Medical Cannabis For Chronic Pain Could Increase Heart Arrhythmia Risk

January 11, 2024 / Thomas Cohn, MD

New research out of Denmark suggests that medical marijuana use for chronic pain issues may significantly increase a person’s risk for de novo arrhythmia compared to patients who pursue other treatments for their pain.

While the absolute risk of developing heart arrhythmia while taking medical cannabis for a chronic pain condition is still relatively low (0.4%), the fact that is raises your risk at all could be a cause for concern for many patients, especially those with a history of heart issues.

“Short-term risk of arrhythmia was significantly elevated in patients prescribed medical cannabis compared with matched control patients, but the absolute risk increase was modest at 0.4% in the first 180 days,” said Anders Holt, MD, cardiologist at Copenhagen University Hospital – Herlev and Gentofte in Denmark, in an interview with Healio.

Medical Cannabis And Heart Issues

For their research, Holt and colleagues used nationwide registers to identify 5,391 patients with chronic pain who began using medical cannabis between 2018 and 2021 as part of their treatment plan. This group was then age- and sex-matched 1:5 to 26,941 control patients with a chronic pain diagnosis that were pursuing another pain medication treatment other than medical cannabis.

For the patients that used medical cannabis:

24% used CBD
29% used combination CBD/THC
47% used THC alone

For patients pursuing other treatments, the most common medications were NSAIDs, anti-epileptic drugs and opioids.

Researchers reported that medical cannabis use was associated with a 180-day absolute risk for new-onset arrhythmia of 0.8%, whereas non-use was linked to a 180-day absolute risk for new-onset arrhythmia of 0.4%, meaning patients who pursued medical cannabis were twice as likely as their counterparts to develop a new heart arrhythmia. Researchers said the increased arrhythmia risk was similar regardless of the type of medical cannabis they pursued.

“Both CBD and THC have an effect on the CB1R receptor, which theoretically could lead to CV [cardiovascular] side effects,” said Holt. “Previously, side effects have been mostly suspected to be related to THC since the psychoactive properties of cannabis arise from this cannabinoid. Findings from this study suggest that both THC and CBD may play a role in the risk of CV side effects.”

The team did note that they observed no significant association between medical cannabis use for chronic pain and risk for acute coronary syndrome

“This study adds important and much-needed data on CV side effects related to medical cannabis; however, clinicians should consider the observational nature of these findings which limits their impact and applicability for clinical recommendations before changing any practice,” Holt concluded. “Considering all available data on medical cannabis treatment for chronic pain, I believe that it should probably be reserved for chronic pain conditions where the effect is supported by sufficient evidence, eg, neuropathic chronic pain. Considering data from this study, some improved monitoring of CV symptoms immediately following initiation could be beneficial, especially in patients with known cardiometabolic disease or history of cancer.”

Dr. Holt’s takeaway point here is key. Given the nature of the study results, physicians should thoroughly review a patient’s heart history before recommending medical cannabis as a treatment option, and heart monitoring could be beneficial for chronic pain patients who are beginning a medical cannabis regimen. Medical cannabis has been shown to be an effective tool in managing symptoms for many types of chronic pain patients, but it’s not without its own risks. Patients would benefit from an open and honest dialogue with their doctor about their heart health prior to beginning a medical cannabis regimen as part of treatment for their chronic pain condition.

For more information about medical cannabis or chronic pain treatment, reach out to Dr. Cohn and his team today at (952) 738-4580.

Chronic Pain Incredibly Common Among TBI Survivors

January 4, 2024 / Thomas Cohn, MD

New research shows that upwards of 60 percent of people living with a traumatic brain injury are affected by a chronic pain condition.

The study found that chronic pain affects a large portion of TBI survivors, even up to 30 years after their initial head injury. The research was published in The Journal of Head Trauma Rehabilitation, and it involved over 3,800 respondents who had previously been hospitalized with a moderate to severe TBI. Most respondents were white (77%) and male (75%), with an average recovery time since injury of five years (between 1-30 years).

For the study, researchers surveyed participants about their head injury and other current health issues they are facing, like chronic pain, which was defined as “persistent or recurring pain that lasts longer than three months, including headaches or pain anywhere in the body, which occurs more than half of the days over a three-month period.”

Study Results

After looking at the data, researchers uncovered some concerning statistics about the connection between TBIs and chronic pain onset. They found:

46 percent said they were currently living with a chronic pain condition.
14 percent said they previously dealt with a chronic pain condition.
40 percent reported no chronic pain symptoms now or since their TBI.
32.5 percent of participants with a current chronic pain condition reported constant pain.
Compared to those with no chronic pain, patients with a current chronic pain condition had severely worse scores on three outcomes measured in the survey – the Functional Independence Measure, the Disability Rating Scale and the Glasgow Outscore Scale.

Another concerning finding from the survey was that medications were the most common form of chronic pain treatment. Medications were used by more than 91 percent of patients with a current chronic pain condition and by 90 percent of patients with a past chronic pain condition. As we’ve always said, it’s not that medications aren’t an effective part of a comprehensive treatment plan, but they cannot be your main or only form of treatment. You need to pursue active interventions, like exercise, diet, weight loss, cognitive behavioral therapy or relaxation/deep breathing techniques in order to get the most out of any medication regimen.

The study stopped short of explaining the specific connection between head trauma and chronic pain onset, but it stands to reason that damage in the brain can affect nerve relays throughout our body. Nerve damage can cause our pain signals to be fired when no painful stimuli is felt, or it can cause your brain to interpret a normal sensation as a painful one. It should come as no surprise that patients with a moderate to severe head injury ended up having some neural connection issues even long after the trauma. It speaks to the importance of working to overcome the totality of the TBI so that symptoms don’t manifest later down the road.

If you’re struggling with chronic pain and believe it may be tied to a previous head injury, reach out to a pain specialist in your area like Dr. Cohn. We can work to pinpoint the source of your chronic pain issue and get you set up on the road to recovery. It’s never too late to take the first step towards less chronic pain. For more information, or for help with a different pain issue, reach out to Dr. Cohn and his team today at (952) 738-4580.

Tips For Starting An Exercise Program When Everything Hurts

December 28, 2023 / Thomas Cohn, MD

Exercising and chronic pain can be like oil and water. It can be hard to start exercising if you have chronic pain, but there’s a good chance that your chronic pain condition will improve by pursuing an exercise program. But how can you overcome a chronic pain condition and begin a beneficial exercise regimen? In today’s blog, we share some tips for starting an exercise program when your body hurts as a result of a chronic pain condition.

Starting An Exercise Program In Spite Of Chronic Pain

Starting and sticking to an exercise routine that will see you become a healthier version of yourself is never easy, and that’s especially true if you have a chronic pain condition. That said, there are some ways to make it a little easier to exercise despite your chronic pain condition. Here’s how:

Get Creative – When people think of traditional exercise, they oftentimes think of a running program. Running is a great way to build your muscles and challenge your body, but it certainly isn’t the only way to exercise. Get creative when it comes to exercise and pursue an activity that you find enjoyable (or at least bearable). Consider doing some yoga, riding your bike around the city or swimming laps at the local pool.

Develop A Routine – We know that developing a standard routine isn’t always easy when you have to adapt to the challenges of chronic pain, but begin to carve out some regular time for exercise. Perhaps that means waking up a half hour earlier on Mondays and Thursdays, or stopping at the gym on your way home from work a couple days a week. Your body and your brain will slowly start to get used to this routine, which will make it easier to regularly pursue exercise.

Pay Attention To Your Recovery Period – Even if you don’t have a chronic pain condition, odds are you’ll have some soreness and discomfort after exercising. It’s important that you help your body recover after exercise so that this discomfort doesn’t linger. Eat a healthy diet, get up and move, do some light stretching and stay hydrated to make it easier for your body to recover from the rigors of exercise.

Set Attainable Exercise Goals – We’re more likely to keep coming back for more exercise if we set realistic and attainable goals. Don’t plan to exercise 4-5 times a week if you are starting a new program. Slowly begin a new exercise program and gradually push yourself to take on bigger challenges. If you bite off more than you can chew or your goals are too lofty, you can end up sabotaging your own exercise routine. Set challenging but realistic goals.

Work With A Pain Management Specialist – Finally, know that you don’t have to develop and pursue an exercise program while dealing with chronic pain on your own. Dr. Cohn and his team can help you develop an exercise routine tailored to your strengths and current limitations so that it’s easier for you to reach your goals. Chronic pain can be isolating, but you have resources that you can lean on when your pain condition makes daily activities like exercise difficult. Let us help you make is easier to pursue regular exercise in spite of your pain condition.

Exercise has countless benefits for your body, and oftentimes it can really help to lessen symptoms of a chronic pain condition. It won’t be easy to start an exercise program when everything hurts, but we know it will be worth it. For more information, or for help with a different chronic pain issue, reach out to Dr. Cohn’s office today at (952) 738-4580.

How To Manage Chronic Pain During Holiday Travel

December 21, 2023 / Thomas Cohn, MD

The holidays are right around the corner, and tens of millions of Americans will travel by plane, train and automobile to get to a holiday destination this weekend. If you are visiting family or spending the holidays somewhere warm, the prospect of traveling to your destination can have you feeling less than enthused, especially if you are dealing with a chronic pain condition.

Dr. Cohn and his team want to make your holiday travel a breeze even if you have chronic pain, so in today’s blog, we share some tips for making holiday travel less messy if you have chronic pain.

Traveling With Chronic Pain

If you want to help keep your chronic pain condition at bay during your holiday travels, keep these tips in mind:

Move When Possible – Chronic pain tends to worsen when we’re stuck in the same position for an extended period of time, so take advantage of opportunities to get up and move when the situation presents itself. If you stop for gas or the captain turns off the seat belt sign, get up and move, as this will help healthy blood circulate more easily. This tip is also easier to perform if you also keep the next tip in mind.

Leave Early – If you’re driving to your destination, leave a little early so that you can make some pit stops to stretch if pain starts to worsen. If you’re running behind schedule, you may not want to stop and stretch, and that can make your pain condition worse. If you’re traveling by plane and can’t control your arrival time, make it a point to stand up and move around in the time leading up to the boarding process. Squeezing in some last minute movement before you sit for an extended period can help keep chronic pain flareup at bay.

Medication Management – If you’ll be gone from home for an extended period, make sure that you have refills of any prescription medication that may be hard to acquire from a different pharmacy. Also be sure to pack your over-the-counter pain relievers and consider taking some anti-inflammatory medications before you get in the car. Always follow the instructions on the bottle and do not get behind the wheel if it is not advised to operate heavy machinery while under the effects of your medication.

Stay Hydrated – Always have a bottle of water nearby so that you can stay hydrated. Drinking plenty of water will help boost your circulation and prevent muscle stiffness, which can contribute to pain.

Dress Appropriately – Give some thought to the clothes you’ll be wearing as you travel. Your vehicle or the plane may start off colder and get warmer over time, so you’ll want to be able to add or remove layers to regulate your body heat. CRPS and other pain conditions can flare up when your body can’t effectively regulate its temperature, so wear layers of comfy clothes and add or remove them as needed during your travels.

We hope that you have a wonderful holiday season, and that starts by keeping pain at bay during your travels. Keep these tips in mind, and we’re confident that you’ll be giving yourself a great chance to maintain control over your chronic pain condition. For more information, or for personalized help with a pain issue, reach out to Dr. Cohn and his team today at (952) 738-4580.

What Is Chronic Fatigue Syndrome?

December 14, 2023 / Thomas Cohn, MD

A new report published by the Centers for Disease Control and Prevention estimates that roughly 3.3 million Americans are battling what’s known as chronic fatigue syndrome. CDC Dr. Elizabeth Unger, co-author of the report, noted that chronic fatigue syndrome is clearly “not a rare illness.” But what is chronic fatigue syndrome, and can it be effectively treated? We take a closer look in today’s blog.

Understanding And Treating Chronic Fatigue Syndrome

Chronic pain and chronic fatigue syndrome are similar in that they both describe a condition that has gone unresolved for months. Pain is considered chronic when it remains present despite attempts at treatment for more than three months. Chronic fatigue syndrome is characterized by at least six months of severe fatigue and exhaustion that is not improved by bed rest. Other symptoms that commonly accompany chronic fatigue syndrome include:

Brain fog
Pain
Discomfort after physical activity

Medical professionals don’t really know a specific cause of chronic fatigue syndrome, but many believe the problem is housed in the immune system. If something triggers a reaction of the body’s natural immune response, it can be physically draining. It’s not just the presence of a virus or bacteria that is making your tired, it’s also because your body is working hard behind the scenes to fight off this foreign invader. For many patients with chronic fatigue syndrome, it’s believed that their immune system is hypersensitive or has been exposed to a prolonged overreaction.

Although there is currently no cure for chronic fatigue syndrome, that doesn’t mean that treatment is futile. Treatments can help to manage and relieve symptoms, so you have options when it comes to fighting back against chronic fatigue. Oftentimes a combination of the following treatments are recommended for patients with chronic fatigue syndrome:

Medications
Anti-depressants (if appropriate)
Pace training to avoid overexertion
Low-impact exercise
Improving sleep quality
Mental and emotional health counseling
Cognitive behavioral therapy

Like chronic pain, chronic fatigue syndrome is highly unique to the individual, so while the above treatment techniques are oftentimes recommended, it is in your best interest to connect with a specialist and develop a treatment plan tailored to your specific needs.

Finally, chronic pain can oftentimes be misclassified as chronic fatigue syndrome. Pain is physically, mentally and emotionally draining, and this can leave you feeling tired and unmotivated. However, there oftentimes is a cure for chronic pain conditions, so don’t give up on your quest to find relief. If you are wondering if your fatigue is tied to a chronic pain issue, consider reaching out to a pain management specialist in your area. Dr. Cohn specializes in helping patients find the true source of their issue and so that they can get access to the specific types of treatment they need to overcome their condition. If pain is truly at the heart of your fatigue, let us be a resource for you.

For more information about chronic fatigue syndrome, or for assistance overcoming a chronic pain problem, reach out to Dr. Cohn and his team today at (952) 738-4580.