Science-Based Alternative Pain Relief

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When Painkillers Aren’t Helping, These Things Might

Maybe you want to avoid painkillers, or maybe you’ve already maxed out what you can have, and want more options as an extra help against the pain.

Today we’ll look at some science-backed alternative pain relief methods:

First: when should we try to relieve pain?

There is no such thing as “this pain is not too much”. The correct amount of pain is zero. Maybe your body won’t let you reach zero, but more than that is “too much” already.

You don’t have to be suffering off the scale to deserve relief from pain!

So: if it hurts, then if you can safely get relief from the pain, it’s already wise to do so.

A couple of things we covered previously

CBD and THC are technically drugs, but are generally considered “alternative” pain relief, so we’ll give a quick mention here:

Short version:

  • CBD can treat some kinds of treatment-resistant pain well (others, not so much—try it and find out if it works for you)
  • THC can offer some people respite not found from other methods—but beware, because there are many health risks to consider.

Acupuncture

Pain relief appears to be its strongest suit:

Pinpointing The Usefulness Of Acupuncture

Cloves

Yes, just like you can get from the supermarket.

In its medicinal uses, it’s most well-known as a toothache remedy, but it has a local analgesic effect wherever you put it (i.e., apply it topically to where the pain is), thanks to its eugenol content:

Syzygium aromaticum L. (Myrtaceae): Traditional Uses, Bioactive Chemical Constituents, Pharmacological and Toxicological Activities

Boswellia (frankincense)

The resin of the Boswellia serrata tree, this substance has an assortment of medicinal properties, including pain relief, anti-inflammatory effect, and psychoactive (anxiolytic and antidepressant) effects:

Frankincense is psychoactive: new class of antidepressants might be right under our noses

And as for physical pain? Here’s how it faired against the pain of osteoarthritis (and other OA symptoms, but we’re focusing on pain today), for example:

Effectiveness of Boswellia and Boswellia extract for osteoarthritis patients: a systematic review and meta-analysis

Here’s an example product on Amazon, but feel free to shop around as there are many options, including for example this handy roll-on

Further reading

Intended for chronic pain, but in large part applicable to acute pain also:

Managing Chronic Pain (Realistically!)

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  • Peaches vs Plums – Which is Healthier?

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    Our Verdict

    When comparing peaches to plums, we picked the peaches.

    Why?

    Both are great! But there is a clear winner out of these two botanically-similar fruits:

    In terms of macronutrients they are very similar. Peaches have slightly more protein and plums have slightly more carbs, but the numbers are close enough to make no meaningful difference; they’re both mostly water.

    They’re also not too far from each other in the category of vitamins; peaches have more of vitamins B2, B3, B5, E, and choline, while plums have more of vitamins B1, B6, B9, C, and K. They’re equal on vitamin A, by the way, and the vitamins they do differ in, differ by around the same margins, so this category is a clear tie.

    When it comes to minerals, however, peaches win easily with more copper, iron, magnesium, manganese, phosphorus, potassium, selenium, and zinc. The two fruits are equal on calcium, and plum is not higher in any minerals.

    While they already won easily because of the mineral situation, it should be noted that peaches also have the lower glycemic index. But honestly, plums are fine too; peaches are just even lower.

    So: enjoy both, but if you’re going to pick one, peaches boast the most!

    Want to learn more?

    You might like to read:

    Take care!

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  • Evidence doesn’t support spinal cord stimulators for chronic back pain – and they could cause harm

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    In an episode of ABC’s Four Corners this week, the use of spinal cord stimulators for chronic back pain was brought into question.

    Spinal cord stimulators are devices implanted surgically which deliver electric impulses directly to the spinal cord. They’ve been used to treat people with chronic pain since the 1960s.

    Their design has changed significantly over time. Early models required an external generator and invasive surgery to implant them. Current devices are fully implantable, rechargeable and can deliver a variety of electrical signals.

    However, despite their long history, rigorous experimental research to test the effectiveness of spinal cord stimulators has only been conducted this century. The findings don’t support their use for treating chronic pain. In fact, data points to a significant risk of harm.

    What does the evidence say?

    One of the first studies used to support the effectiveness of spinal cord stimulators was published in 2005. This study looked at patients who didn’t get relief from initial spinal surgery and compared implantation of a spinal cord stimulator to a repeat of the spinal surgery.

    Although it found spinal cord stimulation was the more effective intervention for chronic back pain, the fact this study compared the device to something that had already failed once is an obvious limitation.

    Later studies provided more useful evidence. They compared spinal cord stimulation to non-surgical treatments or placebo devices (for example, deactivated spinal cord stimulators).

    A 2023 Cochrane review of the published comparative studies found nearly all studies were restricted to short-term outcomes (weeks). And while some studies appeared to show better pain relief with active spinal cord stimulation, the benefits were small, and the evidence was uncertain.

    Only one high-quality study compared spinal cord stimulation to placebo up to six months, and it showed no benefit. The review concluded the data doesn’t support the use of spinal cord stimulation for people with back pain.

    What about the harms?

    The experimental studies often had small numbers of participants, making any estimate of the harms of spinal cord stimulation difficult. So we need to look to other sources.

    A review of adverse events reported to Australia’s Therapeutic Goods Administration found the harms can be serious. Of the 520 events reported between 2012 and 2019, 79% were considered “severe” and 13% were “life threatening”.

    We don’t know exactly how many spinal cord stimulators were implanted during this period, however this surgery is done reasonably widely in Australia, particularly in the private and workers compensation sectors. In 2023, health insurance data showed more than 1,300 spinal cord stimulator procedures were carried out around the country.

    In the review, around half the reported harms were due to a malfunction of the device itself (for example, fracture of the electrical lead, or the lead moved to the wrong spot in the body). The other half involved declines in people’s health such as unexplained increased pain, infection, and tears in the lining around the spinal cord.

    More than 80% of the harms required at least one surgery to correct the problem. The same study reported four out of every ten spinal cord stimulators implanted were being removed.

    A man lying on a bed with a hand on his lower back.
    Chronic back pain can be debilitating. CGN089/Shutterstock

    High costs

    The cost here is considerable, with the devices alone costing tens of thousands of dollars. Adding associated hospital and medical costs, the total cost for a single procedure averages more than $A50,000. With many patients undergoing multiple repeat procedures, it’s not unusual for costs to be measured in hundreds of thousands of dollars.

    Rebates from Medicare, private health funds and other insurance schemes may go towards this total, along with out-of-pocket contributions.

    Insurers are uncertain of the effectiveness of spinal cord stimulators, but because their implantation is listed on the Medicare Benefits Schedule and the devices are approved for reimbursement by the government, insurers are forced to fund their use.

    Industry influence

    If the evidence suggests no sustained benefit over placebo, the harms are significant and the cost is high, why are spinal cord stimulators being used so commonly in Australia? In New Zealand, for example, the devices are rarely used.

    Doctors who implant spinal cord stimulators in Australia are well remunerated and funding arrangements are different in New Zealand. But the main reason behind the lack of use in New Zealand is because pain specialists there are not convinced of their effectiveness.

    In Australia and elsewhere, the use of spinal cord stimulators is heavily promoted by the pain specialists who implant them, and the device manufacturers, often in unison. The tactics used by the spinal cord stimulator device industry to protect profits have been compared to tactics used by the tobacco industry.

    A 2023 paper describes these tactics which include flooding the scientific literature with industry-funded research, undermining unfavourable independent research, and attacking the credibility of those who raise concerns about the devices.

    It’s not all bad news

    Many who suffer from chronic pain may feel disillusioned after watching the Four Corners report. But it’s not all bad news. Australia happens to be home to some of the world’s top back pain researchers who are working on safe, effective therapies.

    New approaches such as sensorimotor retraining, which includes reassurance and encouragement to increase patients’ activity levels, cognitive functional therapy, which targets unhelpful pain-related thinking and behaviour, and old approaches such as exercise, have recently shown benefits in robust clinical research.

    If we were to remove funding for expensive, harmful and ineffective treatments, more funding could be directed towards effective ones.

    Ian Harris, Professor of Orthopaedic Surgery, UNSW Sydney; Adrian C Traeger, Research Fellow, Institute for Musculoskeletal Health, University of Sydney, and Caitlin Jones, Postdoctoral Research Associate in Musculoskeletal Health, University of Sydney

    This article is republished from The Conversation under a Creative Commons license. Read the original article.

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  • Do we need animal products to be healthy?

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    Do we need animal products to be healthy?

    We asked you for your (health-related) perspective on plant-based vs anima-based foods, and got the above-pictured spread of answers.

    “Some or all of us may need small amounts of animal products” came out on top with more votes than the two more meat-eatery options combined, and the second most popular option was the hard-line “We can all live healthily and happily on just plants”.

    Based on these answers, it seems our readership has quite a lot of vegans, vegetarians, and perhaps “flexitarians” who just have a little of animal products here and there.

    Perhaps we should have seen this coming; the newsletter is “10almonds”, not “10 rashers of bacon”, after all.

    But what does the science say?

    We are carnivores and are best eating plenty of meat: True or False?

    False. Let’s just rip the band-aid off for this one.

    In terms of our anatomy and physiology, we are neither carnivores nor herbivores:

    • We have a mid-length digestive tract (unlike carnivores and herbivores who have short and long ones, respectively)
    • We have a mouthful of an assortment of teeth; molars and premolars for getting through plants from hard nuts to tough fibrous tubers, and we have incisors for cutting into flesh and (vestigial, but they’re there) canines that really serve us no purpose now but would have been a vicious bite when they were bigger, like some other modern-day primates.
    • If we look at our closest living relatives, the other great apes, they are mostly frugivores (fruit-eaters) who supplement their fruity diet with a small quantity of insects and sometimes other small animals—of which they’ll often eat only the fatty organ meat and discard the rest.

    And then, there’s the health risks associated with meat. We’ll not linger on this as we’ve talked about it before, but for example:

    If we avoid processed and/or red meat, that’s good enough: True or False?

    True… Ish.

    Really this one depends on one’s criteria for “good enough”. The above-linked studies, and plenty more like them, give the following broad picture:

    • Red and/or processed meats are unequivocally terrible for the health in general
    • Other mammalian meats, such as from pigs, are really not much better
    • Poultry, on the other hand, the science is less clear on; the results are mixed, and thus so are the conclusions. The results are often barely statistically significant. In other words, when it comes to poultry, in the matter of health, the general consensus is that you can take it or leave it and will be fine. Some studies have found firmly for or against it, but the consensus is a collective scientific shrug.
    • Fish, meanwhile, has almost universally been found to be healthful in moderation. You may have other reasons for wanting to avoid it (ethics, environmentalism, personal taste) but those things are beyond the scope of this article.

    Some or all of us may need small amounts of animal products: True or False?

    True! With nuances.

    Let’s divide this into “some” and “all”. Firstly, some people may have health conditions and/or other mitigating circumstances that make an entirely plant-based diet untenable.

    We’re going light on quotations from subscriber comments today because otherwise this article will get a bit long, but here’s a great example that’s worth quoting, from a subscriber who voted for this option:

    ❝I have a rare genetic disease called hereditary fructose intolerance. It means I lack the enzyme, Aldolase B, to process fructose. Eating fruits and veggies thus gives me severe hypoglycemia. I also have anemia caused by two autoimmune diseases, so I have to eat meat for the iron it supplies. I also supplement with iron pills but the pills alone can’t fix the problem entirely.❞

    And, there’s the thing. Popular vegan talking-points are very good at saying “if you have this problem, this will address it; if you have that problem, that will address it”, etc. For every health-related objection to a fully plant-based diet there’s a refutation… Individually.

    But actual real-world health doesn’t work like that; co-morbidities are very common, and in some cases, like our subscriber above, one problem undermines the solution to another. Add a third problem and by now you really just have to do what you need to do to survive.

    For this reason, even the Vegan Society’s definition of veganism includes the clause “so far as is possible and practicable”.

    Now, as for the rest of us “all”.

    What if we’re really healthy and are living in optimal circumstances (easy access to a wide variety of choice of food), can we live healthily and happily just on plants?

    No—on a technicality.

    Vegans famously need to supplement vitamin B12, which is not found in plants. Ironically, much of the B12 in animal products comes from the animals themselves being given supplements, but that’s another matter. However, B12 can also be enjoyed from yeast. Popular options include the use of yeast extract (e.g. Marmite) and/or nutritional yeast in cooking.

    Yeast is a single-celled microorganism that’s taxonomically classified as a fungus, even though in many ways it behaves like an animal (which series of words may conjure an amusing image, but we mean, biologically speaking).

    However, it’s also not technically a plant, hence the “No—on a technicality”

    Bottom line:

    By nature, humans are quite versatile generalists when it comes to diet:

    • Most of us can live healthily and happily on just plants if we so choose.
    • Some people cannot, and will require varying kinds (and quantities) of animal products.
    • As for red and/or processed meats, we’re not the boss of you, but from a health perspective, the science is clear: unless you have a circumstance that really necessitates it, just don’t.
      • Same goes for pork, which isn’t red and may not be processed, but metabolically it’s associated with the same problems.
    • The jury is out on poultry, but it strongly appears to be optional, healthwise, without making much of a difference either way
    • Fish is roundly considered healthful in moderation. Enjoy it if you want, don’t if you don’t.

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  • Managing Chronic Pain (Realistically!)
  • Cucumber vs Lychee – Which is Healthier?

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    Our Verdict

    When comparing cucumber to lychee, we picked the lychee.

    Why?

    In terms of macros, the lychee has more carbs and more fiber, but both are low glycemic index foods. Functionally a tie, though we could consider it a nominal win for cucumber.

    In the category of vitamins, cucumber has more of vitamins A, B1, B5, and K, while lychee has more of vitamins B2, B3, B6, B9, C, E, and choline. In particular, cucumber has a lot more vitamin K and lychee has a lot more vitamin C. Nevertheless, in terms of overall vitamin coverage, lychee is the clear winner here.

    Looking at minerals, cucumber has more calcium, magnesium, manganese, and zinc, while lychee has more copper (especially rich in this), iron, phosphorus, potassium, and selenium. Another clear win for lychee.

    Both have an abundance of anti-inflammatory polyphenols, but we could find no strong argument for one being better than the other in this category, just different.

    In short, both are fine options, but the more nutritionally dense is the lychee, so that’s our choice!

    Want to learn more?

    You might like to read:

    Cucumber Extract Beats Glucosamine & Chondroitin… At 1/135th Of The Dose?!

    Take care!

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  • Why Adult ADHD Often Leads To Anxiety & Depression

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    ADHD’s Knock-On Effects On Mental Health

    We’ve written before about ADHD in adult life, often late-diagnosed because it’s not quite what people think it is:

    ADHD… As An Adult?

    In women in particular, it can get missed and/or misdiagnosed:

    Miss Diagnosis: Anxiety, ADHD, & Women

    …but what we’re really here to talk about today is:

    It’s the comorbidities that get you

    When it comes to physical health conditions:

    • if you have one serious condition, it will (usually) be taken seriously
    • if you have two, they will still be taken seriously, but people (friends and family members, as well as yes, medical professionals) will start to back off, as it starts to get too complicated for comfort
    • if you have three, people will think you are making at least one of them up for attention now
    • if you have more than three, you are considered a hypochondriac and pathological liar

    Yet, the reality is: having one serious condition increases your chances of having others, and this chance-increasing feature compounds with each extra condition.

    Illustrative example: you have fibromyalgia (ouch) which makes it difficult for you to exercise much, shop around when grocery shopping, and do much cooking at home. You do your best, but your diet slips and it’s hard to care when you just want the pain to stop; you put on some weight, and get diagnosed with metabolic syndrome, which in time becomes diabetes with high cardiovascular risk factors. Your diabetes is immunocompromising; you get COVID and find it’s now Long COVID, which brings about Chronic Fatigue Syndrome, when you barely had the spoons to function in the first place. At this point you’ve lost count of conditions and are just trying to get through the day.

    If this is you, by the way, we hope at least something in the following might ease things for you a bit:

    It’s the same for mental health

    In the case of ADHD as a common starting point (because it’s quite common, may or may not be diagnosed until later in life, and doesn’t require any external cause to appear), it is very common that it will lead to anxiety and/or depression, to the point that it’s perhaps more common to also have one or more of them than not, if you have ADHD.

    (Of course, anxiety and/or depression can both pop up for completely unrelated reasons too, and those reasons may be physiological, environmental, or a combination of the above).

    Why?

    Because all the good advice that goes for good mental health (and/or life in general), gets harder to actuate when one had ADHD.

    • “Strong habits are the core of a good life”, but good luck with that if your brain doesn’t register dopamine in the same way as most people’s do, making intentional habit-forming harder on a physiological level.
    • “Plan things carefully and stick to the plan”, but good luck with that if you are neurologically impeded from forming plans.
    • “Just do it”, but oops you have the tendency-to-overcommitment disorder and now you are seriously overwhelmed with all the things you tried to do, when each of them alone were already going to be a challenge.

    Overwhelm and breakdown are almost inevitable.

    And when they happen, chances are you will alienate people, and/or simply alienate yourself. You will hide away, you will avoid inflicting yourself on others, you will brood alone in frustration—or distract yourself with something mind-numbing.

    Before you know it, you’re too anxious to try to do things with other people or generally show your face to the world (because how will they react, and won’t you just mess things up anyway?), and/or too depressed to leave your depression-lair (because maybe if you keep playing Kingdom Vegetables 2, you can find a crumb of dopamine somewhere).

    What to do about it

    How to tackle the many-headed beast? By the heads! With your eyes open. Recognize and acknowledge each of the heads; you can’t beat those heads by sticking your own in the sand.

    Also, get help. Those words are often used to mean therapy, but in this case we mean, any help. Enlist your partner or close friend as your support in your mental health journey. Enlist a cleaner as your support in taking that one thing off your plate, if that’s an option and a relevant thing for you. Set low but meaningful goals for deciding what constitutes “good enough” for each life area. Decide in advance what you can safely half-ass, and what things in life truly require your whole ass.

    Here’s a good starting point for that kind of thing:

    When You Know What You “Should” Do (But Knowing Isn’t The Problem)

    And this is an excellent way to “get the ball rolling” if you’re already in a bit of a prison of your own making:

    Behavioral Activation Against Depression & Anxiety

    If things are already bad, then you might also consider:

    And if things are truly at the worst they can possibly be, then:

    How To Stay Alive (When You Really Don’t Want To)

    Take care!

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  • Healthy sex drive In Our Fifties

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    It’s Q&A Day at 10almonds!

    Have a question or a request? We love to hear from you!

    In cases where we’ve already covered something, we might link to what we wrote before, but will always be happy to revisit any of our topics again in the future too—there’s always more to say!

    As ever: if the question/request can be answered briefly, we’ll do it here in our Q&A Thursday edition. If not, we’ll make a main feature of it shortly afterwards!

    So, no question/request too big or small

    Q: What’s a healthy sex drive for someone in their 50s?

    A: If you’re happy with it, it’s healthy! If you’re not, it’s not.

    This means… If you’re not (happy) and thus it’s not (healthy), you have two main options:

    1. Find a way to be happier without changing it (i.e., change your perspective)
    2. Find a way to change your sex drive (presumably: “increase it”, but we don’t like to assume)

    There are hormonal and pharmaceutical remedies that may help (whatever your sex), so do speak with your doctor/pharmacist.

    Additionally, if a boost to sex drive is what’s wanted, then almost anything that is good for your heart will help.

    We wrote about heart health yesterday:

    What Matters Most For Your Heart?

    That was specifically about dietary considerations, so you might also want to check out:

    The Knowledge That Harvard Medical School’s Clinical Instructor Dr. Monique Tello Thinks Everyone Should Have About Heart Health

    Take care!

    Don’t Forget…

    Did you arrive here from our newsletter? Don’t forget to return to the email to continue learning!

    Learn to Age Gracefully

    Join the 98k+ American women taking control of their health & aging with our 100% free (and fun!) daily emails: