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.

The Daith Piercing Survey Is Complete!

daith survey completeIf you’ve been following this blog, you probably remember that we’ve been helping Dr. Chris Blatchley collect responses for a study he was conducting on the Daith piercing and vagal nerve stimulation. We’re happy to report that the first report of the findings has been published.

You can find the first report on the role of Daith piercings and vagal nerve stimulation by clicking here. That link will take you to the report, but updated versions of the report can be found on Dr. Blatchley’s main site, which you can get to by clicking here, so be sure to visit the site in the future to see the updated reports.

You Can Still Take The Study

Although the first version of the findings are in, you can still participate in the study if you haven’t taken the survey yet. Remember, this is an updated version of the survey, so even if you completed the survey in the past, you may still be eligible to complete the second version. To take the second version of the daith survey, click here.

Thank you to everyone who helped Dr. Blatchley with his research. He’s informed me that’s he has shared the findings with the British Medical Journal, and he hopes that they will publish the findings. If they are published, it would be the first of its kind research published in a medical journal! He’s also planning to release a full research article in the future based on the second version of the survey.

So please check out the findings, and keep your fingers crossed that they’ll make their way to the BMJ. The more migraines and vagal nerve stimulation are talked about in major medical journals, the more eyeballs we’ll have on the problem, and the more people we’ll have working towards a solution. Thanks to everyone who took part in the survey, and congrats to Dr. Blatchley for finishing the first version of the findings.

The Landscape of Addiction in 2017

addiction opioidsOne of my favorite activities is reading. I read a wide variety of things, some of the most interesting things come from magazines that are not medical. Time magazine regularly has interesting stories of health.  Science, a bi-weekly publication, routinely has articles on a wide range of subjects that challenge the core of what one thought was fact. National Geographic regularly throws in medical stories. A couple years ago they had a great summary on marijuana, and recently now they had a great article on addiction. Medical journals are often a somewhat dry and boring read, but they do allow one to keep up-to-date with current research. Sometimes these other magazines have extremely valuable information as well.

The September 2017 National Geographic lead story is on The Science of Addiction. The problem is more than just opioids, it is a vast variety of problems from smoking to gambling and including all kinds of drugs. Addiction is a very complex process in the brain, and is definitely a disease and not a moral failing. Different types of addictions may affect a variety of brain regions. The processes involve disruptions in pathways responsible for learning, emotion, desire, regulation, and cognition among many neural events. It can change chemical, hormonal, and electrical paths in the brain. Addiction becomes abnormal learning in the brain with the reward being the addictive activity.

Addiction And Our Brains

All addiction has its roots in the primitive regions of the brain. They have to do with our need to survive, and they all involve our senses like sight, smell and taste. Critical in addiction is the neurotransmitter dopamine and that stimulates brain motivation. Those lacking dopamine often are depressed. Further, Parkinson’s disease has a lack of dopamine, and when given to some patients, it causes problems with an addiction like gambling. When something is addictive, it stimulates the dopamine pathways in the brain and is a very positive reward. The dopamine reward is so strong in the brain, people lose the control of impulses and the ability to inhibit behavior even if it is self-destructive.  

Since there are many things that are now considered true addictions, it is likely there are many different strategies to treat them. For drugs, often there are medications that can block the pleasure from the drug and prevent withdrawals. For alcohol, there are drugs that make drinking nauseating. There are also numerous counseling strategies and psychological-type interventions to deal with the behavioral components of addiction. There are also some new novel strategies including electrical and magnetic stimulation of specific areas of the brain to treat addiction.

The problem of drug addiction or any type of addictive behavior is caused by abnormal function and rewards in the brain. Pain and the problems associated with the medications taken can cause addiction, but this isn’t always the case. Taking opioid medications does lead to dependence and tolerance of the drugs that cause them to lose effectiveness. Opioids can also change a person’s sensitivity to pain and make a person perceive pain sensations more intensively. Therefore, in general, opioid medications have many downsides.

Lastly, opioids can be addictive and cause typical addiction issues in pain patients, but it is in only in a small percentage, somewhere between 5-20%. In most chronic pain patients, addiction and problems with opioids are generally not a typical problem. Treatment in pain patients is the same as with any other person who has opioid problems, and is often best handled by a pain care specialist.  If you are a pain patient on opioids, and taking your medication has become the focus of your life, then it is probably time for one to be treated for addiction and be off of these medications.