Use Combination Treatments:

The multi-factorial nature of chronic pain is the reason single modal treatments are rarely effective.

Personalized combination treatment for each patient’s particular pain problem(s) is the answer. We have found this to be true clinically for the past 17 years. At the NPRC, patients receive up to 14 different treatments in personalized combinations.

Research suggests that multidisciplinary care is beneficial for most persons with chronic pain, and likely should be considered the treatment of choice for persons who are at risk for, or who have, chronic pain and disability. Flor et al. (1992) conducted a meta-analytic review of multidisciplinary pain treatment for chronic back pain, which concluded that chronic pain patients treated in multidisciplinary programs were functioning better than 75% of control patients who either received no treatment or who were treated by conventional unimodal approaches. Multidisciplinary treatment was found to be superior to conventional physical therapy alone, had benefits that persisted over time, and was beneficial in improving return to work and decreasing use of health care.

Treat the Neurotransmitter Pain Killers Deficiency:

Correcting the neurotransmitter deficiency is the most important of all the treatments we will discuss.
The Neurotransmitter deficiency in the chronic pain patient is the result of two processes:

1. Poor production from inadequate stage 3 and 4 sleep
2. Reduced release of existing neurotransmitter stores.

Treatment strategies to restore neurotransmitter pain killers to normal levels must concentrate on both increasing production and improving release.
Some treatments help both production and release.

Strategies for increasing production of Neurotransmitter Pain Killer by restoring stages 3 and 4 of sleep include:

	Sleep Hygiene counseling
	CES - A portable Russian electric sleep/pain relief device the size of a deck of playing cards with over 25 years of successful clinical application and over 120 positive studies in the USA and Russia.
	Nutritional Supplementation with Amino acids, vitamins and minerals- the precursors and co-factors needed for proper neurotransmitter production.
	The amino acids, 5-HTP and D-PA have been shown in multiple studies to increase the endorphins and serotonin levels helping chronic pain, insomnia and depression. This allows gradual reduction of dependency-forming prescription sleeping pills.

Strategies for increasing release of Neurotransmitter Pain Killer include:

	Mediation and Spiritual Prayer- Daily 1-hour sessions. This has been used in the United States since the early 1980’s. There are multiple studies demonstrating the effectiveness of meditation, many from the pioneer in this area Dr. Jon Kabat-Zinn
	CES - A portable Russian electric sleep/pain relief device the size of a deck of playing cards with over 25 years of successful clinical application and over 100 positive studies in the USA and Russia. (CES helps both production and release.)

Turn Off Pain Messaging from Structural Damage

There is usually limited ability to stop the pain messaging from damaged structures.

Here are a few of the pain messaging reduction treatment strategies we use at the center:

	Massage
	Manual Physical therapy
	Specific body part and core strengthening
	Brazilian Menthol Pain Relief Lotion

Narcotic, Prescription and OTC Medication and Caffeine Reduction

Rebound pain from narcotics, prescription meds and caffeine can be the cause of up to 50% of someone’s pain. Patients generally consume pain medication and caffeine in large amounts resulting in behavioral addiction. By offering patient non-narcotic and non-drug pain relief treatments most patients gradually reduce and often can stop daily consumption of both drugs and caffeine on their own over 2-4 weeks. Medications are only needed for the rare cases when the natural pain relief treatment fails to completely stop breakthrough pain.