Ep47: How to Deal with Chronic Pain (Management Tips) • Dr Daniel Lewis

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Dr Daniel Lewis
Dr Daniel Lewis: Rheumatologist and Consultant Physician

In today’s interview I get to speak with Australian rheumatologist & consulting physician, Dr Daniel Lewis, about using natural approaches to manage chronic pain, how to reduce inflammation, as well as, maintain general health and wellbeing.

Daniel is very passionate about using the best scientific, evidence based, balanced approach to the diagnosis and treatment of joint pain conditions. Plus, where possible, utilizing lifestyle factors such as diet and meditation to achieve positive results.

In today’s interview we also get a chance to talk about the strong connection between the mind and body and the effectiveness of meditation in managing stress and mitigating its negative effects on our pain levels.

If you know someone who is interested in how natural approaches can help manage chronic pain and reduce inflammation, or, how lifestyle factors such as diet and meditation can impact our health, then this interview is for them.

I enjoyed this interview because I have always had a keen interest in how our mind and our thoughts can impact and change our physiology. I have been more aware of this strong connection after starting my personal brain training experiments (see my Neurofeedback Training Experiment Updates playlist on YouTube for more).

Special discount code offer on Dr Lewis’ Meditating Pathways to Wellbeing audio guide. Go to the the Lewis Institute website here and enter the coupon code “biohackerslab10“, without the quotation marks, and you will get the discounted price off the RRP price at checkout.

Special thanks to Daniel for joining me on the show. Enjoy the episode!

Visit Dr Daniel Lewis website The Lewis Institute for more information or follow him on Twitter.

Show Notes with Timestamp Links

Highlights of what we talk about during the interview:

Click on one of the timestamp links in the brackets to jump to that point in the interview audio.

[00:00] – To get a discount for Dr Lewis’ Guided Meditation Program go to the lewisinstitute.com.au website and enter the coupon code biohackerslab10 at checkout.

[00:42] – Introducing Dr Daniel Lewis, a rheumatologist and consultant physician from Melbourne, Australia who is a musculoskeletal, arthritis and pain management specialist with over 25 years of experience with patient care. He focuses on the best scientific evidence available to guide treatment decisions; including (where possible) safe lifestyle, nutritional and non-drug treatment options.

[01:38] – What are rheumatologists? They are medical doctors who are not only specialised to help manage joint pain, but they also look after immune conditions, such as, rheumatoid arthritis and lupus. Rheumatologists can help with all musculoskeletal injuries, plus individuals with both severe acute pain & chronic pain issues, like fibromyalgia and chronic fatigue.

[03:38] – Daniel explains how the growing understanding about the interconnectedness of the microbiome in our gut and the immune and nervous system function means that the way we are approaching disease is changing. There is often a common causality to a variety of conditions. So, before we can develop an effective treatment, it is key to uncover the underlying driver of the symptoms.

[04:55] – While an orthopaedic surgeon deals with acute interventions, or people dealing with acute post-surgical pain or chronic pain from an isolated perspective, a rheumatologist mostly partners with patients on a longer journey and understands the nuances of pain. (Listen to orthopaedic surgeons, Dr Shawn Baker and Dr Gary Fettke interviews on managing health)

[06:04] – What inspired Daniel to focus on natural approaches to pain management were his own discoveries and interests in personal health, rather than his medical training. He explains how the 12 Pathways to Wellbeing program he teaches stems from original ancient techniques.

[07:55] – When we have a problem the first thing we need to do is look at where the gaps in our lifestyle are. Daniel developed the 12 Pathways to Wellbeing program in order to give people a road map that will help them check where they are in terms of each aspect of their lifestyle such as exercise, nutrition, stress, breath awareness, the connection between mind and body, and service to others. There are 12 in all and each is backed with very good quality evidence that shows they improve quality of life.

[11:34] – The answer to which dietary choices are best for reducing inflammation in the body is changing almost weekly as we learn more about how nutrition interacts with our gut bacteria. We know polyphenols block the effects of inflammation. We also know sugar, toxic oils and hydrogenated fats promote inflammation. Some key things to focus on include fibre to encourage good bacteria to grow, eating nutrient dense foods, good quality water and polyphenols. And finally, identifying and avoiding foods that you don’t respond well to.

[15:45] – Often by changing our diet we are changing our gut flora and this can be very beneficial to most people. Daniel always recommends for people to try anti-inflammatory diets, which there are many versions of; the autoimmune paleo diet and the low carb high healthy fat diet (not necessarily ketogenic) are just a couple of examples. He believes that if someone has a chronic autoimmune disease, chronic pain or inflammatory condition and they can only focus on one thing – after meditation – that should be food.

[18:24] – What are some recommendations for supplements for joint care and pain management? Daniel explains that before recommending supplements the individual needs to get some tests done and look for deficiencies that need correcting. Following that, if he could only recommend one supplement it would be a good quality Omega 3 fatty acid in anti-inflammatory doses – the Omega 3 to Omega 6 ratio almost always needs correcting and can make a huge difference. For more information on how to find a good quality Omega 3 supplement see article on his website.

[20:52] – There is a blood test to test the ratio of Omega 3 and 6, but unfortunately it is not readily available. We are still lacking a good quality test to give us instant feedback on our nutrition. C-reactive protein (CRP) is the go-to test when testing for and monitoring inflammation. The lower the number the better; there is strong evidence showing the higher it gets the more mortality and morbidity is affected. Daniel explains how in some cases, adjusting lifestyle factors alone is not enough to bring inflammation down and medication is necessary.

[25:14] – There is a powerful connection between the mind and the body and we can change our physiology by mental processes. As we age, and our telomeres shorten, our cell’s ability to replicate slows down affecting our quality of life, mortality and morbidity. Nobel laureate Elizabeth Blackburn’s work on telomeres has shown that stress accelerates this process and daily meditation slows it down. Some other things that are believed to influence telomere length include a good anti-inflammatory diet, doing things for others and expressing gratitude.

[29:03] – The more immediate impact of meditation is reducing the negative effect stress has on immune function and inflammatory processes. Daniel explains how excess daily secretion of cortisol can be linked to, up to 85% of ill health and how having a mindful practice such as meditation resets the cortisol and rebalances the body.

[31:47] – We now know everything is linked and our thoughts are picked up by every cell in the body. In Psychoneuroendocrinology or Psychoneuroimmunology, these relationships are studied and quantified using blood markers. Daniel explains how the involuntary or autonomic nervous system which is made up of the parasympathetic and sympathetic systems is often out of balance, and meditation helps with this. There are a number of ways we can quantify when we are out of balance using biofeedback devices including the Oura ring, for example, which continuously measures the variable heart rate (VHR). (Biohackers Lab Tip: listen to our interview with Oura ring CEO Petteri Lahtela for more information).

[36:52] – We talk about using all our sensory inputs such as breath, smell or sound to change the state we are in. Listening to goosebump music i.e. a song that puts us in a good state or smelling essential oils – or other smells that bring back good memories – are great examples of this. Daniel explains how virtual reality is also helping people with chronic pain.

[39:28] – Daniel shares some exciting new research where an electrode was inserted next to the vagus nerve in people with rheumatoid arthritis and by stimulating the vagus nerve they saw the CRP blood levels plummet. There are now double-blind controlled trials testing a small device’s (which is used to stimulate the vagus nerve) ability to control migraine and headache pain.

[42:12] – With so much information available it can be tricky to sort out all the facts and find the best approach. Daniel recommends the best thing people can do to save time, energy and money is to find a knowledge guide – you don’t need to do it all on your own.

[44:09] – Daniel also believes physicians should have a balanced approach: utilising highest quality medicine both in terms of diagnosis and plan of treatment and where necessary using medications to achieve results that can’t be achieved otherwise.

[46:22] – In some cases, the diet and lifestyle modifications result in improvements that mean the patients can go off medication. Daniel explains that, despite the positive results his patients had on a specific diet plan, they all chose to take medications rather than stay on the diet. It is not always a lack of knowledge that is the problem, rather it’s the implementation that can still be a challenge.

[48:37] – Daniel’s program, Pathways to Wellbeing Meditation Audio Guide teaches people how to meditate independently without a meditation app or other assistance. It is available on his website and the first two pathways are free for people to try.

[49:37] – To follow Daniel and find out more about the Pathways to Wellbeing go to his website: lewisinstitute.com.au, where you can find links to numerous resources including his pdf with more information on the pathways, his blog, newsletters, Facebook and Twitter page.

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