Over the past 25 years, we’ve learned that after just a few weeks of significant pain, hormone levels begin to change. One of the first major changes occurs in the adrenal glands. Pain is a stress escalator, and adrenal production of the stress hormone cortisol increases dramatically. This increase in cortisol in turn increases blood sugar, reduces metabolism, and impairs immune function. Increased cortisol levels also lead to increased inflammation and decreased testosterone, both of which shift energy away from building and restoration. Without continuous and constant building and restoration, the body breaks down.
For patients struggling with pain, this breakdown shows itself in poor sleep, low energy, decreased mood, low sex drive, increased body fat, reduced muscle mass, and reduced endurance, to name just a few signs and symptoms. Worse yet, this breakdown process can develop momentum independent of the pain that initiated it and leave patients stuck in a downward spiral.
If ever there were a truly evil self- fulfilling prophecy, this is it!
Shifting out of breakdown and unwellness (aka catabolism) and back into building and vitality (aka anabolism) is absolutely critical. Without this shift, no pain medication, injection therapy, implantation, or surgery will restore lost vigor. Over time and with age, other conditions that create similar signs and symptoms can surreptitiously insert themselves into the picture and contribute to misery (suboptimal thyroid and gonadocorticoid levels come to mind here).
By the time most of us hit our late 40’s and early 50’s, key hormone levels start to decline, and we begin experiencing episodes of inflammatory pain, particularly when we push ourselves in activities involving repetitive movements with weight. Our abilities to “bounce back” are reduced. We may even find old injuries that we brushed off in our younger years reemerging, causing lingering pain that doesn’t fade with rest and activity avoidance. Often enough, we end up getting spine and/or joint x-rays, only to be told that the studies really don’t look bad. True as that may be, these studies are not taking into account age-related hormone reductions. One of the ways in which Revive Pain Solutions can take a unique and intensely personalized approach to managing your pain is by first analyzing your hormone levels and then judiciously supplementing them to make your pain recovery as effective and as rewarding as possible. Even if you’ve been struggling for years, it’s never too late to feel alive and well.
We include this as part of medication management at Revive Pain Solutions.
If you’ve never heard of bioidentical hormone replacement therapy (BHRT) or how it can be used as a powerful pain management tool, you are not alone. It is rarely brought up as an option in most interventional pain practice. Perhaps it’s because the extensive additional education needed to safely and effectively use BHRT is outside of interventional pain management training, or perhaps it’s because we as pain specialists have allowed chronic pain diagnoses to narrow the focus of our patient care to such an extent that we forget to practice holistically. Perhaps it’s because there is no billing code for BHRT.
No physician wants to restrict patient treatment, but unfortunately, in today’s world, this has become a reality unless one steps outside of the health insurance model. From conception forward, Revive has been built to provide multi-modal pain care without compromise, the sort of care that we ourselves would hope to receive if we were patients. Hence, BHRT is at the top of our list of tools to combat pain in patients age 45 and up.
Look for upcoming blogs further discussing BHRT and its role in chronic pain management .