Conquering Chronic Pain

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Hey, it's JJ Virgin. And welcome to the JJ Virgin Lifestyle show where I talk nutrition, exercise, mindset and lifestyle with some of the coolest people in the world. Plus, I give you tips that you can put into fast action to uplevel your health so you can go out there and live that big life you're meant to live. Now, today's show is all about conquering chronic pain because let's face it, if you're under a ton of pain, if you're in pain, you are not going out there and living that big life that you were told to live, right? And it turns out that there are some pretty simple things you can do. Some of them you're probably already doing if you're following the Virgin diet and or Sugar Impact diet, but some you may have been that can make a massive shift quickly. And then one thing that you can take that can help you get off any of those pain medications because as you'll hear in my Talk today with Dr. Joe Tada, pain medications can really create a lot of problems with food intolerance and leaky gut. Now let me tell you a little bit about Dr. Joe. I met Dr. Joe. He's a member of our mindshare community. And one of my fondest memories of Dr. Joe, well, there's actually a couple. One was when he told me I was absolutely fine to dance on my knee replacement, which was great. And he was right on. And the second one was when we were doing kind of a team building ropes course and he as an old gymnast did a big dive over all these ropes. Super awesome, great guy and really smart. He has an approach to pain that you've never heard before. And I'm so excited that he's getting it out into the world now with his book coming out in February 2017, Heal youl Pain, a revolutionary program to reset your brain and body for a pain free life. Let me tell you a little bit about Dr. Cho Tada. He's a doctor of physical therapy and a certified clinical nutritionist. I don't even know if there's other people who have that combo, but it's such an important combo to have. He has a big mission, and that's to transform the health of 20 million people and reverse our chronic pain epidemic. He's the creator of the first ever Healing Pain online summit designed to broaden the conversation around natural strategies towards solving persistent pain. He's got a private practice in New York City with a focus on functional nutrition and physical therapy. And you can learn more by going to drjotada.com all right, so again, today's guest is Dr. Joe Tada. All right, so let's do it. Dr. Joe Tada, welcome to the show. I am so glad to have you here with me today.

Thanks, jj. It's great to be here on your podcast. I'm so excited to talk to you.

Well, this is such a cool subject because you really have created a whole different way of thinking about pain and handling pain and kind of breaking through pain. So really important topic and we really haven't talked about it on the podcast. So I'm excited to dive into it with you. And let's talk about what the current state of the union is with all of this. Like, how are we currently dealing with chronic pain and why has it just been such a failure?

Yeah, it's a great question to start with. And I think if you, you know, have followed the news at all lately, you realize that we have a chronic pain epidemic. And along with that, we have an opioid epidemic that has kind of followed suit. So, you know, over the past 50 years, we have some really good medications that work really well for things like cancer, pain and end of life. But when we're talking about the kind of everyday aches and pains and the chronic musculoskeletal pain that we have and some of the autoimmune diseases that we know we can make an impact on, opioids really don't work for those things. So, you know, we're really moving rapidly away from the long term use of opioids. And in fact, you know, opioids should not be used for chronic pain at all for most people. So that's kind of where we are currently. We really have turned to medication to really solve a problem that really needs a lot of integrated strategies around it.

So now, of course, want to know the integrated strategies. But before we get get there, you know, we have all these different tests and treatments and stuff available for pain. So if we have all this stuff available, then, you know, you just said, hey, there's a chronic PA epidemic. It doesn't take a genius to figure that out. Like you go to the you know, you go to the pharmacy and you see just even all the OTC stuff out there. It's crazy. So, you know, are we just looking at this all wrong? What's going on?

Yeah, I mean, we have some really incredible tests, and those are things like X rays and, you know, MRI imaging, which give us amazing pictures of the body. However, when it comes to chronic pain, we know that those imaging studies or those images really are poor. They don't correlate well with people's pain because pain is a very individual circumstance. So the pain you feel is very different from the pain I feel. So the best example around that is a herniated disc. If I pulled 100 people off the street and did an MRI of everyone's spine, most people would have some kind of herniation in their back. However, some people would have no pain at all. And even people that have herniated discs on studies and they looked at research, up to 75% of them have absolutely no pain at all. So imaging studies are important when we talk about identifying things like cancer and tumors. But again, when it comes to the osteoarthritis, the herniated disc, these are things like. Think of it like gray hair. We all have a little bit of gray hair. We all have a little bit of balding here and there. But the truth is, it doesn't mean that your joints are falling apart, doesn't mean that you have to be in chronic pain for the rest of your life.

So someone who is in pain, and I had my share of pain, although I just kind of ignored it for 20, 30 years. 30 years, actually. 30 years, 35 years. What's the biggest driver of all this pain?

Well, the biggest driver. And if we look at studies, we see this as people's BMI goes up, so as their weight increases, their pain increases. It's kind of very simple. And I think if you're reading the research or you're talking to your patients and calculating bmi, which most clinicians are doing, you're seeing those correlation. So, you know, most of us know that obviously, the more weight you put on, the more pressure that is on your joints. And I tell people, for every £1, it's like adding four extra pounds on your joint. So that's, you know, pretty basic biomechanical. But the more important thing is, you know, we need to kind of look at this on a deeper level, kind of on the, you know, biochemical level, that the fat cells, especially the ones around your belly, they're biologically active. So they're producing these inflammatory chemicals. So when we look at that belly fat and how it relates to all the diseases we have, the diseases of inflammation, the metabolic syndrome, type 2 diabetes, autoimmune disease, even some of the neurodegenerative diseases, most of those have pain as the primary symptom. So, you know, fat puts pressure on your joints, but also those chemicals are really inflammatory, and that's what we have to kind of try to do a better job at making the public aware of.

Yeah, no one's talking about that, which is so crazy.

Yeah, you know, it's kind of just some basic, you know, science and basic chemistry. And, you know, it's interesting. Like, now Medicare makes every single practitioner calculate bmi, but we really have to kind of talk about it in different terms. And we know, jj, that when you educate people, that's really half the battle in getting them to their health transformation.

Well, once you measure, you can improve. That's why it's like, I look at things and go, guys, we need to weigh in every day, but we need to do body fat, and you need to do waist measurements, because that's what's really making a difference, like losing weight, not losing your waist. And here, if you're in pain, you've got all those inflammatory cytokines in your abdominal fat, and it's just creating a problem. So, yeah, it's a great thing for people to start to consider, because it really, really is never talked about. And I know with me, back when I was pregnant, obviously I had the extra weight from being pregnant, but I was also being a. I was eating really wrong stuff. Let's be real. I was eating, I gained way too much weight, and I gained a lot of body fat. And Bo, boy, did things hurt then. So living proof of it. You know, one of the challenges I saw back when I was a personal trainer is my area of specialty was spinal biomechanics and back pain. Because I went, well, if I'm going to focus on something, I should focus on back pain, because everybody seems to have it right. But the challenge was I knew that if they moved, it got better, but then they hurt, so they didn't want to move. So how do you deal with that?

Yeah, I mean, you know, obviously, as a physical therapist, exercise is one of the primary things that I'm talking and using as a treatment modality. Some of the most interesting information that we have coming out around pain is that when you have chronic pain, chronic pain is defined as pain that lasts longer than three months when you have Chronic pain. There are these maladaptive changes that start to happen in your brain. We're rapidly shifting away from looking at the joints as a source of pain and looking to the brain. So we're realizing that once you have pain and that pain is constant, or you have fear, or this constant stress in your life, or there's a lot of immobility, what happens is you start to develop what are called fear avoidance behaviors. So as you fear certain movements, your brain begins to learn, it begins to take note. And what's really important for people in chronic pain to understand is that pain is really just a danger signal. It's just telling you that something could potentially be wrong. Now once people understand that, that the cause is not actually coming from the joint, but it's actually coming from kind of these neuroplastic changes that have happened in the brain, then they start to understand that, okay, I can hurt a little bit, or I can be a little bit sore with exercise, but I'm not actually harming myself. So a little bit of movement each day or a little bit of movement each week, as you start to increase that more and more, you start to kind of quiet your brain down. You start to kind of quiet the nervous system down. You retrain your brain and that danger signal goes away. So you can basically move and live a pain free life. And obviously the more you move, the less pain you're going to have.

And I guess it's an important message for people to hear is that when you do this, you actually are going to make it better, not hurt yourself more over time.

That's right, yeah. Obviously if you haven't exercised at all, then you're not going to go join a CrossFit class, let's say. But just starting out a little bit and progressively working on that, you know, you quiet the nervous system, you release all sorts of wonderful chemicals in your brain that act as natural opioids that we can, you know, we produce that naturally. We don't have to take that from, you know, a pill or a bottle basically. And little by little you start to feel better, you move better and really your entire life changes. Now you can, you know, do your activities, go out with your friends, socialize more, you know, play with your grandchildren, things like that.

So the other thing that I see you doing that is also unique, which is amazing to me that it's unique because it seems like it should be standard. And my big hope is that with your big book coming out, Heal youl Pain now, that people will start to get this Is that diet is important here. So, you know, what do you see as the big blunder that people do when they're in pain regarding their diet?

I mean, nutrition and diet is so important when it comes to pain management. Once I started studying nutrition, it's like my entire brain just like expanded 10 times. I think still today the biggest thing that I see with clients is that they fear fat. And I really want them to know that fat is their friend. And of course we're talking about the right fat because fat can be extremely anti inflammatory. So we're talking about the omega 3 fats, obviously. And there have been studies where they actually take people who have arthritis, they give them some omega 3 fatty acids, about 2000 milligrams, and they compare that to NSAIDs or things like Advil and Aleve, and people actually do better with the anti inflammatory effects of the omega 3 fatty acids. So they see that cartilage height changes, so you can actually regain back a little bit of your cartilage. Your bone health improves, your A1C levels start to lower, which is directly correlated to inflammation. Cytokines decrease. So fat is probably the biggest misa people, they're still scared of fat. I had a client a couple weeks ago saying I'd like to eat more fish, but I'm kind of scared of that oily fat in it. And I'm like, oh no, that's the most important thing you should have in your diet as far as decreasing that inflammation which leads to pain.

Yeah, it is amazing to me that people are still afraid of fat. And you know, having. I tore my ACL and really messed up my right knee when I was 17 and lots of surgeries. Nothing was, nothing really helped it in terms of stuff. And they said, oh, you're gonna have to have a replacement. Well, I put that off for like what, like 40, 30, a lot of 40 something years. And a lot of that was obviously, you know, staying at the right weight. But fish oil was like, why isn't fish oil the first line of defense here? It's amazing what it can do.

Absolutely. I mean, if you look at the studies on osteoarthritis, rheumatoid arthritis, almost every single autoimmune disease, they all do really well with fish oil and the omega 3 fatty acids. Now, of course, if your diet is already high in omega 3s, you only may need 1000 or 2000 milligrams. If your diet is really poor and you're working off that standard American diet, you may actually have to go up to 5,000 milligrams and stay there for a couple months before you see improvements. It's not a quick fix, however, it's a much safer fix because the side effects are almost really none to them.

Yeah. And a lot of these pain medications, since my world is food intolerance and gut health is, gosh, one of the biggest things that these pain meds do is just havoc on your gut, can cause leaky gut, and then food intolerance, then that starts to cause more pain. It just becomes a super vicious cycle. So let's. We're up against the time, and I'd love to hear, just in closing, like, what's one big strategy that you want to recommend to everybody they can get started on now?

Well, the one big strategy is first, you know, realize that hurt doesn't equal harm, and you need to include a little bit of healthy movement in your life. And then if I, you know, put on my other hat, the nutrition side, and I say, okay, what's the big needle mover? I would say take gluten out of your diet for 30 days and see how it affects your pain. And when you look at gluten, it really helps all sorts of pain. Everything from migraines to headaches to joint pain to autoimmune disease. It really can be the one needle mover that obviously will heal your gut and start to take your pain away.

I love that you said that, because as I was first working with pulling gluten out of people's diets, I wasn't aware of this connection. And I had this one client who'd had chronic tendonitis, Achilles tendonitis, for a year. She was going to pt, not you. Unfortunately, every week, three times a week, no help, she pulled gluten out, and it was gone in a week. I was like, yeah. And I was like, what? What? How could this be?

I love it. I mean, you know, if you think about it, obviously, you know, you have these inflammatory proteins that circulate around your body, and they store themselves in tissues. Most of the tissue in your body is musculoskeletal. It's either muscle or it's bone. So the link between gluten and pain is so strong. I really recommend everyone, you know, trying that.

Yes, I love that. That is so awesome. Now, I know that you've got a big book coming out, but you also have an ebook so that people don't have to wait. And that is at, I think, drjotada.com let me spell that, because it's a little bit. It's just like it sounds, but so it's D R, J O E. And then tata is. And I always love this. When I first met you, I'm like, I love your last name. T A T T A. So drjoetada.com and what do they get in there? What's the ebook that you've got there for them?

So they get a guidebook to healing their pain. Now it's a complete guidebook around all the strategies they need to address all sorts of pain. And that's free on my website@drjotada.com awesome.

Because you know what? Gosh, when you hurt, everything goes down. So this is such an important thing. And I've never seen anyone tackle this this way. I'm so excited that you're getting your work out into the world. So thank you. And now after the break, I'm going to be answering a listener's question. So stay with me.

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Welcome back. Now, this is the time where I answer a listener's question. And today's question fits so well with our topic, which is why I picked it. And it's from Robbie from Cincinnati. And he says, jj, you talk about fish oil all the time, and I'm unclear as to how to know exactly how much I should take. All right, Robbie, thank you for that question. And it's such an important question, so I will share with you that I've been taking fish oil for years and years and years, mainly because, as you heard from Dr. Joe, it can help with reducing pain and inflammation.

And I had a chronic knee injury.

And I was able to live on this knee injury. People are like, I don't even know how you're walking. I was bone on bone for years and years and years, and I credit a lot of that with fish oil. One of the things fish oil does is it acts like a natural NSAID in nature's N ibuprofen, and it can reduce inflammation. It also helps with bone remodeling. It also helps give you a great, healthy brain because your brain is made up. You're a fathead, basically, and especially an omega 3 DHA fat head. It can Help with a great mood. It can help lower triglycerides and can help with good, healthy blood flow. It's good for your hair, skin and nails. I mean, just. There's so many amazing things that omega 3 fatty acids do. Now, it is rare that I find someone who doesn't need to supplement with them because most of us are not getting enough from our diet. Most of us are not eating fish for lunch and dinner every single day, right? And of course, nowadays we got to make sure we're getting really clean fish. And that's one of the nice things when you're getting a high quality omega 3 fatty acids, is, you know, that it's not oxidized, that they've gotten it right off the boat and processed it immediately. So the Omega 3s, which are very fragile and when exposed to air, can oxidize, which makes a good thing. Bad, bad. That doesn't happen. And it's also been cleaned and cleared for heavy metals and pesticides and all things that fat can pick up. So you want to make sure that's why, you know, especially with pregnant women. But overall, you're better off supplementing with fish oil and then of course, really making sure that the fish you eat is clean. So how much do you need? Full disclosure. My son, who had the traumatic brain injury, I think one of the reasons, I know one of the reasons he's made it through that and then is thriving now. And I'll tell you what just happened and how he made it through is because he was on 5 grams of fish oil before his accident. We put him on 20 grams of fish oil to help heal his brain, and then he stayed on 6 grams of fish oil. He then went down to 10 for a couple years, and now he's on 6 grams of fish oil a day, and he eats a lot of fish. And unfortunately, last night he cut his hand while cutting a mango, and it was a really bad cut. And he then passed out in the bathroom and hit his head on the bed and not only cut his hand and cut his head and had to have his head stapled, like stapled back together, the 4cm centimeter cut and had to get a CT scan, but actually turns out didn't have brain swelling, didn't have any of the things that should have had when you pass out, hit the side of a bathtub and then remain unconscious for about a minute. So I looked at and went, oh, thank God. I mean, and initially, then of course, we just put them straight back on 20 grams of fish oil for the Next week, and then we'll take them down to 10. So the real issue is that how much fish oil do you need? It depends. In the perfect world, you would go to your functional medicine practitioner and you would have them run a fatty acid test on you to look at your 3, 6, and 9, and especially your omega 3 to 6 ratio. And depending on what you're trying to do, if you've got a mood disorder, if you've got things going on cardiovascularly, if you need help with osteoporosis, you would decide where you want to be in that ratio. Most of us have way too many of the sixes, which are generally pro inflammatory, and too many of the nines and not enough of the threes. And you want to achieve that balance. You don't want to go overboard on the threes because that's problematic too. So you have to have this nice balance between them. What I find with most people is that nice balance if they're eating a good, healthy diet. If you've been following the sugar impact diet and or virgin diet and gone through that process to figure out what's your best way to eat, then you're already incorporating fish a couple times a week. And for most people, if they're not eating bad fats and they're eating good healthy fats, their diet, 2 grams of fish oil a day is awesome. But therapeutically, I will take people up to 5 to 10 grams. That again, depends on what's going on. If someone's gone through what my son went through with a triad brain injury, then the protocol for that, based on work by Dr. Michael Lewis and Dr. Barry Sears, is 20 grams and then tapering. So ideally, again, test. But in the absence of that, I would say if you've got a crappy diet, just like Dr. Joe talked about, fix your diet. Go on the sugar impact diet or the virgin diet, depending on where your biggest needs are first. I think everyone should go through both of them to really dial their diet in so it works for them for the long haul. And initially go to five grams, and then after three to six months, take it to two grams. And make sure you're getting in some good, clean fish every day. All right? Every day. I mean, a couple times a week. All right. If you'd like to submit a question, just go to JJ and you can leave a voicemail for me. I love hearing from you. And one more way, I'd love to hear from you. I would so appreciate it if you could jump on Stitcher or itunes and leave a review for me. It helps a bunch and be sure to subscribe and share the show with your friends. This is JJ Virgin signing off and reminding you that you are worthy. Dare to live a life that matters.

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