Pain is the most common reason why patients consult a doctor or pharmacist. It can be a symptom of many conditions, from the innocuous to the life-threatening. Localization is different. It can be in the chest, abdomen, extremities, head, neck, back, pain due to infection in the respiratory tract. Any pain must be taken seriously, diagnosed and treated. Pain is a subjective experience that is described using several different features or characteristics (quality, localization, intensity, emotional changes, behavioral changes, frequency). Pain intensity is recognized as the most important clinical dimension of pain experience. Therefore, even in the treatment of acute pain, it is important to adequately assess the pain clinically and give an analgesic at the right time.
Chronic bone and joint pain is in most cases caused by some type of rheumatic disease. Rheumatic diseases are characterized by pain and dysfunction of the affected part of the bone-joint system. In certain rheumatic diseases, other organs and systems are also affected, which sometimes manifests as a severe clinical condition, with a possible fatal outcome. The word "arthritis" means inflammation of the joints. There are over 200 different forms of arthritis. This widespread disease is present in almost every hundredth inhabitant of the globe, and it is estimated that every fourth citizen of Europe suffers from some form of inflammatory arthritis.
In addition to obvious rheumatic diseases, pain in the bones and joints can also be the result of some kind of trauma. When we talk about trauma, we mean injuries caused during a fall, a blow, and the like.
There are several types of rheumatic diseases and conditions, and some of them are:
- gout (acute joint pain)
- arthritis
- osteoporosis (decreased bone density)
- ankylosing spondylitis - spondylosis of the spinal column (very limited mobility of the spine)
- arthrosis (changes in the small joints of the hand)
- atrosis (pain in elbow, knee, ankle, shoulder, hip, foot, toe joints)
- fibromyalgia (pain in the back muscles)
- pain and reduced mobility in the elderly
Fibromyalgia is a disease characterized by long-term, widespread pain in muscles and bones, sensitivity of certain points in soft tissues (in muscles and tendons), swelling, severe weakness and fatigue. Patients feel pain, which does not have a clear localization, deep in the body, in the muscles and bones. The intensity of pain is very subjective. The pain is felt on both sides of the body and in the arms and legs. Patients complain that they sleep badly, and in the morning they wake up listless and tired, because their sleep did not bring them rest. Another main complaint is severe fatigue and weakness, due to which physical ability is reduced. Patients often complain of general complaints such as headache and stiffness. They feel that their arm or leg is numb and swollen, although the swelling is not actually present. These symptoms cause anxiety, depression.
Osteoporosis is a disease characterized by reduced bone density, i.e. reduction of bone mass and disruption of bone structure, which makes bones susceptible to fractures. Of course, the amount of calcium in the bones, which normally gives them strength and bone tissue (supporting function), also decreases. It is believed that about 10% of the entire population has osteoporosis, significantly more often women, after the age of 50. Women have a high risk of developing osteoporosis after menopause due to reduced levels of estrogen, the female hormone that helps maintain bone mass (similar to the somewhat milder decline in testosterone production in men). Newer research indicates that the occurrence of osteoporosis at a younger age (in women) is also influenced by inadequate secretion of progesterone, because a well-balanced ratio of estrogen and progesterone is important for maintaining bone mass.
In our bone system, the processes of building and breaking down bone tissue are constantly taking place. About 20% of the bone mass is "replaced" annually. The relationship between building and breaking down bones is different at different ages. In childhood and youth, bone building processes are more dominant, and that's when the bone is built and grows. This process reaches its maximum during the third decade of life. After that period, until about the age of 50, the processes of building and breaking down bones are maintained in balance. After that period of life, bone breakdown processes dominate. So, already after the fourth decade of life, pronounced loss of bone mass begins.
NSAIDs or paracetamol are used as initial treatment for pain. Today, it is recommended that pain should be treated with analgesics with different mechanisms of action, because this improves their analgesic effect, while at the same time reducing their side effects. You can also use local treatments, gels, ointments, creams, dermal patches that will relax the muscles and at least slightly relieve the patient's acute pain.
The pharmacist's recommendation for these patients is adequate supplementation, which helps in the prevention of acute pain and long-term treatment of pathology.
In rheumatoid arthritis, according to the latest research, intensive use of supplements such as Omega-3 fatty acids, turmeric and vitamin D which act synergistically on the inflammation process. Research published in the Mediterranean Journal of Rheumatology found that omega-3 fatty acids can alleviate symptoms in patients with rheumatoid arthritis, by having a modulatory effect on disease activity, that is, on the number of swollen and tender joints. Turmeric has many medicinal properties because it contains numerous nutrients, antioxidants, anti-inflammatory compounds and phytonutrients, which are excellent in the treatment of various inflammations. Since the body is not able to fully absorb its nutrients, it is preferable to combine it with black pepper. The two active ingredients in these spices, curcumin and piperine, relieve pain and reduce inflammation.
A recent study conducted at the Boston University School of Public Health shows a significant association between vitamin D and rheumatoid arthritis. In fact, those with the lowest levels of vit D in the blood plasma (25 (OH) D ) are up to 5 times more likely to develop rheumatoid arthritis and a group of related diseases.
Some of our recommendations are Natural Wealth Omega 3, 7N Omega 3, Natural Wealth Vitamin D 1000 UI, 7N Vitamin D 2000UI or even 10 IU when vitamin D deficiency is established.
Lack of calcium in the diet is most often associated with osteoporosis. In order for calcium to be effectively "integrated into the bone", it is important to establish a balance of other minerals, first of all, phosphorus and magnesium.
Natural Wealth Osteo Complex is a nutritional supplement intended for the skeletal and muscular system, which contains a combination of active ingredients that act on multiple levels. Contains calcium, magnesium, iron, vitamins A, C, D. Osteo complex is a complete, scientifically balanced combination of calcium, magnesium and iron, and vitamins A, D and C, which act synergistically to provide optimal nutritional protection for bone tissue. Minerals calcium and magnesium help preserve bone mass, are important for muscle contraction and proper functioning of the nervous system. Iron is an integral part of many enzymes and proteins, supplies cells with oxygen, supports growth, improves physical strength and strengthens immunity. Vitamins A, C and D promote the absorption and action of these minerals, and also strengthen immunity.
Vitamin K is an important supplement for maintaining bone vitality.
Natural Wealth® K2+D3 Forte is a targeted formulation for bone health. Each capsule contains the recommended daily dose of vitamin K in the form K2-MK7 which directs calcium to the bones and 2000 units of vitamin D in the form of vitamin D3. Vitamin D contributes to the normal absorption of calcium and its normal level in the blood, and together with vitamin K contributes to the maintenance of normal bones. This combination of vitamins is ideal for optimal utilization of calcium from food and supplements and for maintaining bone health and strength. Natural Wealth® K2+D3 Forte comes in an economical package of 40 capsules and is especially recommended for elderly people.
In the case of pain in the bone and muscle system, it must be introduced Magnesium.
Magnesium helps burn fat and produce energy, which is key to fighting fibromyalgia. A study conducted at the USDA Grand Forks Human Nutrition Research Center found that postmenopausal women with low magnesium levels had less energy and did not burn fat as efficiently as women with normal magnesium levels, making physical exertion more difficult. Another study found that people who took daily magnesium supplements experienced significant improvement. Magnesium is necessary for strengthening the immune system, muscle contraction, regulation of body temperature, transmission of signals in the nervous system, mineralization of bones, normalization of cholesterol levels, normal metabolism of carbohydrates, proteins and fats and general increase of energy. Our recommendation is Natural wealth Magnesium 250 mg, Natural wealth Magnesium direct plus B-complex and C vitamin. Magnesium contributes to normal muscle function and electrolyte balance. Vitamins B2, B3, B6 and B12 contribute to the normal functioning of the nervous system and to the reduction of fatigue and exhaustion. An effective magnesium preparation is i 7N Magnesium Citrate plus Vitamin B6. Magnesium citrate is a natural organic compound that provides greater absorption than inorganic forms. Better absorption and resistance to the acidic environment of the digestive system are the two most important advantages of the citrate form. Vitamin B6 additionally increases the absorption of magnesium.
Other supplements that are just as important and can be combined with these vitamins and minerals are glucosamine, chondroitin, hyaluronic acid and collagen. With all supplements, persistence and intensity are important. They should be used for a longer period of time with shorter break periods.
Some of the non-pharmacological measures that are recommended are: anti-inflammatory diet, physical activity, exercise, acupuncture, massages, chiropractic, osteopathy.
Giulija Hadžibeti
Mr. Ph Specialist in pharmaceutical technology
