Author: Thomas Cohn, MD

How Untreated Chronic Pain Can Increase Your Dementia Risk

/ Thomas Cohn, MD

dementiaNew research published this week found that untreated chronic pain can increase a person’s risk of cognitive decline and dementia, and that risk increases based on the number of areas in the body suffering from chronic pain.

The findings, published this week in the journal Proceedings of the National Academy of Sciences, found that chronic pain had an interesting effect on a person’s hippocampus, the area of the brain that is associated with learning and memory. Researchers compared the size of the hippocampus in patients with chronic pain to the size of the hippocampus in aging individuals without chronic pain. When comparing these models, researchers found that chronic pain may artificially age the hippocampus. When compared to a healthy 60-year-old patient, researchers found:

  • Patients with one chronic pain site had a hippocampus that had aged by an additional year.
  • Patients with two chronic pain sites had a hippocampus that had aged by roughly two additional years.
  • Patients with five or more chronic pain sites had a hippocampus that had aged by up to an additional eight years.

“In other words, the hippocampal (grey matter volume) in a 60-year-old individual with (chronic pain) at two body sites was similar to the volume of (pain free) controls aged 62-year-old,” wrote corresponding author Tu Yiheng and his colleagues.

So while you may only be 60 years old, if you are suffering from chronic pain in five or more locations in your body, your hippocampus may have experienced aging similar to that of a 68-year-old. Aging is a common underlying factor in dementia onset, and if your brain is artificially aged due to chronic pain, you may be more likely to experience dementia or cognitive decline.

Prevent Dementia By Treating Chronic Pain

While the findings may be a little concerning for patients dealing with chronic pain, fortunately we can try to reduce our dementia risk by really working to control and treat our chronic pain condition. This is certainly easier said than done, but if you develop a plan and work closely with a pain management specialist like Dr. Cohn, not only can you lead a more comfortable life free of chronic pain, but you can keep your brain healthy as you age.

Treating chronic pain is highly individualized, but may patients find that a combination of the following techniques can help them gain more control over their chronic pain condition:

  • Exercise
  • Posture Improvements
  • Dietary Changes
  • Physical Therapy
  • Stress Relief
  • Sleep Quality Improvements
  • Cognitive Behavioral Therapy
  • Deep Breathing Techniques

As you can see, all of the above techniques are active treatments that focus on improving one or more aspects of your health. Pain medications can certainly play a role in chronic pain management, but the above techniques are better at targeting the underlying pain cause and providing long-term relief.

Of course, working with a pain management specialist can help you find the right combination of treatments for your specific needs. If you want help identifying a pain treatment plan that’s right for you, or you just want to talk to a pain management provider about your symptoms, reach out to Dr. Cohn and his team today at (952) 738-4580.

How To Boost Your Energy If You Have Chronic Pain

/ Thomas Cohn, MD

energyAnyone who has or is currently dealing with a chronic pain condition knows just how physically draining the issue can be. Good days can be exhausting, and it can be hard to muster up the energy to just get out of bed on the bad days. However, it’s important that you get out and be active, as exercise and interactions with others can help to manage your pain condition. But how can you find the energy to thrive in the face of a chronic pain condition? We share some tips for how you can boost your energy if you’re often fatigued due to a chronic pain condition.

Finding More Energy If You Have Chronic Pain

Here are some ways you can work to become more energized in the face of chronic pain.

1. Improve Your Diet – One of the simplest ways to get more energy is to tweak your diet a bit. Foods that are high in fat can leave you feeling sluggish, and while sugar may provide a short-term boost in energy, it also has a propensity to cause you to come crashing down. Instead, choose healthier foods that will help to fuel your body. Fruits, leafy vegetables, nuts, fish and beans are all packed full of vitamins and nutrients that can help provide the right kind of energy for your body.

2. Exercise – It may seem odd that a physically draining activity like exercise can actually help you feel more energized, but it’s true. Exercise gets your heart rate up and increases blood flow to the brain, both of which can help you feel more energized. A high intensity workout can leave you feeling tired, but some light exercise like walking, cycling or swimming can leave you feeling more energized than when you started the activity.

3. Healthy Sleep – We understand that chronic pain can make it difficult to fall asleep and stay asleep. but it’s really important that you work to get in a healthy sleep rhythm if you want to feel more energized in the morning. Going to bed at irregular times and sleeping with a bright television on can make it harder to achieve good restful sleep. You can learn more about developing a healthy sleep routine if you have chronic pain in this blog.

4. Find Your Stress Outlet – Chronic pain can be extremely stressful, but we’re willing to bet that it is not the only form of stress in your life. Stress can be physically draining, so it’s imperative that you find healthy ways to manage stress. Whether that involves exercise, breathing techniques, yoga or any other technique that works for you, if you can find a healthy way to manage stress, you may find a little extra pep in your step.

5. Stay Hydrated – A final way to help avoid feeling achy, cramped and fatigued is by staying hydrated. When you’re dehydrated, your muscles will tire more easily, and it can also lead to a chronic pain flareup. Try to drink plenty of water throughout the day to stay hydrated. A good goal to aim for is to take your body weight, cut it in half and drink that many ounces of water eat day.

If you follow those five techniques and you connect with a pain management specialist like Dr. Cohn who can give you the individualized attention you need, we’re confident that you’ll feel more energized and gain more control over your chronic pain condition. For more information, contact his office today at (952) 738-4580.

Tips For Being A Great Friend To Someone With Chronic Pain

/ Thomas Cohn, MD

chronic pain friendLiving with chronic pain can be extremely challenging for a number of reasons, and as we’ve talked about on the blog in the past, it can have a significant effect on your social life. You don’t want your friends to feel isolated or alone because of their pain condition, but being a great friend can take a little extra work because of the complexity and unpredictable nature of a chronic pain condition.

Because of this, we wanted to use today’s blog to highlight some of the ways you can be a great friend to someone with chronic pain.

Supporting A Friend Who Is Dealing With A Chronic Pain Condition

Here are some ways you can be a supportive friend to someone who is battling a chronic pain condition.

Listen More Than You Talk – As the old adage goes, we have two ears and one mouth, so we should do twice as much listening as we do talking, and that’s especially true when supporting a friend with a chronic pain condition. Let them vent their frustrations to you, or keep the conversation about anything other than their pain condition. Be a good listener and really hear them when they talk.

Know That Cancellations Aren’t Personal – You may have had those plans on the books for months, but temper your expectations and know that a last-minute cancellation is possible and that it is nothing personal. Many chronic pain patients don’t know when their next flare up is coming, and despite their best efforts, they may be having a bad day at the absolute worst time. Be understanding if they have to back out of a commitment and know that their decision to cancel plans isn’t anything personal.

Be A Positive Voice – It can be easy to focus on the negatives of a chronic pain condition, but doing so isn’t good for your mental and emotional health. Do what you can to be a positive voice of encouragement. If you notice that your friend is more physically capable or has made strides since the last time you saw them, let them know. This encouragement and positive talk may be more important to them than you’ll ever know, so try to avoid focusing on the negatives associated with a pain condition.

Be Persistent – Those dealing with a chronic pain condition are less likely to make plans or meet you out on a moment’s notice, so you can be a great friend by regularly asking them to do things. Remember that cancellations or unaccepted invites aren’t personal, but they’ll love that you’re reaching out and wanting to connect. Don’t stop reaching out even if most plans don’t come to fruition. It’s easy for social circles to get smaller and smaller as a result of chronic pain, so don’t stop reaching out even if it takes a while to make plans.

If you do these things and practice patience, you’ll be a great and supportive friend to someone battling a chronic pain condition. It takes a little extra effort, but we know from first hand experience how important it is to have friends like this if you’re working to overcome a chronic pain condition. For more information, or for help with a different chronic pain issue, reach out to Dr. Cohn today at (952) 438-4580.

Opioids – Damned If You Do, Damned If You Don’t

/ Thomas Cohn, MD

painkillersIf you’re a regular reader of our blog, you know our views on opioids for pain management. Used correctly, opioids can be a wonderful compliment to a chronic pain management program, but their use can also cause some health issues even when carefully taken. According to a new study, not only can starting an opioid regimen be potentially hazardous to your health, so too can stopping opioid use. This doesn’t mean that you should plan to take opioids indefinitely, but it speaks to the importance of working with a pain management provider when starting and stopping an opioid regimen.

According to a recent study published in the journal PLOS Medicine, stopping a prescription opioid regimen can actually increase a person’s risk of overdose death. Opioid-related overdoses are a major concern here and in Canada where the study was conducted, and researchers wanted to learn more about the potential impact of discontinuing an opioid treatment plan. You might inherently believe that your risk of overdose falls to zero if you stop taking opioids, and in a perfect world, you’d be right. However, not everyone who stops taking opioids can do so easily, and therein lies the risk of eventual overdose.

Safely Stopping Opioid Use

For the study, researchers reviewed the medical records of more than 14,000 patients in British Columbia who had been on opioid therapy for at least 90 days. After reviewing the records, researchers found that discontinuing opioid therapy for chronic pain was associated with an increased overdose risk for people without an opioid use disorder (OUD). An inverse effect was seen in patients who tapered off of opioid use, as their overall risk of overdose decreased. Researchers concluded that abrupt opioid stoppage could be dangerous, and that patients should work with a provider to taper off of medications so as not to increase their risk of overdose as they seek to end an opioid regimen.

While there were some limitations in the study, including whether or not associated overdoses occurred with prescription medications or those obtained illegally, the general message holds true in that it is extremely important that you work with a physician when working to stop an opioid treatment plan. We understand that you are aware of some of the potential issues associated with opioid use, and we commend you on wanting to curb or eliminate your reliance on these medications. However, there is a right way to go about cutting prescription medications out of your system. Sometimes slow and steady wins the race, and cutting opioids cold turkey could have some unintended withdrawal effects.

If your current medication plan isn’t getting you where you want to be, talk to a doctor about safely adjusting your medication program. We want to help you find the right solution, but finding the right treatment is only part of the battle. You also need to approach the treatment in the right manner, otherwise you may face some unexpected obstacles.

For more information, or for help with a chronic pain condition, reach out to Dr. Cohn and his team today at (952) 738-4580.

New Findings On Why Poor Sleep May Lead To Chronic Pain

/ Thomas Cohn, MD

sleepA new study involving mice may have provided some more insights into why poor sleep and chronic pain may be linked.

According to the study, nerve injuries may cause certain brain cells to act excitedly during sleep, and this sudden excitement may lead to chronic pain onset. On a positive note, researchers say that stopping this hyperactivity during sleep could help provide significant pain relief

As we’ve talked about on the blog in the past, sleep disorders and chronic pain are closely related, but the exact nature of why certain sleep problems increase the risk of different types of chronic pain is not well understood. We’ve talked about how it can be hard to break out of the sleep-pain cycle, which theorizes that chronic pain makes it hard to fall asleep and stay asleep, and poor sleep quality can intensify pain sensations, but this recent study wanted to learn more about the exact connection between the two.

Sleep And Chronic Pain

For the study, researchers honed in on neuropathic pain, which is pain that derives from an injury or disease in the nerves that relays sensory information from the body to the brain. Researchers studied mice with injuries in one of the sciatic nerves, the large nerve that branches from the spinal cord through the hind legs. The team analyzed brain activity in the mice both before and after the sciatic nerve injury in order to see how the brain responded to this new pain. The team found that there were significant changes after the injury in the wrinkled cerebral cortex, which is the area that receives and stores sensory data from the hind legs. Moreover, certain brain cells became progressively more active in the weeks after the injury as the mice’s pain became chronic.

Perhaps most interestingly, this brain cell activity peaked during non-rapid eye movement sleep (NREM), which is when deep sleep occurs. Researchers said these neurons became hyperactive during NREM sleep as a result of an issue with the anterior nucleus basalis, a cluster of neurons located deep in the front of the brain. Researchers noted that the activity of the anterior nucleus basalis also increased after the nerve injury, and this triggered the cells to send a chemical response to the cerebral cortex. As a result of this chain reaction, the previously mentioned brain cells shifted into overdrive during NREM sleep.

This increase in brain activity was linked to an increase in pain sensitivity in mice, as researchers stated that once-painless stimuli suddenly became painful. In follow up experiments, researchers were able to relieve this pain by blocking cell hyperactivity along certain neural pathways during NREM sleep.

“Inhibition of this pathway during NREM sleep, but not wakefulness, corrects neuronal hyperactivation and alleviates pain,” the researchers concluded.

So while the study only examined mice, it does provide insights into how neural action during sleep can lead to increased pain during wake periods, and researchers are hoping that some of the findings would be similar in a human population. Future studies are sure to follow, and hopefully we continue to learn more about the connection between poor sleep and chronic pain onset.

For now, do what you can to prioritize healthy sleep if you have a chronic pain condition. Avoid caffeine late in the day, get regular exercise, go to bed around the same time each night and keep electronics out of the bedroom so that you have an ideal sleep environment. You may not be able to control what happens during NREM sleep, but you can work to break out of the sleep-pain cycle by making it easier for your body to fall asleep and stay asleep.

If you’re dealing with sleep issues as a result of your chronic pain condition, or you want help with a different pain issue, reach out to Dr. Cohn and his team today.