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From the Townsend Letter
November 2016

Anti-Aging Medicine
by Ronald Klatz, MD, DO, and
Robert Goldman, MD, PhD, DO, FAASP
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Anti-Aging Approaches to Pain Management
Severe and lasting physical pain drains quality of life. It is estimated that 25.3 million US adults (11.2%) have experienced pain every day for the preceding 3 months. Nearly 40 million Americans (17.6%) experience severe levels of pain – which are commonly linked to a worsened health status. Among older men and women, pain is common and is often associated with significant declines in physical function and ability to live independently. Pain is one of the leading reasons that Americans turn to complementary health approaches such as yoga, massage, and meditation – approaches that aim to manage pain and other symptoms that are not consistently addressed by prescription drugs and other conventional treatments. In this column, we review various methods of coping with chronic pain.

Nahin RL. Estimates of pain prevalence and severity in adults: United States, 2012.
J Pain. 2015 Aug;16(8):769–780.

For Knee Condition, Supplement Shows 'Comparable Efficacy' to Drug
Knee osteoarthritis is a painful condition that often compromises functional independence. Marc C. Hochberg, University of Maryland School of Medicine, and colleagues completed a study to assess the effectiveness of a dietary supplement of glucosamine with chondroitin sulfate, as compared with a widely anti-inflammatory drug commonly prescribed for the condition (celecoxib). The Multicentre Osteoarthritis interVEntion trial with SYSADOA (MOVES) study enrolled 606 men and women with knee osteoarthritis and experiencing moderate-to-severe pain. Subjects were randomized to receive for 6 months either 400 mg chondroitin sulfate + 500 mg glucosamine hydrochloride 3 times a day or 200 mg celecoxib daily. Assessing subjects using a standardized osteoarthritis scale, the glucosamine-chondroitin supplement was found to have comparable efficacy to the prescription on pain (50% reduction in both groups), stiffness (46.9% reduction via supplement vs. 49.2 with drug), and function (45.5% via supplement vs. 46.6% with drug). The study authors write: "[Chondroitin sulfate with glucosamine] has comparable efficacy to celecoxib in reducing pain, stiffness, functional limitation and joint swelling/effusion after 6 months in patients with painful knee osteoarthritis, with a good safety profile."

Hochberg MC, Martel-Pelletier J, Monfort J, et al., on behalf of the MOVES Investigation Group. Extended report: Combined chondroitin sulfate and glucosamine for painful knee osteoarthritis: a multicentre, randomised, double-blind, non-inferiority trial versus celecoxib. Ann Rheum Dis. 14 January 2015.

Yoga Improves Arthritis Symptoms
A leading cause of disability, arthritis affects 1 in 5 adults – many of whom are younger than age 65. Left unmanaged, arthritis compromises mobility and can cause declines in quality of life. Susan J. Bartlett and colleagues from Johns Hopkins University (Maryland, US) completed a study in which 75 sedentary men and women, aged 18 years and older, with either knee osteoarthritis or rheumatoid arthritis, were randomly assigned to either a wait list or 8 weeks of twice-weekly yoga classes, plus a weekly practice session at home. Compared with the control group, those doing yoga reported a 20% improvement in pain, energy levels, mood, and physical function, including their ability to complete physical tasks at work and home. Walking speed also improved to a smaller extent, though there was little difference between the groups in tests of balance and upper body strength. Improvements in those who completed yoga was still apparent 9 months later. The researchers report: "Preliminary evidence suggests yoga may help sedentary individuals with arthritis safely increase physical activity, and improve physical and psychological health and [health-related quality of life]."

Moonaz SH, Bingham CO 3rd, Wissow L, Bartlett SJ. Yoga in sedentary adults with arthritis: effects of a randomized controlled pragmatic trial. J Rheumatol. 2015 Jul;42(7):1194–1202.

Spice Combats Soreness
The yellow pigment that gives turmeric its color, curcumin has been shown by numerous previous studies to exert antioxidant and anti-inflammation effects. David S. Rowlands and colleagues from Massey University (New Zealand) enrolled 17 men in a study in which each subject received either 5 grams curcumin daily, or placebo, for 2 days before and 3 days after performance tests. This was followed by a 2-week washout period, after which the subjects crossed over to the other intervention. Moderate-large reductions in pain during exercises, as well as small increases in performance, were achieved in 1 to 2 days among the curcumin group. The study authors report: "Oral curcumin likely reduces pain associated with [delayed onset muscle soreness] with some evidence for enhanced recovery of muscle performance."

Nicol LM, Rowlands DS, Fazakerly R, Kellett J. Curcumin supplementation likely attenuates delayed onset muscle soreness (DOMS). Eur J Appl Physiol. August 2015;115(8):1769–1777.

Tiny Treatment Delivers Big Pain Relief
In that a human hair measures 100,000 nanometers wide, gold nanorods are tiny rods that are 1 to 100 nanometers wide and long. Tatsuya Murakami and colleagues from Kyoto University's Institute for Integrated Cell-Material Sciences (Japan) coated gold nanorods with a lipoprotein – a special type of protein that transports fat within the body, allowing the nanorods to bind efficiently to nerve cell membranes bearing a pain receptor called TRPV1 (transient receptor potential vanilloid type 1). When  near-infrared light was applied to the nanorod-coated pain receptors, the nanorods heated up and activated the pain receptors to allow an influx of calcium ions through the membrane. Prolonged activation of TRPV1 is known to subsequently lead to their desensitization, bringing pain relief. Importantly, heating the gold nanorods enabled safe activation of the TRPV1 pain receptors alone, without affecting the membrane in which they lie. The study authors report: "Our method provides an optogenetic platform without the need for prior genetic engineering of the target cells and might be useful for novel TRPV1-targeted phototherapeutic approaches."

Nakatsuji H, Numata T, Morone N, et al. Thermosensitive ion channel activation in single neuronal cells by using surface-engineered plasmonic nanoparticles. Angew Chem Int Ed. 6 August 2015.

Multitude of Benefits of Meditation
As a natural, nondrug therapy, meditation helps many people to reduce psychological stress and stress-related health problems. The practice of "mindfulness meditation" is aimed at allowing the mind to pay attention to whatever thoughts enter it, such as sounds in the environment, without becoming too focused. Madhav Goyal and colleagues from the Johns Hopkins University (Maryland, US) completed a meta-analysis conducted on 47 published studies of mindfulness meditation involving a total of 3515 subjects. The team found up to a 10% improvement in anxiety symptoms among people who took part in mindfulness meditation, compared with those who did another activity. Further, the researchers identified a 10% to 20% improvement in symptoms of depression among those who practiced mindfulness meditation, compared with the other group. As well, mindfulness meditation was associated with reduced pain. Writing, "Clinicians should be aware that meditation programs can result in small to moderate reductions of multiple negative dimensions of psychological stress," the study authors urge that "clinicians should be prepared to talk with their patients about the role that a meditation program could have in addressing psychological stress."

Goyal M, Singh S, Sibinga EMS, et al. Meditation programs for psychological stress and well-being: a systematic review and meta-analysis. JAMA Intern Med. 6 Jan. 2014.

Other alternatives are PRP injections, low level laser light therapy, osteopathic manipulative therapy, and cannabidiol. To stay updated on the latest breakthroughs in natural approaches for pain, visit the World Health Network (, the official educational website of the A4M and your one-stop resource for authoritative anti-aging information. Be sure to sign up for the free Longevity Magazine e-journal, the A4M's award-winning weekly health newsletter featuring wellness, prevention, and biotech advancements in longevity.

Consult your doctor before using any of the treatments found within this site.

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