Dr. Weyrich's Naturopathic Functional Medicine Notebook is a collection of information on topics of interest to Dr. Weyrich that may be of interest to the world wide audience. Due to limitations of time, not all information that Dr. Weyrich knows or would like to further research is published here. Dr. Weyrich welcomes financial contributions to support specific research topics, as well as copies of non-free access journal articles for him to review on a topic. Constructive criticism is also welcome.


Overview of Pain

There are many causes for pain that may afflict different parts of the body. This web page discusses general principles that apply to many different types of pain.

It is important to note that pain is the body's cry for help - the cause should be found and treated, rather than covered up with pain medications. While various medicinal herbs, over-the-counter and prescription pharmaceuticals may be helpful, these should only be used for temporary relief while the underlying cause is being diagnosed and (hopefully) treated.

In other cases, the underlying damage cannot be corrected, and chronic pain results. Dr. Weyrich can prescribe palliative prescription medications in these cases, but prefers to augment the drug protocols with natural therapies to address the root cause.

Over time, uncontrolled chronic pain can lead to a "rewiring" of the nervous system that makes the pain response ingrained. It is difficult to break this cycle once it has been initiated. However, there is evidence that both neurotransmitter rebalancing, neuro-feedback, and biofeedback are useful in breaking this chronic cycle.

Complimentary and alternative treatments for chronic pain that are considered below include:

  • Acupuncture
  • Chiropractic, osteopathic, and naturopathic manipulation
  • Low Dose Naltrexone
  • Conventional Neuro-feedback
  • Neurotransmitter Balancing
  • Medical Marijuana

Please also refer to the web page for the specific part of the body:


Etiology of Pain

Some practitioners have noted an association between chronic pain and inflammatory process mediated by homocysteine [Rogers2008, pg 9]. Note that the common diuretic hydrochlorothiazide (HCTZ) increases homocysteine levels [Westphal2003].


Differential Diagnosis of Pain


Treatment of Pain

Please see conventional, complimentary and alternative medical treatments for important background information regarding the different types of medical treatments discussed below.

Naturopathic, Complimentary and Alternative Treatments

Acupuncture

Acupuncture can be useful in treating both acute and chronic pain, if the right practitioner is chosen. Dr. Weyrich is trained and licensed in acupuncture. Dr. Weyrich prefers to use acupuncture meridian-based protocols as taught by Dr. Tan [Tan1991], [Tan1994], [Tan2003], [Tan2007], as opposed to zang-fu methods taught at most acupuncture schools - but which are most applicable when combined with Chinese herbology.

Meridian-based approaches start with identifying the "sick" meridian - the channel through the body in which the blockage of the free flow of energy ("Qi") is causing pain. There are 12 meridians or channels: 6 in the upper body and 6 in the lower body. These are:

  • Tai Yang - the major surface of the back of the body (UB/SI).
  • Tai Yin - the major surface of the front of the body (Sp/Lu).
  • Yang Ming - the region posterior to the boundary between the front and back (St/LI).
  • Shao Yin - the region anterior to the boundary between the front and back (K/Ht).
  • Shao Yang - the region between Tai Yang and Yang Ming (GB/SJ)
  • Jue Yin - the region between Tai Yin and Shao Yin (Liv/PC).

After identifying the sick meridian, acupuncture points are chosen along the sick meridian and along homologous points on other "reciprocal" meridians [Tan2007, pp 2-4] using what Dr. Tan calls the "Balance Method".

The Traditional Chinese Medicine aphorism "If there is free flow, there is no pain; If there is no free flow, there is pain" (Tong ze bu tong; bu tong ze tong) [Unschuld2003, Chapter 39] applies to the flow of Qi, blood, and lymph - in both acupuncture and manipulation.

Chiropractic, Osteopathic, and Naturopathic Manipulation

Dr. Weyrich finds chiropractic, osteopathic, and naturopathic manipulation techniques to be complementary to acupuncture. Whereas acupuncture deals with the flow of energy ("Qi") through the soft tissues, the manipulation techniques focus more on correcting the misalignment of bones and their joints, but some techniques can also break up scar tissue and allow improved flow of blood and lymph.

All of these techniques arise from a common background, and the name of the technique has more to do with the particular school/licensed professional than the type of technique. Dr. Weyrich has been trained in manipulation techniques by DC and ND, using textbooks written by DC, DO, ND, and MD. However, Dr. Weyrich usually refers patients needing these treatments to Go to Dr. Robert Gear, Jr. Dr. Robert Gear, Jr.

Low Dose Naltrexone (LDN)

[LDN_Chopra] has discussed the use of LDN in treating chronic pain. Dr. Weyrich has been trained in the use of Low Dose Naltrexone (LDN). However, Dr. Weyrich has not treated any cases of chronic pain with LDN, other than fibromyalgia.

Please see What is Low Dose Naltrexone? for more information.

Conventional Neuro-feedback

Neuro-feedback has proven useful for treating chronic pain. Dr. Weyrich has been certified in Neuro-feedback since 2008, and more recently completed an additional residency training program at ADD Clinic of Scottsdale, AZ. However, Dr. Weyrich has not treated any cases of chronic pain with this technique.

Please see What is Neurofeedback? for more information.

Neurotransmitter Balancing

Neuro Research [Hinz2015] reports that chronic pain can be mitigated by balancing neurotransmitter levels in the body.

Dr. Weyrich has been trained in neurotransmitter balancing protocols, but has not treated chronic pain using this technique.

Please see What is Neurotransmitter Balancing? for more information.

Medical Marijuana

Some patients may find Medical Marijuana to be helpful with fewer side effects than prescription opiates (morphine, oxycontin, hydrocodone, hydromorphone, etc); Dr. Weyrich does not write recommendations for Medical Marijuana, but Go to Dr. Robert Gear, Jr. Dr. Robert Gear, Jr. can evaluate patients in Arizona and write recommendations when appropriate.

Because of the controversial legal status of Medical Marijuana in some states and the Federal Government, patients should consider "CBD" oil, which is legally available and has many of the medicinal properties of marijuana without the "high."


ICD-10 Codes related to Pain


References for Pain