Pain without Inflammation?!

Updated November 30, 2020

We have seen a number of patients with significant pain but without any signs of inflammation, deficiency, or tissue damage.

Inflammatory biomarkers not elevated (CRP, ESR, Ferritin)

Normal Omega-3, Mg, D, other nutrient levels

Normal Xray and MRI

Non-response to steroids (oral, epidural)

Limited response to body work (massage, yoga, chiropractic, etc)

In some cases, patients are made worse by massage, as if something is released from the tissues.

Is there an explanation?  I am hypothesizing that these patients are dealing with a toxic process that causes pain, but through a non-inflammatory mechanism.

Inflammation represents an activation of certain mechanisms. Toxicity is the blockage of certain mechanisms.

If nerves are either inflammed or toxic, then they can malfunction. Depending upon the location of the nerve and its function, dysfunction can manifest as any host of problems such as:


mood (anxiety, depression)


autonomic nervous system dysfunction (blood pressure up or down, gut moving too fast or slow, cold or hot extremities, changes in vision, hearing, sensation)

When pain is localized, such as in the right neck, left shoulder, or middle back, we quickly jump to the conclusion that its a structural issue. However, if these structures show no visible damage on xray or MRI,  perhaps instead, they are places where certain neuro-toxins accumulate. There is very little information in the literature on the distribution of toxins, which locations and tissues they prefer.

Such toxins (see elewhere) include lead (Pb), mercury (Hg),  pesticides, glyphosate, plastic residues (BPA), volatile organic compounds (VOC’s from solvents, paint, glue, hair and skin and nail products).

A number of these patients have evidence of toxicity:

Mildly elevated liver enzymes

Low glycine and glutamine levels, improvement with supplemental  glycine and glutamine (helps with detox)

Improvement with glutathione suppositories

Related Links

Pain without Inflammation 2