Minnesota Researching Opioid Alternatives

opioid abuse alternativesEven if you’re not a chronic pain sufferer, you’ve probably heard about the “opioid crisis” here in America. Overdoses and accidental deaths from pain medications have skyrocketed in recent years, and things are only getting more divisive as we try to put an end to overdoses. There are too many competing interests working against one another. For example:

  • You have a government officials who are supported by money from big pharma.
  • You have big pharma, who is making a lot of money through the increase in prescription medications.
  • You have some overworked doctors who jump right to pain pills instead of taking more time to find solutions.
  • You have some chronic pain patients who take the idea of opioid regulation as a personal offense.

That’s simply too many interests pulling in too many directions, and chronic pain patients are suffering because of it. However, Minnesota has recently taken some tangible steps to look for alternatives to opioids.

Opioid Alternatives

Earlier this month, leading medical minds met in St. Paul to talk about some alternatives to pain management to help combat the opioid epidemic. They discussed a range of possibilities, including such options as:

  • Electrotherapy
  • Radio-frequency ablation
  • Cryogenics
  • Implantable spinal cord stimulators
  • Epidural injections
  • Medical gadgetry
  • Chemical compisitions
  • Physical therapy techniques

The goal of the meeting was to help lawmakers understand that they have the ability to influence how research funding can be allocated for some of these alternatives, and that the future of these pain management techniques are worth exploring.

Dr. Clarence Shannon, an anesthesiologist who works in the University of Minnesota Pain Clinic in Minneapolis, spoke about the summit and how it’s important to test out potential treatment options before jumping to opioids.

“It’s a stair-step approach that I like to use: nonsteroidals, anti-epileptics or neuropathic medications. We’ll try radio-frequency ablation if we can. We’ll do nerve blocks. And then we’ll move up to the things like the implantable devices,” Shannon said.

These alternatives aren’t perfect solutions, and while they do have some drawbacks, the downsides are much less threatening to a patient’s health than the negative consequences of opioids. Medical devices may cost more, may be more prone to malfunction and may require battery changes, but those downsides are worth it if they can protect us against opioid abuse and overdose.

The pain management summit was a good start, but we need to also focus on getting everybody on the same page. We need to the government to look at the bottom line in terms of lives saved and not dollars earned. We need to take the burden off doctors so they don’t feel the need to fall back on opioid prescriptions without first exhausting some other options. We need chronic pain patients to realize that searching for alternatives does not mean the government is going to come and take away their prescriptions that they are using responsibly to manage their pain.

We need to work together to find a solution, or we can’t expect anything to change. Hopefully Minnesota can be at the forefront of that change.

Chronic Pain Management When Soldiers Return Home

military painChronic pain is a widespread problem for millions of Americans, but it may be even more of an issue for our returning servicemen and veterans. According to a recent study, a survey of one of the Army’s leading units revealed that 44 percent of deployed soldiers suffered from chronic pain, and 15 percent reported regular use of opioids to manage the condition.

Even though soldiers have easier access to comprehensive medical care, these figures are much higher than expected. A survey of the general population suggests that an estimated 26 percent of Americans suffer from some chronic pain condition, while four percent actively use opioids to manage the condition. This means a service member is more than 1.5 times more likely to suffer from chronic pain than an average civilian, and nearly four times as likely to be taking opioids on a regular basis.

Chronic Pain and Military Members

Other findings from the chronic pain survey include:

  • 50 percent of male veterans and 75 percent of female veterans report that pain is the most common physical complaint.
  • More than 40 percent of returning service members with chronic pain also reported having PTSD or post-concussive symptoms.

One of the biggest obstacles facing veterans with pain or mental health issues is that they don’t want to ask for help. People don’t really like to ask for help in the first place, and when you combine it with the mentality of a soldier who is supposed to be tough and selfless, it often leads to situations where they believe asking for help is a sign of weakness, which it’s absolutely note. If you are suffering from chronic pain or you just feel like you haven’t been in a healthy frame of mind lately, reach out to Dr. Cohn or another healthcare provider for assistance.

Creating A Plan To Treat Chronic Pain In Soldiers

Here’s a look at the recommendations provided by the Pain Management Task Force for helping soldiers get the care and treatment they deserve.

  • Provide tools and infrastructure that support and encourage practice and research advancements in pain management.
  • Build a full spectrum of best practices for the continuum of acute and chronic pain, based on a foundation of best available evidence.
  • Focus on the warrior and family.
  • Synchronize a culture of pain awareness, education, and proactive intervention.

The last point is key. We need to focus on shifting the culture of pain awareness and treatment from one where chronic pain patients feel shamed or scared for seeking help towards one that encourages everyone to seek active treatment for their pain. If you need help, speak up.

5 Tips For Exercising With Chronic Pain

exercise painExercise can help prevent and manage chronic pain, but chronic pain can also make it difficult to exercise on a regular basis. However, if you keep some tips in mind, you may find it easier to get through your exercise routine even if you are plagued by chronic pain.

Today, we share five tips that can make exercise easier even if you are battling a chronic pain condition.

Chronic Pain and Exercise

Here are five tips for making your exercise routine a little more bearable when you’re dealing with chronic pain.

1. Avoid The Wrong Activities – Try to get your exercise in by being mindful of where pain exists and which activities overstress these areas. You want to strengthen certain areas while avoiding overstressing painful areas. For example, if you have chronic low back pain, exercise activities like cycling or canoeing may put excess stress on your lumbar spine. Don’t partake in activities that will make the problem worse.

2. Find Your Pace – Yoga classes or group exercise routines can help make exercising more fun, but not if you’re struggling to keep up. Go at your own pace and do not worry what other people are doing. If you’re dead set on working out with a group or another person, find someone who closely matches your ability and who will be willing to scale things back or stop altogether if pain makes exercise too difficult.

3. Aqua Therapy – We’ve pushed the benefits of aqua therapy in the past, and we think it’s a great option for chronic pain sufferers because the water’s natural buoyancy helps to take stress and pressure off our joints. Also, the water provides natural resistance, which makes it easier to strengthen different structures that you might not be able to as easily on land.

4. Balanced Routine – While we want you to find what works for you, it’s also important that you find some balance in your workout routine. You need to focus on your cardiovascular health, aerobic conditioning and strength training in order to best keep chronic pain at bay.

5. Accept That Not Every Day Is Going To Be Great – This happens with everybody, so don’t get discouraged if you just don’t seem to “have it” on any given day. As long as you are up and trying to improve your physical health, that day is a win. It’s not going to be easy, and it’s not always going to go smoothly, but if you’re making a conscious effort to exercise 4-5 times a week, your body will thank you for it.

For more tips on how to exercise with chronic pain, or to talk to a doctor about your chronic pain condition, reach out to Dr. Cohn today.

Let’s Talk About Chronic Pain and Suicide

chronic pain suicideNew research presented at PAINWeek 2017 in Las Vegas suggested that individuals with chronic pain are twice as likely to attempt suicide than those without chronic pain.

For their study, researchers asked more than 1,500 chronic pain sufferers to fill out a questionnaire on their pain and their mental mindset. What they found was that individuals with chronic pain were twice as likely to attempt suicide than individuals without chronic pain, and that 32 percent of chronic pain sufferers reported “suicide ideation in some degree.”

According to researchers, chronic pain (as opposed to acute pain) may share some neural networks with mental health disorders like depression, which can contribute to self-harm tendencies.

“This shared neurobiology may explain why cognitive behavioral interventions can be effective in chronic pain patients,” said Dr. Joseph Pergolizzi, who suggested that patients with chronic pain should be evaluated for other helpful treatments, like cognitive behavioral therapy or mental health counseling. They recommended that mental health assessments during the diagnosis and treatment of chronic pain could be clinically important for reducing the risk of suicide or self-harm in this patient population.

Getting The Help You Need

As someone who is prone to chronic back pain from an injury I suffered back in college, I know how frustrating chronic pain management can be. It can take forever to find a solution that works, and there’s no guarantee that it will work the next day. You’re fighting an uphill battle, but it’s important that you try to stay positive. Remember that you can only control what you can control. You can’t always control your pain, but you can:

  • Get regular exercise
  • Eat a healthy diet
  • Partake in physical therapy
  • Seek a second opinion
  • Get involved a chronic pain group
  • Try new treatment alternatives
  • Share your experiences with others online
  • Take time to focus on your mental and physical health

Pain may play a role in your life, but you should never feel like it is controlling your life. If you’ve found that it’s harder to get out of bed or you just haven’t been the same lately, reach out to a Pain Management specialist. We can take another look at your pain and figure out the best way to help you manage it. We can also set you up with wonderful programs to ensure that your mental health remains positive while you’re tackling your chronic pain issue.

Nobody knows exactly what you’re going through, but that doesn’t mean we’re not willing to learn or to help. Please, if you’re struggling with chronic pain or depression, make a call to our office or to a pain specialist in your area. We’ll do everything in our power to help reduce you pain levels and find something that works for you. We can’t promise solutions, but we can promise that we will try our hardest to find a treatment option that makes your day a little brighter. Contact us today.

Pain Management – Out With The New, In With The Old?

chronic pain programComprehensive chronic pain programs (CPP) have a long history, and they used to be the mainstay of treating pain. Up until the mid 1990’s, they were present across the country and there were several hundred present in the United States. With the widespread adoption of the use of opioids and the ratcheting down of medical expenses by insurance companies, many of these programs were eventually forced out of existence.

These programs cost between $5,000 and $20,000 and sometimes involved 2-4 weeks or more of inpatient care. In retrospect, considering the cost of surgeries and medications, these programs were probably a cheap investment for high quality proven outcomes. Today there are very few of these programs left – less than 100 nationwide – and we are suffering from a crisis of pain management and opioid addiction. In Minnesota, there only several left in the state.

Comprehensive Chronic Pain Programs

The typical chronic pain program is a behavioral based approach to pain with an emphasis on weaning off of all opioids. Nonaddictive medications are fine, and surgical or interventional approaches to pain are usually not a part of the program. Most of the emphasis is on changing behavior as it relates to pain. There is guided physical therapy, often aquatics, dietary advice and significant amounts of group and some individual psychological intervention toward the effects of pain on mood and activity level. The goal is to increase activity and function and show a person that their pain levels are often minimally impacted.

These programs are most successful for those whom have withdrawn from life and interactions. A typical patient in one of these programs is depressed, isolated, sedentary and not working. They often are very focused on taking medications and feel their pain prevents them from doing anything. However, to be successful in such a program, they must want to change their lifestyle.

Unfortunately, if you have chronic pain and are maintaining function in life, these programs often have little to offer. For a person who is well adjusted, with multiple outside of the home interests, working full-time, trying to exercise, doing meditation and not taking opioids, these programs have minimal things to offer that would be worthwhile. Pain management for many complex chronic pain patients is often much more difficult. Further, there are very few physicians in general who specialize in pain, and even fewer who have the interest, knowledge and experience to deal with many of these people.  

Finding a chronic pain program is often not too difficult, and asking your insurance company or physician will probably get you pointed in the right direction. Finding a good pain physician that will meet your needs can be extremely challenging. A good place to start is a Physical Medicine and Rehabilitation Physician that is board certified in pain. After that, look for recommendations and then visit with the doctor to see if they can meet your needs. Finding the right physician is often difficult, and unfortunately there are no easy answers when it comes to pain management.