Chronic Pain 

Acute pain is your body’s burglar alarm—sharp, loud, and designed to grab your attention. Chronic pain, on the other hand, is that alarm refusing to shut off months after the break-in is long forgotten. Defined as pain lasting three months or longer (with or without a clear cause), chronic pain now affects a jaw-dropping 24–30% of adults—that's over 60 million North Americans and growing every year.

In other words: if chronic pain were a club, it’d have a frighteningly long waitlist.

Sadly, yes—chronic pain is trending, but not in a fun TikTok way. The prevalence of chronic pain surged post-pandemic and continues to climb, with an 18% jump between 2019 and 2023 alone. Younger adults and women are feeling the brunt, and the economic toll now runs over $600 billion a year in North America.

Chronic pain is the ultimate medical shapeshifter—sometimes springing from an old injury, arthritis, surgery, nerve damage, or simmering inflammation. Other times, it’s rooted in stubborn “pain memories” (where your nervous system keeps hitting replay on discomfort long after the cause is gone), or classic “invisible” suspects like fibromyalgia, irritable bowel syndrome, migraine, endometriosis (with pain that keeps on giving), or complex regional pain syndrome (CRPS). To keep things exciting, emerging triggers like Long COVID are also joining the guest list, reminding us that pain can have many faces.

Bottom line: with chronic pain, there’s always a reason—even if it sometimes plays hide-and-seek with your doctor.

Think less fortune-teller, more medical detective. Diagnosis starts with your story—where it hurts, how it started, what makes it worse (or better), and any patterns or triggers. Your doc rules out “masqueraders” (like infections or tumors), orders targeted labs or imaging if needed, and often relies most on a keen ear and clinical know-how.

The chronic pain landscape is shifting: gone are the days when unexplained pain meant eye-rolls or gaslighting—today’s doctors (especially NDs) listen, validate, and collaborate. If anyone tells you “it’s just in your head,” it’s time for a second opinion. Plus, to help crack the pain case, a pain diary may be recommended—helpful for tracking what’s happening, when, and why.

You get a full toolbox—not just one “magic” wrench!

• Move over, RICE—hello, MEAT! Modern pain science champions Movement, Exercise, Analgesia, and Treatments over “Rest, Ice, Compression, Elevation.” Consistent gentle movement (even a few minutes a day) helps tissues heal, keeps you limber, and prevents your nervous system from overreacting to pain.

Evidence: The shift from RICE to MEAT is supported by studies showing active rehab leads to better outcomes in many soft-tissue and joint injuries.

• Medications:
  • SAMe (S-adenosylmethionine) may ease osteoarthritis and mood symptoms.
  • PEA (palmitoylethanolamide) is a natural fatty acid amide studied for neuropathic and inflammatory pain, showing promise and few side effects.
• Anti-inflammatories (NSAIDs): Best for inflammatory pain, flare-ups, or injury.
• Neuropathic agents (gabapentin, pregabalin): Target overactive nerves—think neuropathy, fibromyalgia, CRPS.
• Antidepressants (TCAs, SNRIs): Useful for “centralized” pain (fibro, migraine) and when pain is tangled up with mood.
• Low Dose Naltrexone (LDN): Works on the microglial cells to dial down neuroinflammation; helpful in fibromyalgia, neuropathic pain, and select autoimmune conditions, with a growing evidence base.

• Procedures:
• Injection therapy: PRP (platelet-rich plasma) injections for osteoarthritis or tendon injuries; corticosteroid injections for frozen shoulder or severe joint inflammation; and hyaluronic acid for knee OA.
• We refer to top interventionalists for ultrasound-guided joint injections—so you get precision therapy when it’s the right choice.

Evidence: PRP has moderate support for OA and soft tissue injuries, while steroid shots are best for acute inflammation and mobility.

 
• Emerging Therapies:
• BPC-157: A synthetic peptide touted for tissue healing and reduced inflammation, used judiciously and through regulated channels; current best evidence is for soft tissue and tendon repair with early clinical promise—more human trials needed.

Our Policy: We use BPC-157 only from Health Canada–approved sources and only in select, well-justified cases—no wild-west peptide medicine here.

 
• Integrative approaches:

• Acupuncture: Multiple RCTs and meta-analyses show credible benefits for musculoskeletal, neuropathic, and even migraine pain—especially when added to conventional treatments.

• Massage Therapy: Well-conducted studies and systematic reviews confirm that regular massage can reduce tension, improve mobility, and ease chronic pain syndromes—from low back aches and fibromyalgia to post-injury recovery—by enhancing circulation, reducing stress hormones, and dialing down muscle stiffness.

• IMS with a Physiotherapist / Dry Needling with an Acupuncturist: Intramuscular stimulation (IMS) and dry needling target tight muscle bands and trigger points with fine needles, offering relief for persistent pain, muscle tension, and neuropathic symptoms—RCTs show improvements in pain and function, especially for chronic back, neck, and myofascial pain.

• Osteopathic Medicine: Osteopathic manipulative therapy (OMT) employs hands-on techniques (stretching, gentle manipulation, soft tissue work) that can improve range of motion, reduce pain, and enhance quality of life in chronic musculoskeletal conditions; studies support its use as part of integrative pain management, especially for back pain and joint issues.

• The Future is Here:
• Journavx™ (suzetrigine): A brand-new, first-in-class non-opioid oral medication, approved for acute moderate-to-severe pain. Works by blocking Naᵥ1.8 sodium channels in sensory nerves (think: silencing the pain telephone before it rings!). Not for chronic pain, but a game-changer for post-surgery or injury when opioids would otherwise be considered.

Chronic pain isn’t always a forever friend—many people see major improvement or remission with the right tools, time, and teamwork. Some underlying conditions, like post-injury pain or certain autoimmune flares, do resolve with focused care. Mysterious or multifactorial pain (fibromyalgia, arthritis) rarely “vanishes” entirely, but it can wax, wane, and—most importantly—become manageable. Think marathon, not sprint; progress over perfection.

Chronic pain doesn’t respect boundaries—it drains your joy, clouds judgment, blocks sleep, and can put relationships on ice. Up to two-thirds of those with chronic pain wrestle with depression or anxiety, and sleep can become a distant memory. In naturopathic medicine, we look at the whole picture—addressing mind, mood, lifestyle, nutrition, and relationships, not just the physical ache.

Pain is real, but so is hope—and so is support.

Safety comes first. As naturopathic doctors, we don’t prescribe opioids—but we’re experts in minimizing risk, medication interactions, and side effects with everything else in your plan. We favour “start low, go slow,” regular medication reviews, and—above all—exploring non-drug and integrative therapies as first-line options. Education, shared decision-making, and open communication keep you in the driver’s seat. When prescription medications are needed, we work closely with your family doctor or pain specialist to make sure your treatment is both safe and effective.

1. Depression

Chronic pain and depression are frequent companions—persistent pain can drain your mood, dampen motivation, and make everyday joys feel far away, while depression can actually heighten your perception of pain.

2. Anxiety Disorders

Worry and pain like to fuel each other: pain creates uncertainty and stress, while anxiety tightens muscles and amps up your nervous system, turning up the volume on aches and discomfort.

3. Sleep Disorders (e.g., Insomnia)

Pain loves to keep you up at night, while poor sleep magnifies pain—the “vicious cycle” that leaves you tired, cranky, and less resilient during the day.

4. Fibromyalgia

A classic “pain amplification” syndrome with widespread aches, tender points, brain fog, and fatigue—even when tests look normal.

5. Irritable Bowel Syndrome (IBS)

When pain goes abdominal: IBS brings gut cramping, bloating, and a rollercoaster of bathroom drama, often spiking alongside chronic pain elsewhere in the body.

6. Chronic Fatigue Syndrome / Myalgic Encephalomyelitis (CFS/ME)

Long-lasting fatigue that’s not improved by rest, plus muscle aches, brain fog, and post-exertional crashes—a common bedfellow for chronic pain.

7. Migraine

More than “just a headache,” migraines are recurring, severe head pain attacks, often with nausea, sensitivity to light/noise, and sometimes body-wide pain.

8. Complex Regional Pain Syndrome (CRPS)

A challenging nerve condition after injury or surgery—causing burning pain, swelling, colour changes, and tenderness even to a light touch.

9. Endometriosis

Chronic, often severe pelvic pain linked to tissue similar to the uterine lining growing outside the uterus—affecting pain at multiple sites, not just the pelvis.

10. Arthritis (Osteoarthritis and Rheumatoid Arthritis)

Both types bring joint pain and stiffness; rheumatoid can also cause fatigue and systemic issues, while osteoarthritis is wear-and-tear related but just as disruptive.

11. Peripheral Neuropathy

Nerve damage (often from diabetes, chemotherapy, or injury) that leads to numbness, tingling, and burning pain, mostly in the hands and feet.

12. Long COVID

Persistent symptoms—including aches, fatigue, headaches, and brain fog—hanging on long after the initial COVID infection.

13. Autoimmune Diseases (e.g., Lupus, Multiple Sclerosis)

Conditions where the immune system attacks the body, causing pain, fatigue, and inflammation in various organs and tissue.

These conditions often overlap or “travel in packs,” reinforcing why an integrative, whole-person approach is so crucial in chronic pain care. If you’re dealing with chronic pain and any of its sidekicks, know you’re not alone—and there’s help for every part of the picture.