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Natural Medicine Options for Chronic Pain
and Musculoskeletal Injuries

Ryan MInarik, ND, LAc
2006 NCNM grad, 2 year residency
drminarik at elixiawellness dot com
but him if you want a preceptor, he's not good about returning email
drminarik.com see pt education blog
8113 S# 13th , 97202
also works at Back in Motion Sports Injuries (chiro practice 11385 SW Scholls Ferry Rd, Beaverton, 97008)

CHRONIC INJURIES AND PAIN
his interest
acutes mostly resolve with or without dr intervention
1) establish cause of injury
2) locate sites of pain (depth of pain, referred?, ANS dysfx?, can't ID?, long term/habitual--brain pain?)
3) ID barriers to healing

MOAs
MVA, whiplash, sports, exercise-->mx system focus
infx-->GIm dysbiosis, immune, stress
no known trauma-->endocrine, stress, hormones, nutrit, interference fields

ANS DYSFX
trauma, emot, accident, iatrogenic, infx/abscess (teeth), foreign objects in body
first sx: pain (dull, diffuse, mb nausea) then restrx blood flow (smooth mm not regulated)
--->tight/contxn of fascia around dysfx-->tissue tearing

INTERFERENCE FIELDS
neurotherapy
Dr Kidd
electrical disturbances called interference fields are manifestations of cell membrane.....

BARRIERS TO HEALING
stress: cort, inflam, uneasy personal relations
interference fields: scars, emot, thoughts, past or separate injuries
thyroid, consider with pain, swelling, tendonitis, must test T3 and T4, TSH doesn't tell whole story

diet/digestion: inflam, absorption, artifical sweeteners (sugar, fats, toxins, acid, gluten)
gluten: either elimination diet or testing, patient picks

aspartame-->phenyalanin, aspartic acid, methanol-->metab to formaldehyde (v toxic with oxidant combo)
recommends movie: Sweet Misery, documentary on woman with neuro prob post sweetener

other: vit D (NGF, pain), immune dysfx, heavy metals

poor sleep, insomnia: in well nourished lean humans GH released early in deep sleep
and pattern of release is constant from night to night

vit D stims production of NGF, nerve growth factor, regulates voltage gated Ca+ channels, modulates Schwann cells, has neuroprotective and neuroreg actions

NSAIDS stop healing cascade

TX
eliminate barriers to cure
uses procaine injx into dermis and scars to interrupt interference fields

PE
palpation!! touch the tissue
orthopedic exams
observation: watch them do what hurts
AK, muslce testing, ART = autonomic response testing

LABS
CBC, ferritin, thyroid, ESR/CRP, lipids, autoimmune, gluten, heavy metals, gluten
Imaging: US, MRI, X-ray
he has diagnostic US in ofice

TX
kinesiotape
herbs, nutrit
graston & GuaSha
acupx
prolo with dextrose, he uses 3 txs

PRP, platelet rich plasma: pts own blood drawn, sorted, re=injx, blood processing is half of the cost
provokes healing cascade, used in high level sports medicine
for tendon tears, arthritis, meniscus, epicondylitis, achilles teninsosis, OA
serum still has stem cells in it, injx with US guidance, causes inflam don't suppress, avoid heavy lifting, takes 6 months for full healing, 3-4 injx spaced 3-4 wks apart, 5ccs/injx, liquid is hypertonic and causes burning, need pain kill local or nerve block, jams needle deep into joint and into meniscus, hard to watch

other injx: trigger pt, biopx, sarapin
cold laser
orthotics
AK
osteopathic manipulation

KINESIOTAPE
no latex, no underwrap
follow insertion and origin taping of mm
wrinkles skin, allows relief of pressure by incr lymph and blood flow
changes proprioception, augments it

NUTRIT he uses
Mg, Mn, B12, vit C, Ca, K, Si
Mn vital for synthesis of collagen
glucosamin, chondroitin
quercetin and flavonoids, impedes conversion of arach acid to inflam, inhib mast cells, good for pn
turmeric/curcumin inhib sev enz, decr IL6, IL1B, MCP1, metalloproteinases
bromelain, papain, trypsin, chymotrypsin, give away from food, decr inflam, he has mixed results
boswellia inhibi 5LOX and TNFalpha for OA
his faves: glucosamine, white willow bark 25mg tid, capsaicin .025-.075% topical for OA, RA, neuropathy

TOPICALS
his fave: 20%DMSO, 20%MgCl, 3% emu oil applied bid-tid to affected area
traumeel
many others

pain society of oregon, great group of practitioners
painsociety.com
great presentations

prolo
get training
do this first if you want to do PRP

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