Sleep and Caffeine May Play Key Role In Controlling Chronic Pain

sleep caffeineNew research out of Boston suggests that sleep and caffeine may play integral roles in controlling chronic pain flareups.

It’s probably not a huge surprise that sleep is beneficial for controlling chronic pain, as we’ve talked about the restorative benefits of sleep on our blog many times before, but the part about caffeine is interesting. Here’s what the researchers had to say.

Benefits of Sleep and Caffeine

For their study, researchers looked at the effects of sleep (or lack thereof) and caffeine on mice and their pain sensitivity. Researchers began by tracking normal sleep cycles and measuring brain activity, then they began to disrupt this healthy sleep cycle by giving mice toys and activities that entertained them and kept them awake (much like Netflix or our iPads do for humans).

“Mice love nesting, so when they started to get sleepy (as seen by their EEG/EMG pattern) we would give them nesting materials like a wipe or cotton ball,” says Dr. Alban Latremoliere, PhD and pain expert at Boston Children’s Hospital. “Rodents also like chewing, so we introduced a lot of activities based around chewing, for example, having to chew through something to get to a cotton ball.”

Researchers kept mice awake for up to 12 hours in one night or for six hours five nights in a row. They examined that fatigue, stress and pain sensitivity all increased during this time.

“We found that five consecutive days of moderate sleep deprivation can significantly exacerbate pain sensitivity over time in otherwise healthy mice,” says Dr. Chloe Alexandre, a sleep physiologist.

Caffeine’s Role

According to researchers, common painkillers did not help mice combat pain, and morphine was less effective in sleep-deprived mice, meaning chronic pain patients who are tired may have to up their morphine dose in order for it to be effective. However, researchers found that caffeine helped to block pain sensitivity.

This led researchers to conclude that a good night’s sleep combined with caffeine during the day (along with other good habits like regular exercise and a healthy diet) may be more effective for managing chronic pain than simply relaying on analgesic medications.

“Many patients with chronic pain suffer from poor sleep and daytime fatigue, and some pain medications themselves can contribute to these co-morbidities,” Dr. Kiran Maski, M.D. at Boston Children’s hospital who studies sleep disorders. “This study suggests a novel approach to pain management that would be relatively easy to implement in clinical care.”

Opioids and a Healthy Mindset For Managing Pain

Pain MindsetThe most common treatment option in America for individuals suffering from chronic pain is opioids or pain medications. According to statistics, the US is home to 5% of the world’s population yet we consume 80% of the world’s opiates. Our pain isn’t any different than pain felt by someone in Africa or Asia, so why do we rely so heavily on opioids?

According to Dr. Aneesh Singla, it’s because we have the wrong mindset when it comes to setting expectations for opioid effectiveness.

The Myth of Zero Pain

The Centers for Disease Control and Prevention states that the number of prescription opioids sold in the US since 1999 has quadrupled, yet the number of Americans reporting pain hasn’t changed. That’s because opioids are viewed as a solution, not as an aid to simply decrease pain while other treatments are performed. Opioids will never cure a chronic pain condition on their own, yet we expect them to rid us of all our pain. In a recent article, Dr. Singla said this problem can sometimes be traced back to the physician, who fails to explain that a chronic pain situation is not a zero sum game.

“I believe that pain is protective to us and that opiates will never cure pain 100%; so we set expectations for perhaps 50% pain relief from opiates, so that opioids are not overused in search of 100% pain relief,” said Dr. Singla. “I tell my patients that a 50% reduction in pain is a reasonable goal when treating chronic pain, and we seek this with multiple treatment options, not simply through opiates.”

There are two key takeaways from that quote. First, that the main goal of pain care treatment needs to be a reduction in pain, not its elimination. If you’ve been dealing with chronic back pain for years, it’s unreasonable to think that treatment will completely cure the problem and leave you with zero pain or discomfort, so the focus needs to be on making every day or every week less painful than the previous. The second point is that opiates alone will never solve this problem.

Opioids and Pain Expectations

We talk about pain medications on this blog and on our social channels a lot, and it’s interesting because the topic often brings out a knee-jerk response from different people. When we write articles about painkiller abuse or that pain will never be solved by a pill alone, many people are quick to defend their responsible opiate use and feel that we are attacking individuals who truly need pain pills to help them get through their day. The problem is that knee-jerk reaction couldn’t be farther from the message we’re trying to convey when talking about addiction, abuse or painkillers in general.

Opioids can be a key component to effectively managing chronic pain. We aren’t against opioids at all. What we’re trying to show in these articles is that our current views on them are misguided and that they need to be re-evaluated. It starts with the pharmaceutical companies who only care about their bottom line; It trickles down to the doctors who over-prescribe or under-educate patients on what they should expect from the opioids and how they can be used in conjunction with other treatment modalities, and it ends with the patient who decides to take an extra pill because their back is more painful than normal because they’ve skipped their last three physical therapy sessions.

Managing pain is not easy, and opioids play a vital role, but we need to do a better job of setting expectations and pairing pills with active rehab options to ensure the best results for our patients.

When Pain Management Becomes A Pain

chronic pain managementLet’s be honest, taking part in a daily pain management routine is rarely fun, and at times it can become downright exhausting. Sometimes all the things you need to do to care for your pain become more burdensome than the pain itself, but that doesn’t mean you should give up and give into pain. Today, we share some tips for what to do when pain management becomes a pain.

Tips For Managing Pain

Whether you’re dealing with chronic regional pain syndrome, asymptomatic back pain or irregular headaches, here are some tips to keep in mind to help pain management become less burdensome.

1. Active Distractions – If you can distract your mind from your pain, all while working to rid yourself of chronic pain, you’re winning the battle. Things like Netflix or a bowl of chocolate ice cream can help take your mind off the pain, but they won’t actively help you strengthen your body and keep symptoms at bay. Try to find activities that are somewhat physical in nature that don’t feel like exercise or therapy. Activities like swimming, Tai Chi, cycling, walking, or yoga can all help strengthen key muscle groups and keep your mind off your pain without feeling like a regular exercise routine.

2. Vent – It can be healthy to vent about your pain once in a while, but don’t dwell on it. Most patients with chronic pain try to hide their pain from everyone because they don’t want to be seen as weak or “complainers,” but it’s perfectly healthy to express frustration with your pain. Whether it’s just yelling out loud for five seconds each day or blogging about your pain on a message board, these channels allow us to speak out about pain when so often we remain silent. Find what works for you.

3. Professional Help – Pain management physicians are trained in helping people who are battling complex pain problems, so reach out to one if you have questions or concerns about your pain. Odds are we’ve heard the question before, or we can think it over and give you some healthy advice. It doesn’t need to directly relate to your pain, either. You can ask about different therapy techniques or support groups in the area, and we’ll do our best to help give you some professional guidance.

4. Small Victories – Fighting the daily battle against chronic pain can feel like an uphill battle where for every two steps you take forward, you find yourself taking one or more steps backwards. This will be undoubtedly frustrating, but try not to dwell on the bad and instead focus on what you’ve accomplished and the progress you’ve made. Maybe your chronic back pain was so painful that you couldn’t go for a run like you planned, but instead you bucked up and did 20 minutes of therapy stretches. Don’t focus on the missed run – focus on the therapy you did to kick your pain’s butt! Enjoy the small victories as they come along.

The Importance Of Complementary Medicine

As we talked about in our blog post on Tuesday, there’s no simple way to treat chronic pain. No magic pill is going to cure your pain. Instead, you need to have a comprehensive and multifaceted approach to controlling your chronic pain. Sometimes, that approach includes complementary medicine options.

We are a traditional pain clinic, but it would be wrong to simply ignore the benefits of some complementary options. We’ve talked about the benefits of acupuncture on our blog in the past, and our most viral post isn’t exactly a traditional medicine method.

Complementary Medicine Benefits

Mindfulness, acupuncture and other complementary medicine methods are key components to finding the best way to treat chronic pain, and that’s a sentiment shared by our friends at Burning Nights CRPS. In fact, they believe in the benefits of complementary approaches so much that they designed a wonderful infographic to help inform others. Take a look at the infographic below, and be sure to check out their site for more helpful information on how to best beat chronic pain!

complementary medicine

4 Key Components For Combating Chronic Pain

Battling chronic pain is no easy task, but it gets easier if you know the best way to tackle the condition. Today, we share four ways to help combat chronic pain, and we explain how these factors can help you conquer your daily discomfort.

The 4 Keys To Conquering Chronic Pain

chronic pain keysThere is no magic pill that will get rid of your chronic pain. If you want to reduce your daily pain, focus on these for areas.

1. Exercise – If there’s one thing we can recommend when it comes to conquering chronic pain, it’s regular exercise. As someone who struggles with back pain, I find that it is best controlled when I’m actively working on strengthening the area. We know that chronic pain can make it difficult to exercise, but try to find an activity that works for you, whether it be running, cycling, walking or swimming!

2. MindfulnessA recent article published on Medscape suggests that mindfulness probably won’t help you with back pain. It’s true that mindfulness alone won’t magically cure your back pain, but we’ve found that patients who try to eliminate stress in their life and who focus on putting pain behind them instead of feeling sorry for themselves seem to respond better to treatment. Mindfulness isn’t something you can just achieve, but there are a number of activities you can participate in to help push pain out of your mind. From speaking with a therapist, to taking a Tai Chi class, to simply making it a point to get out of bed and not let pain slow you down, treating your mental health is just as important as your physical health when it comes to conquering chronic pain.

3. Diet – Your diet also plays an important role in chronic pain expression. A number of chronic pain flare ups are caused by inflammation, and that inflammation can be triggered by certain foods in our diet. Try to eat a wide range of fruits, vegetables, proteins and fish, and stay away from the sugars and saturated fats. Sometimes a diet change is all you really need.

4. Professional Assistance – Finally, don’t try to take on your chronic pain on your own. Medical professionals can help you get to the bottom of your condition and devise a number of different treatment methods to suit your needs. You wouldn’t try to fix your own cavity or fill your own taxes (Okay – some of you are probably brave enough to do your own taxes, but I prefer to hand it all over to a professional), so don’t try to combat your chronic pain all alone. We’ve studied this stuff for decades, let us help!