Norepinephrine (or Noradrenaline)
can help Control Pain

Norepinephrine (also called Noradrenaline) is interesting because it is a biochemical produced by your  body that acts as both a hormone and a neurotransmitter.

It is produced as a hormone by the adrenal gland and released into the bloodstream. As a neurotransmitter, it is secreted by nerve cells in the spinal cord and certain parts of your brain. 

  

  

  

  

  

Remember:

A hormone is produced by a gland and then it travels through the circulation to influence the  activity of one or more of your organs.

A neurotransmitter is produced by a nerve and transmits the nerve signal from one nerve to the  next at each nerve junction.

As part of the autonomic nervous system neurotransmitters can have different influences at different locations. Noradrenaline is a good example of this. At your heart it is excitatory and increases your heart rate and blood pressure. While in your brain and spinal cord it is inhibitory and suppresses the pain signal traveling through your nerves. 

Part of the Sympathetic Nervous System Response

Norepinephrine is an important part of the sympathetic nervous system reaction stress and it plays a key  role in the "flight or fight" response.

Important actions of Norepinephrine:

• Increase Heart Rate

• Increase Blood Pressure

• Increase Blood Sugar

• Increases Blood Flow

• Sharpens Your Attention

• Quickens Your Reactions

As part of the autonomic nervous system neurotransmitters can have different influences at different locations.

Noradrenaline is a good example of this. At your heart it is excitatory and increases your heart rate and blood pressure. 

While in your brain and spinal cord it is inhibitory and suppresses the pain signal traveling through your nerves. 

  

  

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Norepinephrine and Pain

Norepinephrine has been shown to increase acute pain at the site of a wound or other injury. It also causes contraction of blood vessels helping to stop bleeding. It is used during surgery to control bleeding. 

When norepinephrine acts as a neurotransmitter in the spinal cord and brain it is inhibitory and suppresses the pain signal. Serotonin is another neurotransmitter with similar effects. Increasing your levels of these chemicals, noradrenaline and serotonin, makes them more effective and suppresses the pain even more.

Many different medications attempt manipulate your levels of noradrenaline and serotonin to control chronic pain. They have been shown to be very effective for some people.

TCAs (tricyclic anti-depressants) and SNRIs (serotonin and norepinephrine reuptake inhibitors)  are medications that slow the breakdown and reabsorption of these neurotransmitters. Allowing them more time to suppress the pain signal even further. 

Some Popular TCAs: amitriptyline (Elavil), doxepin (Sinequan), nortriptyline (Pamelor)

Some Popular SNRIs: venlafaxine (Effexor), milnacipran (Savella), duloxetine (Cymbalta)

All Medications can have Side Effects

All medical treatments carry the risk of unintended consequences and especially therapies that manipulate the levels of neurotransmitters because these important biochemicals are active in so many different  ways in so many different locations. 

Side Effects of TCAs: dry mouth, dry nose, blurry vision, lowered gastrointestinal motility or constipation, urinary retention, cognitive and/or memory impairment, and increased body temperature.

Side Effects of SNRIs: drowsiness, dizziness, fatigue, headache, increase in suicidal thoughts, nausea/vomiting, sexual dysfunction, and urinary retention.

In many cases these side effects are mild and well tolerated but they are something that you should be aware of before starting treatment. 

How Do You Know if these Medications are Right for You?


You don't know unless you try. 

Medications that increase your levels of noradrenaline and serotonin can be very helpful for controlling pain in some people. You should avoid these medications if you are taking tramadol for pain or MAOIs for psychiatric illness. 

If you have chronic muscle pain, fibromyalgia, or neuropathic pain that is not well controlled you should talk to your doctor about a trial of one of these medications. He can discuss the risks as they relate to you and your medical history. 


  


  

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