As he did so often in life, Prince is once again offering us the opportunity to heal a problem that desperately needs to be fixed. Tests confirmed Thursday that he died of an overdose of the powerful painkiller fentanyl that is used to treat severe and chronic pain.
It is suspected that he is one of the 15,000 Americans who die each year from an overdose of prescribed narcotics. Having severe hip pain which did not go away with hip replacement surgery, he required the narcotic Percocet for pain relief. Although it helped, it did not do so enough. He was simply one of the 33% of Americans who suffer needlessly with pain.
Why do I say needlessly? Because despite modern medicine having many incredible strengths, it is horrible at treating pain. As physicians, we are taught how to treat the kind of emergencies that come to hospitals. This occurs, simply, because this is where we are trained. Heart attacks? Hot appendix? We’re right on top of it.
But except for using a few medications to mask the pain, or narcotics for cancer pain, as physicians our training in pain management is woefully inadequate. I discovered this first hand when I came down with fibromyalgia in medical school. It forced me to drop out of school and left me homeless for almost a year. It also forced me to learn the basics of pain management on my own, while experiencing what it was like to be on the other side of the white coat.
Nowadays, people with pain, and the physicians who treat them, face a Sophie’s choice: suffer with pain or use potentially addictive narcotics. Fortunately, there is a “door number three” to choose from.
Unlike infections, pain is not an outside enemy. Rather, like the oil light on our car’s dashboard, it is part of our body’s monitoring system that tells us when something needs attention. Different kinds of pain tell us different things. To extend the analogy, medicine treats the flashing oil light by either putting a Band-Aid over it, or by trying to disable the flashing red light. We never even think about simply putting oil in the car. Which is the safest and best way to make the annoying flashing light go out.
Looking at Prince’s case, it was likely that the hip replacement did not work because it did not address the real underlying problem. Studies and clinical experience have shown that what we see on the x-rays very often have very little to do with what is actually causing the pain. For example, many marathon runners, with absolutely no pain at all, will have hip x-rays that likely looked worse than Prince’s.
Often, the actual cause of the hip pain comes from the muscles and ligaments surrounding the hip. By simply treating these, the pain could’ve gone away. Without the need for surgery or narcotics. Sadly, most physicians are simply not trained in doing an exam for muscle (or myofascial) pain. Despite causing the majority of pain in this country, muscle pain does not even cross their mind in most cases.
My experience with fibromyalgia, which begins as widespread muscle pain before morphing into other kinds of pain, helped me learn how to diagnose and treat tight muscles. Muscles are like a spring. They take more energy to relax than to contract. This is why after a hard workout you come home and say “Honey, my muscles are so tight,” instead of complaining how loose and limp they are.
The brilliant work by the late Prof. Janet Travell, the godmother of pain management and the White House physician for presidents Kennedy and Johnson, taught us the importance of treating the underlying causes of our muscle’s energy crisis. This included treating the structural issues by releasing the tight muscles, as is done in many forms of bodywork including chiropractic and osteopathic manipulation. In addition, it is necessary to treat the underlying biochemistry to restore adequate energy in the muscles. Our published research showed that by treating with what we call the “SHINE Protocol,” optimizing Sleep, Hormones, Infections, Nutrition, and Exercise as able, 91% of people with fibromyalgia pain improve, usually dramatically. Dr. Travell found that treating these same issues often helped dramatically with muscle pain in general.
Similarly, research has shown that treating the root causes can also be very effective for migraines, arthritis, and a host of other chronic pains.
A problem? These treatments are generally very inexpensive, so that the research done on them does not get much attention. But they do offer the possibility of treating chronic pain very effectively and safely.
Prince’s death is a tragic loss. Yet, it also provides us with a powerful opportunity. A fitting tribute to Prince? It’s time to apply the extensive but ignored research on treating the root causes of pain. This can prevent tens of thousands of needless deaths, and eliminate the unnecessary suffering of millions.