A pain management approach to long-haul COVID, gut issues, and what to know about medical marijuana

June 23, 2022

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Staying on top of current research in pain management is very important to Dr. Lisa Barr, who has more than 30 years of experience as a board-certified physician treating patients in Tidewater with muscle, nerve, and joint problems related to sports injuries and degenerative conditions. The author of Outsmart Your Pain: The Essential Guide to Overcoming Pain and Transforming Your Life (Synergy Health Quest, LLC, 2018), Barr discusses with Jewish News the most common issues she comes across and what new research reveals.

Jewish News: What are the different types of pain and their causes that you typically see in your practice?

Dr. Lisa Barr: At the  Barr Center, we provide non-surgical treatment for low back and neck pain, as well as sports injuries and overuse conditions using traditional modalities as well as regenerative therapies. We also have a keen interest in functional medicine which seeks to assess the root cause of many diseases and conditions. This includes looking for nutrient deficiencies, hidden gut infections and genetic weaknesses that impact cellular function. As an offshoot of our functional medicine program, we recently opened an IV therapy practice with a focus on solving challenging problems like long-haul COVID. We also advocate the use of CBD products as the studies of the endocannabinoid system are overwhelmingly positive for reducing pain, improving gut function, and helping with brain function and mood, as well as supporting immune function.

JN: With long-haul COVID, what should people know about for pain management?

LB: The primary concerns we see are brain fog and generalized fatigue. The reason people get long-haul issues is the effect of the virus on ACE2 receptors that ultimately cause vascular issues and inflammation that can impact any organ system. It also impacts the critical energy-producing organelles called mitochondria. Brain inflammation causes brain fog and mitochondrial dysfunction severely limits our ability to produce energy, causing fatigue. COVID also effects the gut microbiome which impacts production of the crucial neurotransmitters responsible for pain threshold.

JN: Concerning medical marijuana, what do people need to know about its use, including the legality of it for pain management as prescribed by a doctor?

LB: Marijuana and CBD are both phytocannabinoids. That means that they are plant-based substances that can influence our endocannabinoid system (the role of which is to regulate one’s ability to achieve homeostasis; by regulating the nervous system, it protects the immune system). Both marijuana and CBD come from the hemp plant, but each is bred to yield plant material with different features; some plants have more THC and others have more CBD. There are nearly 60 different phytocannabinoids and these are the most popular, but there is also CBN, CBC, and CBG which have different therapeutic effects.

The legal limit of THC in any phytocannabinoid in the US is < 0.3%. Anything higher than that is considered marijuana. THC is a powerful pain reliever, but it is also a hallucinogen and potentially addicting, while CBD is not, so when we determine someone would benefit from a phytocannabinoid, we consider these factors.

Topical CBD salves are effective in treating pain in the neck and extremities as they are easily absorbed and provide an all-natural form of pain relief and reduced inflammation. For more diffuse pain conditions, most patients start with full spectrum CBD gummies or tinctures and only if they don’t respond do they consider getting a medical marijuana card. Products are purchased at a dispensary.

To obtain a medical marijuana card, you have to apply online through the Virginia Board of Medicine and have a physician’s support.

JN: What role does the gut’s microbiome play in pain?

LB: The gut microbiome is responsible for about 60% of our immune system. A healthy and diverse gut microbiome is essential for good health. When there is an overgrowth of certain bacteria or a significant deficiency, we can experience symptoms such as IBS and autoimmunity. Pathogenic bacteria, viruses, parasites, and candida can cause pain, arthritis, gastric ulcers, IBS, cancer, and many other disorders. A simple stool sample can assess the health and diversity of one’s microbiome. The gut microbiome is linked to the gut-brain connection and that is why our gut is often referred to as our second brain. Think ‘gut instincts.’ They are real!

JN: Advice to people experiencing pain about how to find the right practitioner?

LB: Seek providers that focus on the root cause of pain so that the underlying cause/causes are addressed rather than simply treating symptoms. Make sure that your provider can distinguish between compensatory patterns and pathology, and address each appropriately. In other words, we can have an injury, and through our body’s innate protective behaviors, adopt painful postural and gait patterns. At a certain point, these compensatory patterns can take over and become the cause of persistent pain.

The Barr Center for Innovative Pain & Regenerative Therapies is located in Virginia Beach. Visit barrcenter.com or call 757-578-2260.

-Debbie Burke


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