Discussing Pain Management

By Ben Sheard

Disclaimer: I am not a medical professional, and this advice comes exclusively from my own experiences, along with similar experiences by close friends.  This is merely a run-down of the pros and cons within different methods of pain management.

Anybody who has been powerlifting, or strength training in any capacity long enough knows that aches, pains, and unfortunately injuries are all part of the game.  Some injuries are preventable through prehab, stretching, and mobility work, but aches, pains, and injuries will happen.  How you choose to deal with that pain is up to you.  There are many methods of pain management available to athletes.  Some will have short-term benefits but also can lead to long-term damage and side effects that you will ultimately have to deal with.  NSAIDs, prescription opioids, kratom supplementation, topical pain relief cream, CBD oil, and even medical marijuana are several ways that athletes can manage pain. Pain is a problem and usually needs to be treated; you need to do it in the safest way possible.

NSAID (Non-Steroidal Anti Inflammatory Drugs) are widely used to help with aches and pains associated with sports injuries.  These include over the counter options such as ibuprofen, aspirin, naproxen, and prescription NSAID’s such as Diclofenac and Piroxicam.  NSAID’s block the effects of chemicals that increase the feeling of pain.  They also help to reduce the swelling that can sometimes be the root cause of the pain to begin with.  These provide short term relief and should not be used daily.  Although it is common for people to be using these medicines daily, it is also common that people incur serious damage to their internal organs due to overuse/misuse.  Every year over 100,000 individuals are hospitalized and over 16,000 are killed from the side effects.  Typical long term side effects are damage to the gastrointestinal tract (esophagus, stomach, small intestine) in the form of bleeding ulcers.  More than half of all bleeding ulcer cases are a result of the overuse of NSAID’s.  High blood pressure and kidney damage has also been observed as a side effect.  Although these are pretty serious problems, they can be avoided for the most part by only using these drugs when it is absolutely necessary, and in moderation.

Prescription narcotics are an option that have been highly overprescribed by doctors and abused by patients.  I have done enough real world application of abusing these medications personally and know enough to better inform you of the possible (probable) risks. Prescription narcotics include Vicodin, Percocet, Dilaudid, Morphine, and my old favorite, OxyContin.  The only benefit to these drugs is that they mask the pain and make you feel good enough at first to not notice how much pain you are really in.  Unless you have a chronic condition that needs to be treated, you most likely do not need this level of pain relief. The potential for addiction is not only great, but for the most part is imminent.  After using narcotic pain relievers for a few days, your body will develop a physical tolerance for it and become sick without it.  Even those without an addictive personality will fall into the trap after realizing their body goes through flu like symptoms without it.  You don’t want to be trying to manage your pain this way, and end up selling mom’s wedding ring to keep from getting sick.  There will be some people who disagree with this, but if you don’t have cancer or any kind of terminal illness, you will be much better off staying away from this method of pain management.

Kratom is a natural supplement that has been around for ages, but only in recent years has it seen its popularity increase.  There is a reason for this and that is the fact that several strains of kratom leaf are very good at relieving pain.  Like marijuana, it has many different strains from different locations and different parts of the plant used for different medical needs.  The positives here are that you don’t need a prescription from a doctor to acquire it, and it can be very good at mimicking the effects of prescription narcotics.  There are definitely some negative effects associated with kratom use, especially if used often, or abused in heavy amounts.  Since it is good at imitating the positive pain killing effects of opiates, it also unfortunately has some of the negative effects of opiates.  Although the side effects are to a much smaller degree, the potential for abuse and physical addiction exists.  Anyone using kratom daily will develop a tolerance and physical addiction towards it.  This means feeling less than your best and physically ill to a certain degree without it.  If one were weighing the options on whether to manage their pain with prescription narcotics or natural kratom supplementation, I would without a doubt recommend the kratom over anything you get from a doctor.  Side effects have not been fully researched since it is not a federally regulated drug, so long term effects are fairly unknown.  Cases of liver and kidney damage have surfaced in heavy users, so caution definitely needs to be taken when considering this option.

Topical pain relievers do exactly what one would assume they do: they relieve surface pain through use of a topical ointment, cream, or gel.  Icy Hot, Bengay, Tiger Balm, and others all work essentially the same way. Although they may contain different ingredients, most create a burning or cooling sensation that distracts your mind from the pain.  Capsaicin is the main ingredient in chili peppers and also one of the most effective ingredients for topical pain relief.  Another topical method of pain relief comes in the form of hot and/or cold packs.  Ice is always used immediately after a sports injury because it numbs the sore areas and reduces the pain and swelling of the injury.  Heat packs or heating pads relax your muscles and dilate blood vessels to send more oxygen and blood to the afflicted area.  These topical methods of pain relief are the best options when weighing the pros and cons because they cannot be overused or abused, and will cause no long term damage to your body at all.  Consider this your first and best option for all injuries/aches/pains.

CBD (Cannabidiol) is a popular natural remedy that can be used as a method of pain management.  CBD is one of the chemical compounds found in marijuana that provides relief of pain and other symptoms without the psychoactive component attached to it.  CBD oil does not produce any kind of “high” associated with marijuana but can provide the pain relief that marijuana has been used for centuries.  Studies have shown that CBD may help reduce chronic pain by impacting endocannabinoid receptor activity, reducing inflammation, and interacting with neurotransmitters.  It has been effective in reducing pain associated with diseases like multiple sclerosis and rheumatoid arthritis.  Outside of pain relief, there are studies that have suggested many other benefits of CBD use.  These include reducing anxiety and depression, insomnia, acne, heart disease, nausea, vomiting, and may help stimulate appetite.  Negative side effects noted in studies include diarrhea, changes in appetite, and fatigue.  It is also known to interact with several medications, which can cause harmful interactions.  Like kratom, CBD is a natural product not regulated by the federal government.  Because of this, limited studies have been done and long term side effects are unknown. At this point, it is still a very good option for those seeking pain relief, especially over most of the other methods.  Use caution, but consider this an option before kratom, or narcotic pain medication.

Finally, THC/marijuana has been used as an option in pain management longer than any of the other methods combined.  Let’s be clear; I’m talking about medical marijuana where it is legal.  I don’t want you to go out and take my advice here and get fired from your job.  The stigma that surrounds marijuana is becoming less of an issue, and the medical community has embraced it in individual states. Reasons for this exist because it has shown an improvement on pain management patients with less side effects than previously mentioned prescription drugs. Outside of the lethargy, anxiety, and increases in appetite that may occur, side effects are relatively limited.  Similar to the kratom leaf, different strains are available for various ailments.  Indica strains have been shown to improve headaches, neuropathy, muscle spasticity, joint pain, and insomnia.  Medical marijuana offers a safer alternative when weighing the side effects against other treatment options.  Pretty much any useful treatment option that does not involve the risk of addiction and physical withdrawal is a must before considering opiates.

There is also the option of just trudging through the pain you may be experiencing as an athlete.  For the most part, powerlifters have a relatively high pain tolerance and only seek treatment options when it becomes overwhelming. There are many options for pain management as mentioned above, and most need to be better informed before deciding on how to manage it.

To read more from Ben and to follow his training leading into his upcoming meet, check out his Author Page.  If you’ve been dealing with pain yourself and need some advice on how to trouble shoot your lifting to see if there is some root cause, consider submitting some video into our Q&A section and get some insight from our industry experts!

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Ben Sheard

Ben Sheard started powerlifting at age 13, competing in single ply from 1999-2004 back in his home state of Ohio. He started powerlifting again in 2014 after struggling with substance abuse/addiction for over 10 years. Competing as a raw powerlifter, he achieved an Elite Total at 198 lbs. Best raw lifts at 198 are 611 squat, 352 bench, and a 606 lb deadlift. Recently made a transition to Multi-Ply in 2017. Coached by Brian Carroll using 10/20 Life, he achieved a Pro Total in his most recent meet at 198lbs. Best equipped lifts in a meet are an 804 squat, a weak 463 bench, and a 700lb deadlift. He is a NASM certified PT, but works full time as a Supervisor at a Drug and Alcohol Treatment Center in Deerfield Beach, FL. Currently training out of Boynton Barbell Center in Boynton Beach, FL. Ben will be competing next at the XPC Pro Day in Columbus, where he looks to secure a 2,000+ lb total at 198.
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