Interview by Sarah Clark, LAc
I had an opportunity to sit down last week and talk with Dr. Chang about his passion for treating chronic pain, and the ways in which he supports athletes to reach their full potential. This is what he had so say:
Sarah: Tell me about how you work with patients with chronic pain.
David: I use many different approaches to help patients with chronic pain. I have found two approaches particularly helpful; Prolo-injections and acupuncture. These tools address chronic pain and degeneration very directly. Chronic pain is probably costing Americans more money than any other disease. This is why I feel that providing a very effective, long term solution is vital.
I also address chronic pain from a holistic perspective. Assessing contributing factors such as diet, chronic disease, family history and mental/emotional well-being is crucial in successfully overcoming chronic pain. Pain comes with social and emotional costs, and it can affect people in many aspects of their lives. So, to address it on multiple levels is important.
Sarah: Can you explain what Prolotherapy is?
David: Prolotherapy is a very effective injection treatment that was invented in the 1950s by a medical doctor. Essentially, you’re using the body’s inflammatory response as the tool to launch the tissue repair process. Structures like ligaments, tendons, cartilage and nerves don’t heal very well on their own due to insufficient blood supply. So, when a sprain/strain or trauma takes place in that tissue, it becomes chronically weak; creating constant instability and pain. Prolotherapy can initiate very specific inflammation at the site of an injury, and help the body complete the healing process that it wasn’t able to accomplish immediately following the injury. This signals the body to regrow new soft tissue cells and heal the damaged structures. There aren’t a lot of techniques that can address actual cellular healing at such a molecular, ligamentous level. It’s amazing! Prolotherapy can be used in place of surgery because it’s actually able to help re-grow the body’s own ligaments and tendentious tissue. Surgery, on the other hand, usually cuts these things out and then puts foreign objects into the body which can often cause more damage.
Sarah: Is prolotherapy a good alternative to opiates?
David: Yes! Prolotherapy can be a really good alternative to opiates because you are treating the underlying cause. Pain medication masks the problem by blocking pain signalling, but the structural damage is still there and noticeable as soon as you stop taking the medication. Right now, we’re facing an epidemic of opiate abuse and addiction among patients with chronic pain. With prolotherapy, I’ve been able to help people who have been in chronic pain for over 40 years. It’s important for people with chronic pain to know that there are alternatives to taking opiates. People never think it’s going to happen to them. Then they have an injury and take pain medication for a period of time; it can so easily develop into an addiction.
Sarah: So, how do you work with someone who comes in with an opiate addiction?
David: I believe very strongly in an integrative approach with the patient leading the team. I always make sure to include their primary care and chronic pain doctors as their support is very important. I will always go back to treating the cause of the problem; correcting any structural damages by imitating healing, and working to establish balance in a person’s health through nutrition and lifestyle changes.
Sarah: Tell me about your work with athletes?
David: I’ve always been an athlete myself. I played multiple sports in high school. I’ve been active my whole life and have been around a lot of sports injuries. I know how devastating it is to have an injury, and how difficult it is to come back. We’re not all as lucky as professional athletes who are able to afford around-the-clock training and care, so a lot of people with sports injuries don’t recover well. Sometimes people also lack information about how to recover well. I strive to not only help athletes recover from injuries, but to also help them become better at what they do.
Sarah: Tell me about that.
David: There’s a lot of information about nutrition available now, but too much information can be a detriment. Sometimes people don’t know where to put their focus. Some information is misleading, without actual guidance people can try things that don’t actually benefit them. I’ve had a lot of high level athletes come in for care, only to find that they’ve missed the important aspects of diet and nutrition. It’s important to have a naturopathic doctor help target your diet to your specific needs as an individual. Not everyone is the same. I give guidance about what my patients need as individuals, not just as athletes. This has had a noticeable effect on their performance.
Sarah: What are some common aspects of proper nutrition that you see patients missing?
David: This misconception goes beyond just athletes: A lot of people still think fat is bad. For example, people are still thinking that the healthy way to eat is to avoid the egg yolk and just eat the egg white. They avoid fat as much as they can, and focus on eating low fat foods. What they’re missing is that sugar and carbohydrates are the bigger culprits of disease. Healthy fat offers protection which helps us avoid cardiovascular disease and diabetes. Even though there’s a lot of research available now about the benefit of fats, old habits die hard. We have had such a fear of fat in the last 20 years, it’s been a hard paradigm to shift.
Sarah: And are there certain inflammatory foods that people should stay away from?
David: Gluten and sugar are the biggest inflammatory foods that we see on the market, and they are the hardest things for people to avoid. The problem with gluten replacements are the hidden sugar, soy, and corn that we’re not able to get out of processed foods. What we can do as consumers is to really control what we eat. Making your own food is great because then you control what goes into your diet. More importantly, it’s not just the inflammatory food that can cause problems, it’s hidden food allergies and poor digestive health that are big culprits to chronic health problems.
Sarah: What about weight loss?
David: Weight loss is interesting. There are a lot of different diets out there. Some popular options such as HCG, Weight Watchers, and many more are a little extreme in my opinion. At the end of the day, I don’t put so much emphasis on calories or pounds. I look at a patient’s well-being and how to help them be the healthiest people they can be. Ultimately, that is what’s going to help them lose weight. I make sure their emotional well-being is addressed because weight loss can often be tied to emotions and social stigma. I make sure they know how to exercise properly and eat properly in a way that fits with their lifestyle. In walking through this process, we see the weight come down.
There can be so much fixation on pounds and dress sizes. But often that becomes a detriment. There’s too much pressure on a person to get past a number. Patients put so much emphasis on the amount of weight they lose with certain diets, but most of it comes back because the weight they have temporarily achieved isn’t sustainable. If patients learn to be healthy and address their whole self, the weight comes off and is more sustainable.
Sarah: What would you say to people who live with chronic pain and have lost any hope of getting better?
David: I don’t believe in absolutes. I’m committing my whole life, my whole career, to helping people with that problem. And I would hate for finances, or fear, or misunderstanding, or lack of knowledge to come in the way of having a better life. So, I just encourage people to give it one more shot. I know most people with chronic pain have tried many different treatments. But I’ve been able to help many people who thought they were beyond help. Maybe I’m not curing them of chronic pain, but most of the time, I’ve been able to help them live their lives more normally and go back to the things they enjoy doing— back to being with their loved ones instead of bed-ridden and instead of being in too much pain to function. I’m always going to be here to help people as long as they come out and seek help.