effect.

To reduce the risk of liver damage, the committee also recommended that FDA lower the maximum daily dose of acetaminophen to less than 4 grams and the maximum single dose from 1000 mg to 650 mg.

Dean Mosca, president, Proprietary Nutritionals Inc. (PNI), Kearny, NJ, said concern regarding NSAIDs, as well as products containing acetaminophen, and their side effects has led to growing focus on preventative care, which positively impacts the dietary supplement market. “Pain management, overall, is growing tremendously. As one example, many chiropractors are extending their services to include therapeutic pain-management techniques. Pharmaceutical companies continue to launch and market all manner of pain-lessening drugs, and even yoga centers teach mental and physical exercise techniques to help the body adapt to and overcome pain.”

For example, in August the New England Journal of Medicine published a study that concluded the ancient Chinese practice of tai chi might be an effective therapy for fibromyalgia, a complex condition that affects 5 million Americans, mostly women, according to the CDC. After 12 weeks of tai chi, patients with fibromyalgia performed significantly better in measurements of pain, fatigue, physical functioning, sleeplessness and depression than a comparable group given stretching exercises and wellness education. Tai chi patients were also more likely to sustain improvement three months later.

In light of side effects associated with conventional NSAIDs and pain medications, Lakshmi Prakash, vice president of innovation and business development, Sabinsa Corporation, East Windsor, NJ, said, “Interest in natural approaches will continue to grow both in the human and pet supplement segments. Both nutritional and topical approaches will receive attention.”

Mr. Mosca agreed, noting that his company offers Celadrin, a proprietary blend of cetylated fatty acid esters and other active synergists, as a topical solution or oral supplement. “The topical form provides quick relief, in as few as 30 minutes, while the oral form provides more long-term joint support,” he said. “We see dietary supplements that address discomfort growing in the market as a non-invasive and non-side-effect-inducing part of an overall pain management strategy.”

Additionally, a clinical study of patients with knee pain showed PNI’s Perluxan, a hops extract, had a fast-acting effect on relieving discomfort—and significant improvement over placebo—after two hours following the first dose. Another pilot study demonstrated that Perluxan was comparable to ibuprofen in reducing pain-causing inflammatory enzymes, said Mr. Mosca.

http://www.nutraceuticalsworld.com/contents/view/29418

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