Recently my son dislocated his small toe and after an x-ray found he had broken it as well. Aside from buddy strapping and not putting weight on it, time will knit the bone back together and will eventually reduce the inflammation.

In this instance, inflammation is positive as it brings blood and nutrients to the area for healing. Pain is experienced as a reminder not to put weight on the joint and to rest. It is a great example of the body's natural ability to heal itself.

To manage pain, he was prescribed Stilpane, similar in ingredients to Panado, Calpol and Adco-dol, available as over the counter medications without a prescription.

Stilpane contains three active ingredients:

Paracetamol (aka acetaminophen) - a common pain reliever and fever reducer that works by blocking the production of certain chemicals in the brain.
Codeine - an opioid pain medication that works by binding to certain receptors in the brain and spinal cord to reduce the perception of pain. Codeine can cause drowsiness and respiratory depression, and can be habit-forming if used for long periods of time.
Caffeine - a stimulant that can help to enhance the pain-relieving effects of paracetamol and codeine, and also helps to counteract the drowsiness caused by codeine.

The entire class of NSAIDs (non-steroidal anti-inflammatory drugs) does some damage in exchange for short-term relief, whether it is in the gastrointestinal tract (as is the case with aspirin, ibuprofen (e.g. Nurofen, Brufen) or in the liver (as is the case with acetominophen (e.g. Adco-dol, Panado, Calpol) – even at regular dosage levels for just 2 weeks, liver enzymes are elevated in over one-third of patients).

If you want to understand the differences in ibuprofen and acetaminophen, this article is well-written and easy to follow..

I wanted him off Stilpane ASAP and to switch to a natural pain killer without all the side effects of NSAIDs. For this I chose curcumin (an excellent clinical overview here). An ancient spice, turmeric is the bright gold ingredient found in many Asian dishes, ubiquitous in curries. If you’ve cooked with it, you’ve experienced the permanent yellow stain it gives anything plastic or wooden.

Curcumin has been studied extensively and found to be a powerful antioxidant, antimicrobial, brain protectant, detoxification agent, and anti-inflammatory.

It reduces pain in the body using a similar inflammatory molecule “quenching” that is found in NSAID medications – but without the potential gut-damaging risks.

My clients use curcumin to reduce inflammation from arthritis, lower back pain, tennis elbow, joint replacement, cancer, infections, auto-immune diseases. You use it even if you struggle with occasional achiness after a rough week or an aggressive workout, curcumin can be quite helpful.

However, there’s a catch. Not all herb products are the same. To be effective, extracts must be pure and potent. Curcumin is notorious for being poorly absorbed in the blood stream, with 40-85% of dosage being passed through the GI tract unabsorbed.

To ensure maximum efficacy, I recommend a specific formulation of curcumin that is a phytosome. That is, the curcumin is bound to a lipid (fat) molecule. This allows it to be absorbed into our lymph system for greater distribution to our body-wide blood supply.

This phytosome is called Meriva, and research shows that the bio-availability of Meriva is about 10 times that of plain curcumin (e.g 500mg dose of Meriva can be as as effective as more than 4000mg of typical curcumin). Note that Meriva is a trade name and not a brand name, so you find it sold under many brands.

I recommend my clients start with a 500mg dose of Meriva twice a day for pain and inflammation, allowing it to build up in their body for 5 days before increasing if necessary to 1000mg twice a day. The only negative reaction I have ever heard to Meriva is in one person who had an unknown (and unusual) food allergy to turmeric.

In some individuals depending on what detoxification pathways are used by their medications there may be an overlap/burden created by using high-dose curcumin that affects the activity of those pathways. In this case, you may want to use other anti-inflammatory herb options like bromelain or boswellia.

Another excellent anti-inflammatory food extract is bromelain, found in pineapple stems. Technically an enzyme, bromelain is well-absorbed in the GI tract and reduces inflammation by reducing the production of bradykinin, an inflammatory mediator that reduces our pain perception threshold. It has been shown to be particularly useful for joint pain.

I recommend my clients start with 250-500mg of Bromelain taken twice a day. Use the lower end of this spectrum if you have hypertension (Bromelain is also an effective “fibrinolytic agent” meaning it can break down fibrin or other clots in the blood and effectively thins blood).

For this reason, do not use it if you are taking prescription blood-thinning medications (e.g. Warfarin) without direct doctor supervision. Again, I know of no common, negative side effects barring outright allergy to the extract itself (or the food it came from – in this case, pineapple).

General Recommendations for Healing Pre/Post Surgery

If you have an upcoming surgery, it's recommended that you immediately discontinue any anti-inflammatory supplements, such as Omega-3 (fish oil), as they can inhibit the body's healing process.

However, there are some supplements that can actually boost your immune system prior to surgery, such as Vitamin D, Vitamin A, zinc, and probiotics, that are worth continuing or starting.

Even if you don't start these supplements prior to surgery, they can still be added post-surgery to help with wound healing and infection prevention. Just make sure to wait at least one week after surgery to resume any anti-inflammatory remedies, unless there are issues with poor wound healing.

In the first week or so after surgery, I recommend focusing on consuming liquid-based nutrients, such as green juice, protein smoothies, soups, and pureed stews. This helps minimize the digestive effort required and allows your body to conserve energy and focus on healing.

When it comes to your lifestyle during this time, it's important to prioritize quality sleep as a key healing activity. Consider taking steps to ensure you can sleep soundly, such as sleeping in a separate bedroom, using earplugs, or taking a small dose of melatonin at night.

Additionally, it's important to avoid any stressful circumstances or conversations for a while after surgery, and to find distractions like comedy movies or recordings to help you relax.

Finally, post-surgery is an excellent time to start a meditation practice to help you manage stress and support your body's natural healing processes. There are many meditation apps available, such as Headspace or Calm, that can help you get started.

If you are prescribed multiple medications to prevent post-surgery complications, it's important to support your liver with a supplement such as Metagenics Advaclear Take this alongside your medications as long as they last.

I wish you a speedy recovery and hope these tips help support your body's natural healing processes!