ModerateGBS: 76 (Moderate-High Risk)nutrition

Chronic Pain Management (Non-Opioid)

Developer: Various pain specialists, integrative medicine

Varies widely - some rapid improvement with interventions, some require months of multi-modal approach

Protocol Overview

Comprehensive multi-modal protocol for chronic pain using non-opioid approaches: diet, supplements, mind-body, regenerative therapies. Addresses central sensitization and biopsychosocial factors.

Conditions Treated

Chronic pain

fibromyalgia

chronic back pain

neuropathic pain

Protocol Steps

Understand chronic pain: Different from acute pain - central sensitization (nervous system amplifies pain signals), neuroplasticity (brain changes), biopsychosocial (not just tissue damage)

Rule out underlying causes: Inflammatory (RA, autoimmune), infectious (Lyme), structural (herniated disc, stenosis), metabolic (hypothyroid), cancer - treat underlying condition

Anti-inflammatory diet: Reduce neuroinflammation - eliminate gluten, dairy, sugar, processed foods, seed oils. Emphasize omega-3, turmeric, ginger, vegetables

Omega-3: 3-4g EPA/DHA (anti-inflammatory, neuroprotective)

Curcumin: 1-2g daily (anti-inflammatory, pain reduction)

Boswellia: 1200mg 3x/day (reduces inflammatory pain)

PEA (Palmitoylethanolamide): 600-1200mg 2x/day (endocannabinoid-like, reduces neuroinflammation and pain - studied in Europe for chronic pain)

CBD oil: 25-100mg 2x/day (analgesic, anti-inflammatory, anxiolytic - helps pain and pain-related anxiety)

Alpha-lipoic acid: 600mg 2x/day (neuropathic pain, antioxidant)

Magnesium: 400-800mg (muscle relaxation, NMDA receptor antagonist - reduces central sensitization)

Vitamin D: Optimize 50-80 ng/ml (low D associated with chronic pain, fibromyalgia)

B-complex: Methylated B-vitamins (nerve health, especially B12 for neuropathic pain)

LDN (Low-Dose Naltrexone): 3-4.5mg nightly (modulates neuroinflammation, reduces pain via glial cell modulation - works for fibromyalgia, CRPS, neuropathic pain)

Acetyl-L-carnitine: 1500-3000mg daily (neuropathic pain)

Kratom: Controversial botanical (opioid-like effects but not classical opioid) - 2-5g 2-3x/day. Helps many chronic pain patients reduce opioids but has addiction potential, variable legality

Topicals: Capsaicin cream 0.075%, CBD cream, compounded ketamine/gabapentin/diclofenac/baclofen cream, arnica, lidocaine patches

Mind-body therapies: CBT for chronic pain (changes pain perception), mindfulness meditation (reduces pain intensity 20-30% in studies), MBSR (Mindfulness-Based Stress Reduction), ACT (Acceptance and Commitment Therapy), biofeedback, progressive muscle relaxation

PRT (Pain Reprocessing Therapy): Emerging - treats chronic pain as learned neural pathway (not tissue damage). Teaches brain pain is safe signal, not danger. Remarkable results in recent RCT

Emotional work: ACEs (Adverse Childhood Experiences) associated with chronic pain, trauma therapy (EMDR, somatic experiencing), address depression/anxiety (90% comorbidity with chronic pain)

Physical therapy: Graded exercise, desensitization, movement (fear-avoidance worsens pain), strengthen surrounding muscles

Acupuncture: Moderate evidence for pain reduction, worth trying

Chiropractic/osteopathic manipulation: For musculoskeletal pain

Regenerative medicine: PRP, prolotherapy, stem cells for structural issues (joints, tendons)

Spinal cord stimulation: For refractory neuropathic pain (implanted device)

Ketamine infusions: IV ketamine 0.5mg/kg over 40 minutes, series of 6 infusions (NMDA receptor antagonist, reduces central sensitization) - emerging for CRPS, fibromyalgia, refractory pain

Medical cannabis: THC:CBD combinations for pain (if legal), individualize ratio

Sleep: Optimize 7-9 hours (poor sleep lowers pain threshold, worsens chronic pain)

Avoid: Long-term opioids (hyperalgesia paradox - chronic opioids increase pain sensitivity), excessive rest (movement needed for recovery)

Functional restoration: Gradual return to activities despite pain (pacing, not complete avoidance)

Support: Chronic pain support groups, validation (pain is real even if no clear structural cause)

Key Resources

The Way Out by Alan Gordon (PRT), "Explain Pain" by Lorimer Moseley, LDN Research Trust, pain psychology literature

Contraindications & Risks

Kratom has addiction potential (not benign), LDN generally safe, CBD generally safe, ketamine requires medical setting

Important Notes

Chronic pain epidemic - 50+ million Americans, leading cause of disability. Chronic pain ≠ acute pain: Acute pain is warning signal (tissue damage). Chronic pain is disease of nervous system (central sensitization - nervous system amplifies pain signals even after tissue healed). Neuroplasticity: Brain changes with chronic pain - pain centers hypertrophied, gray matter loss. Pain becomes learned pattern. Biopsychosocial model: Chronic pain not just tissue damage but also psychological (depression, anxiety, trauma, catastrophizing) and social (isolation, disability, loss of meaning) factors. All must be addressed. Opioid crisis: Long-term opioids don't work for chronic non-cancer pain (tolerance, hyperalgesia - opioids increase pain sensitivity). Plus addiction, overdose deaths. Non-opioid approaches essential. LDN: Emerging as effective for fibromyalgia, CRPS, neuropathic pain. Modulates microglial cells (neuroinflammation). No addiction, minimal side effects. PEA: Endocannabinoid-like (but not cannabinoid), reduces neuroinflammation and pain. Studied in Europe, available as supplement in US. CBD: Analgesic, anti-inflammatory, anxiolytic. Helps subset. Mind-body is key: MBSR (mindfulness) reduces pain 20-30% in RCTs. CBT for chronic pain teaches cognitive restructuring. ACT focuses on living with pain, not eliminating (acceptance reduces suffering). PRT (Pain Reprocessing Therapy): New approach - treats chronic pain as learned neural pathway (like phantom limb pain - brain generates pain without tissue damage). Teaches brain pain is false alarm, safe. Recent RCT showed 66% pain-free at 1 year. Revolutionary if replicable. Trauma connection: ACEs (childhood trauma) strongly associated with chronic pain. Trauma therapy (EMDR, somatic experiencing) helps many. Movement: Fear-avoidance worsens pain (avoid activity because hurts → deconditioning → more pain). Graded exposure, pacing, gradual return to activity despite pain (PT guidance). Ketamine: NMDA antagonist, resets central sensitization. IV infusions showing promise for CRPS, fibromyalgia. Chronic pain requires multi-modal approach (diet, supplements, mind-body, PT, addressing trauma, sleep, social support). No single magic bullet. Validation important - chronic pain often dismissed ("it's all in your head") causing suffering. It is in the brain (neuroplastic) but real and treatable.

Also Effective For

Chronic Fatigue / Fibromyalgia

Key Supplements & Herbs in This Protocol

Supplements

L-Carnitine

Herbs

Ginger

Zingiber officinale

Turmeric

Curcuma longa

Boswellia

Boswellia serrata

Arnica

Arnica montana

Critical Safety Warning

This protocol is documented for educational purposes only. The Gabriel Bullshit Score (GBS) of 76 reflects significant institutional response and controversy. Some alternative health protocols have resulted in serious harm or death.

Always consult with qualified healthcare professionals before beginning any treatment. Do not delay or forego proven medical care.

Quick Overview

Evidence LevelModerate

GBS Score76 / 100

Categorynutrition

DeveloperVarious pain specialists, integrative medicine

DurationVaries widely - some rapid improvement with interventions, some require months of multi-modal approach

About GBS Score

The Gabriel Bullshit Score reflects the magnitude of institutional response, controversy, and documented concerns. Higher scores indicate greater institutional pushback, not necessarily inefficacy. This is a research tool, not medical advice.