What is the maximum dose of Tylenol I can take in one day for my pain?

The maximum Tylenol dose is about 4000 mg per day, which is a big amount. It is best to take about 800 mg 3-4 times a day. If you still have pain after this, you may want to add alleve or some type of NSAID.

I have had back pain for some years and my doctor suggests I should buy a TENS device. Do these machines really work?

Transcutaneous Electrical Nerve Stimulation (TENS) is a non-pharmacological method of treating back pain. The device delivers low voltage electrical currents to the skin. TENS has been used by millions of people to treat a variety of pain disorders. Almost every healthy food store and pharmacy sells these devices. So do these devices actually work?

Review of the literature indicates that that the majority of people who used TENS found no pain relief. In fact, the pain relief by the sugar pill was much greater than the TENS device. The few people who did find relief noticed that the pain relief was very short in duration. After several months, most people found that TENS devices were more suitable as a paper weight.

So what does all this mean for the consumer? TENS mania has led to billion dollar industry which has thrived chiefly because of desperate people spending their hard earned money on bullshit devices. For the consumer with pain, do not spend your hard earned money on crap. Be knowledgeable, read about the devices before you buy them and avoid pain clinics- this is the one place where you are most likely to meet charlatans who will suck you dry.

I am a diabetic with severe neuropathic pain. Do you think capsaicin may help relieve this pain?

Capsaicin has been heavily marketed for a variety of pain syndromes. Today people buy this product and use it for the treatment of neuropathic and herpetic pain. When capsaicin is first applied, it actually worsens the pain, but then the pain sensitivity is reduced after repeated applications. While many people claim that it works, there are very few clinical studies that have actually looked at its efficacy. Based on some studies, capsaicin may work for mild neuropathic pain but complete relief is not possible. The product must be combined with other medications.

One can buy a low dose cream containing 0.075% capsaicin which can be used for repeat applications or use the 8% formula for single application. One of the most common side effects of capsaicin is the skin irritation which often leads to discontinuation of therapy. Capsaicin also does not come cheap. If you have the money, you may want to try the small dose of capsaicin. Pain relief is not instant and often takes many days. If you do not have money to waste on a product that may not work, you may want to try lyrica.

Can a cup of “Brazilian mint tea” relieve pain? Part 2

Graciela mentions that the Brazilian mint tea is very different to the taste and in fact tastes more like sage rather than mint. She added, "Not that nice, really, but then medicine isn't supposed to be nice, is it?" 

They plan to launch clinical trials to find out how effective the mint is as a pain relief for people.

Experts in pain control say that these are interesting findings and more likely to help a significant number of patients who suffer from pain.

Dr Beverly Collett, chair of the Chronic Pain Policy Coalition, said: "Obviously further work needs to be done to identify the molecule involved, but this is interesting research into what may be a new analgesic for the future. The effects of aspirin-like substances have been known since the ancient Greeks recorded the use of the willow bark as a fever fighter.”

She added, "The leaves and bark of the willow tree contain a substance called salicin, a naturally occurring compound similar to acetylsalicylic acid, the chemical name for aspirin."

But before you stock up on Brazilian mint tea for the holidays, just a final note.  Anecdotal reports claim that the beverage tastes horrible (sucks) and the pain relief is mild and not seen in all individuals.

The study is published in the journal Acta Horticulturae.

Can a cup of “Brazilian tea” relieve pain? Part 1

A recent study from Newcastle University in England suggests that Brazilian mint tea may have pain relieving properties. In fact, the tea may provide as much relief from pain as traditional drugs. For centuries, the herb hyptis crenata has been ingested by people of South America to treat a variety of medical problems including pain relief. Anecdotal reports have circulated for many years that individuals who drink Brazilian mint tea feel relaxed and have a higher tolerance to pain.

Working on mice, researchers in Newcastle proved that this herb may indeed have pain killing properties. The researchers first undertook a survey on Brazilians to determine the quantity and frequency of use of this herb for pain relief. The most common method of ingestion was to boil dried leaves in water for 30 minutes and allow the liquid to cool before drinking it as a beverage.  The researchers found that when the mint was consumed at doses similar to that prescribed by traditional healers, the beverage was as effective at relieving pain as the NSAID, indomethacin. 

Said lead researcher Garciela Rocha, "Since humans first walked the Earth we have looked to plants to provide a cure for our ailments - in fact it is estimated more than 50,000 plants are used worldwide for medicinal purposes. "Besides traditional use, more than half of all prescription drugs are based on a molecule that occurs naturally in a plant.”

She added, "What we have done is to take a plant that is widely used to safely treat pain and scientifically proven that it works as well as some synthetic drugs. Now the next step is to find out how and why the plant works."

IS TENS JUNK THERAPY?

Transcutaneous electrical nerve stimulation (TENS) is a very popular chronic pain treatment in society. Almost every family has a TENS machine. Besides mass marketing by medical companies, many physicians constantly recommend TENS for their patients. The business of pain and TENS machines is a billion dollar industry. There are TENS machine which cost a few hundred and there are others which cost a few thousand dollars. While in some cases a prescription is required to get a TENS machine, one can easily buy a TENS from any one of the online cyberspace pharmacies without a prescription. However, despite its wide usage the benefits of TENS is still in question.

A recent review by Cochrane examined both high frequency and low frequency studies in the literature. There were no restriction on where the studies were done or how many people were involved.

A large amount of data was extracted and various types of pain measures were analyzed by the researchers. About 25 studies were analyzed and only nine were found to be controlled. From the nine controlled studies, 7 studies showed no benefit of TENS. Each time a blind and randomized study was analyzed, TENS worked just as well as fake electrical stimulation (just holding a wire to the skin).

As of today in Jan 2010, there is no evidence that TENS does anything for people with chronic pain. There is not a single randomized blind study which has categorically shown that TENS works to decrease pain.

So for the time being TENS cannot definitely not be recommended for pain control. Some health care professionals who recommend these devices often have shares in these companies or are paid to give out positive reviews. The next time you get prescription for a TENS machine from a physician, go get a second opinion. Of course there will always be some who argue otherwise; for these non believers go read Cochrane reviews on this topic. Consumers should save their hard earned money for things that work and not on scam devices.

For those who hate medical jargon- in plain English- TENS is junk therapy.