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Pain patients come to the doctor expecting medication to relieve their pain. They have also learned to expect that their dose
of medication will have to be increased with time as their body becomes ?used to? the medication. Patients and disability
adjusters expect the dose of medication to be sufficient for patients to be able to ignore their ?problem? and function well
enough to hold a job. On the other side we have learned that combinations and high doses of these medications can be lethal,
and regulatory agencies have acted aggressively to protect the public from both well meaning physicians and ?pill mills.? Truth
is known however, narcotic pain medication in reasonable doses does not work well enough to stop severe pain and allow
activity for employment. Doses of medication that are high enough to work well can be fatal, and equally important, there
is a reason for narcotic medication to show decreasing efficacy with time, and it is not tolerance. Usual doses of medication
should not have to be increased with time to maintain efficacy. Surprisingly, the great equalizer is our patient?s choices of food.
Indeed there are foods that not only increase inflammatory pain; they also decrease the efficacy of narcotic pain medication.
When these foods are discontinued, narcotic medication resumes its efficacy and lower doses are again effective for reducing
pain. With this information, the doctor can put more of the burden of pain relief back on to the patient, expecting medication
to work better, and at lower doses. Learning to teach patients that exacerbations of pain are due to food choices more than
physical activity and insufficient doses of pain medication reduces patient manipulation and improves patient outcomes.
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