Chronic Pain In College Part 1 – Pain and Your Grades

Minneapolis Grades Pain School(Below is Part 1 of a four-part series on chronic pain in high school and college. It was penned by a college student who has dealt with chronic pain throughout her academic career. The four-part series will cover four important aspects of college life – Academics, Dating, Employment and Social Life. Here’s Part 1 on how Chronic Pain can make studying for exams and getting good grades even more of a challenge.)

What can I say, chronic pain sucks sometimes. That said you can still live an “almost normal” life as a young adult with chronic pain. Personally, I’ve been dealing with chronic pain in my neck and back since 2008 when I had my first of four back surgeries to correct my severe scoliosis. Over the last almost eight years, I’ve grown into a young adult, and I am attending college to obtain an engineering degree while dealing with a plenitude of medical appointments in addition to trying to enjoy college and life in general. I intend on addressing the following topics of concern among young adults with pain—getting through school (high school, college, technical training, etc.), working and keeping a job, having a significant other, and day-to-day life enjoyment.

Chronic Pain and College Grades

Having any medical condition that can affect class attendance and performance can be difficult and daunting for many as they think about pursuing higher education. Throughout grade school, middle school, and high school your parents can work with the health office to create a 504 plan in order to address your needs. I found it helpful to have a second set of textbooks so I could keep a set in my locker and a set at home so I wouldn’t have to carry a heavy backpack. If your pain causes problems during exams you may want to look into extra time or extended breaks for exams to be added to your 504 plan. While many teachers at the high school level will allow you the time needed to finish an exam, if this could affect standardized tests such as ACT/SAT and others, you will need 504 documentation in order to apply for these accommodations on standardized tests.

If you are in the process of touring colleges or looking up universities and know you have chronic pain, look into the resources the school offers for “students with disabilities.” At my university, we have a “Services for Students with Disabilities Office” that helps everyone with anything from a temporarily broken arm, to ADHD and chronic pain. Personally, I’ve found the office very helpful in providing documentation to professors and needed accommodations.

Some helpful things to consider as you begin college while dealing with chronic pain include:

  • Getting notes from the professor or using a scribe to take notes for you in class.
  • Talking with your teacher at the beginning of the semester about the possibility of getting extra time for assignments & excused class absences in the event you have a pain flair.
  • Extra time or stretch breaks during classes and exams.
  • Book scanning services (to have a digital version of textbooks to reduce backpack weight).
  • Look into scholarships to purchase an iPad (light-weight computer alternative).

After looking into a combination of the above-mentioned accommodations, I find myself much more easily able to meet the academic demands at a top university. Being proactive about your chronic pain from the moment you step foot on campus will help prepare you for an inevitable flare up, will help professors learn of potential issues before a problem arises (this is key), and help prevent symptoms from worsening. It’s not easy, and you’ve got enough on your plate as a new college student, but it’s crucial to be proactive.

Part 2 will be published on Wednesday.

Opioid Success Rates in Women With Chronic Pain

Women opioids in MinneapolisA recent study has found that using opioids to treat chronic pain in females is often not helpful. The study found that less than 20 percent of females receive pain relief with the use of narcotic-type medications. The article was published in the July 2015 issue of the Journal of Woman’s Health, and it indicates that women often do not receive any significant chronic pain relief pain from the use of an opioid. About 50 percent of men receive adequate pain relief from opioids, but only a small percentage of women have a response.

Chronic pain is a complex problem. There are often multiple problems occurring that cause the pain, and it is rare that there is a simple solution. Pain is complex and a multitude of different techniques and methods are necessary to treat these types of problems. Not only are there multiple peripheral generators of pain signals, the interpretation by the brain of pain is often short-circuited.

Opioid Use and Women

The brain, when it receives multiple pain signals, develops what is called “central sensitization.” Both abnormal and multiple pain signals are interpreted as significant pain, and normal signals can be also perceived as pain. Central sensitization and many of the peripheral receptors are not responsive to opioid medications. When looking at the big picture, it’s not surprising that women don’t respond well to opioid therapy.

As noted above, chronic pain is a complex condition. Simple solutions like opioids often do not work to help with pain. New research is being done to better understand all aspects of pain, and we’ve made huge gains of the last few years. That said, pain care has not received a lot of research funding, but hopefully that will change. Research can lead to better solutions to prevent and treat pain, we just need to put in the time, money and effort.


Chronic Pain as a College Student

Having chronic pain problems as a college student sucks. There are multiple problems and too many compromises that need to be made. You can’t just live a normal life, and the ability to be spontaneous does not easily happen. Everything is affected, from the living situation, to study habits and working with groups and exam schedules can be a problem. Name the situation, and it may be a problem, especially if you just want to be normal.

Chronic Pain in College

No day is typical, and just starting the day may be a problem. Waking up in the morning is often very painful. First, one may not have slept very well because pain kept waking you up at night, or it was extremely restless. Then one is sore and you need to start stretching and doing some morning exercises just to get moving. There is no last minute rolling out of bed and running off to class, you just can’t move fast without the morning routine.

Chronic Pain in College

Once you are at class, most lecture rooms and other classrooms have bad stadium seats or very uncomfortable chairs without any back support. Sitting in these chairs worsens the back and neck pain, and trying to take notes and concentrate is an effort. If you are lucky, they may provide a special chair to sit in, but good luck at getting the right seating in every classroom. It is also weird when you need to get up for a minute, stand in the back of the room and stretch to help relieve the pain. Lastly, making to the professor’s office hours when you are in pain is an added burden. Then you may also need to explain the need for accommodations due to your situation, adding again more stress to the pain.

As the day goes on, your back and neck may start to hurt more. Standing, stretching or walking around may not help and the best option for your back may be to lie down. Well, there are not many places to rest and lay down on campus.

After you made it through your classes, then there is the homework, group projects, and social life. Studying may be a challenge at times due to back pain and fatigue. Concentration is reduced by pain and more breaks are needed. Planning ahead is essential and leaving stuff to the last minute does not work since you may be having a bad day with pain at the wrong time. Further stress will worsen the pain, lower the concentration ability, and it definitely increases as deadlines for tests and big projects near. The group projects for some classes also are often a problem, you have to ignore your pain needs often to match the schedules of everyone else in the group, and at the end of the day, you may be just about in tears since you hurt so much and you still have a ton of stuff to get done.

Chronic Pain and Your Social Life

A big part of college is developing oneself in a new social environment. One wants to be just like everyone else, carefree and happy. When you are sleep deprived from pain, stressed out, and uncomfortable sitting in most chairs or standing long times, participating in social activities is tough. Ignoring the pain works at times, but sometimes it comes back to bite you and you are down for the count for several days because you did too much. Normal kids do all those things without a problem, for you it can be a nightmare, and you are physically sick for a week afterward.

There is no secret solution for having success as a college student when having chronic pain. It is a constant effort to be your best, and keep moving forward. Those who do manage this tight rope act are some of the toughest, smartest and grittiest kids imaginable. It takes a huge amount of effort, often alone and without good medical guidance. There are very few doctors who understand the challenges and can adequately help find the additional resources to ease some of the problems. Furthermore, there are few resources and pain treatments that make a difference for many young adults. The struggle is very real, and the problems of living with chronic pain just sucks.

Medical Marijuana: Why It’s Different

Medical Marijuana St. CloudRecently, one of the two suppliers of medical marijuana to patients in Minnesota offered a tour of their facility to a small group of leading pain physicians. The business is fascinating and a completely different model from anywhere else in the country. In the rest of America, marijuana for medical purposes is not highly regulated, and is sold by minimally regulated distributors selling whatever types of marijuana they feel might be useful. Needless to say, it is basically the same marijuana that is being sold for recreational purposes to get high.

Minnesota has taken a very different approach to the legalization of marijuana. First, the legislature has recognized that there may be some legitimate medicinal value to marijuana, and that for certain conditions it may be helpful. The legislature also felt recreational marijuana had a spectrum of problems and wanted to avoid adding to the problems of abused substances. Therefore, in Minnesota, only medical marijuana is available, and it is tightly regulated.

There are only two producers of medical marijuana currently allowed in Minnesota. These producers can provide only to patients that have been certified with certain conditions approved to receive such medication. The patient receives extracts from the marijuana plant to ingest as a pill, concentrated liquid, or to inhale as a vapor. It is not available for smoking or as an additive in food. The formulation received by the patient is determined by a pharmacist, and adjusted as well as titrated to help with a patient’s particular symptoms. The pharmacist also will evaluate the effectiveness of the treatment every time the patient is seen, and information for the State is being kept on the treatment, its effectiveness, and what is being given to the patient.

Medical Vs. Recreational Marijuana in Minnesota

Medical marijuana is usually very different than the marijuana found on the street. For most medical conditions, the cannabinoids of interest are the “CBDs” and not THC, the part that gets one “high.” From research done around the world, plants with different amounts of CBD to THC are being grown to produce the desired amounts of these compounds to be used in the medications. Unfortunately at this time, isolating specific CBDs known to exist has not yet been the focus of manufacturing. The medications manufactured currently just have specific amounts and ratios of CBD and THC.

The producer that I visited was extremely interesting. The growing of the plants is very high tech. From the plants used to the growing conditions, all aspects are tightly controlled. After the plants are harvested, the components are isolated and carefully extracted and made into the medicines for each particular individual.

Not all patients who have been qualified by a physician will be accepted by the medical marijuana distributors. Further, since all medical marijuana is considered experimental, none of the cost of treatment is covered by insurance. Doctor visits regarding certification, follow up visits, and all drug and pharmacy costs are cash only and no credit cards are accepted. Medication costs are also fairly expensive since they are made at a custom pharmacy with strict quality controls for safety and purity.

Medical marijuana is truly a product currently for those who have failed conventional treatment. The treatment is only now for certain conditions. If qualified, it may or may not work for any individual. The cost is quite expensive, not supported by insurance, and is cash only. The benefit is medical marijuana is designed as another medication tool to help control symptoms of certain conditions. It is consistent and manufactured like most other drugs to be pure and safe. It is not designed for recreational use and getting high.

Intractable Pain and Medical Marijuana

Marijuana in MinnesotaMedical marijuana for intractable pain is now on the agenda for Minnesota. The commissioner for the Department of Health is now evaluating whether to add intractable pain as a condition that will be included in its medical marijuana program. The commissioner received recommendations against adding pain from the medical advisory committee. There will be a public hearing this week and comments can be sent directly to the Department of Health, at

In Minnesota, intractable pain would most likely be handled differently than any other diagnosis for medical marijuana. Already, the medical panel has advised that it be restricted to people over the age of 21. Further, they want to make sure that anyone prescribed is not pregnant and that conventional treatments for pain have already failed.

What is Intractable Pain?

In Minnesota, intractable chronic pain is a legal definition set up by the legislature in the 1990’s. It means pain caused by some medical condition that is unresponsive to normal medical care including medication, physical therapy, and other management. If a patient has intractable pain, then they qualify for the use of opioid medication for management of symptoms. One other component of chronic intractable pain is that it must be certified by two different physicians. Unless new legislation is passed, chronic intractable pain would need to be certified by two physicians, not just one provider in order to qualify for the medical marijuana program.

Over the next month the Minnesota Health Commissioner is going to make a decision on adding intractable pain as a condition for medical marijuana, and it will affect both patients and healthcare providers. If you want to have input on the decision, now is the time. Past history has shown that the most vocal and persuasive voices will influence the decision on what diagnoses are on the list to receive medical marijuana. Mothers with children that had severe seizures were the main force that started the legalization in Minnesota. Patients and medical providers will be the force that determines if intractable pain is added to Minnesota’s list of conditions that are accepted for medical marijuana.