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

The Link Between Chronic Pain and Insomnia

chronic pain insomniaThe following guest article was written by Katrina Rice.

Anyone who suffers from chronic pain from health issues like rheumatoid arthritis or osteoarthritis knows the drastic effects it has on their way of living – whether it be restricted mobility, increased medical expenses or reduced social life, accomplishing tasks seem to become quite unbearable every single day. And at night, sleep is disrupted due to the aching hips, back, knees and legs.

According to medical experts, arthritis sufferers are highly likely to suffer from insomnia as well. But recent studies show that restless nights and arthritis symptoms are a “two-way street” problem. Chronic pain can lead to a lack of sleep, and sleep deprivation can make chronic pain worse.

Doctors have recently become more focused on treating insomnia to improve the health conditions of patients suffering from chronic pain. One important note to remember is pain and insomnia work in a cycle. According to Professor Alan Silman, a medical director of Arthritis Research UK, “Pain induces insomnia and insomnia induces pain”.

Arthritis and Insomnia

Osteoarthritis is the wear and tear or degradation of bone tissues whereas rheumatoid arthritis is when the immune system attacks the joints. Much of the pain patients feel is due to the inflammatory responses of their body whenever it travels to their joints. It is fully understood by experts that disrupted sleep does increase the number of inflammatory markers and further aggravates the joints.

Inflammatory compounds in the body play a vital role in sleep disturbance. This disturbance will then alter the natural cycle of hormones in the body and affect the underlying levels of inflammation. Other cytokines (pro-inflammatory messengers) may also be involved in this activity. While insomnia releases more damaging inflammatory chemicals in the body, it also means the body misses out on the opportunity to heal when sleeping. After all, sleep is the longest time when the body is at rest and has low inflammation levels. So it is really the best time for the damaged cells to heal.

Effects Of Sleep Deprivation On Chronic Pain

The most notable effect of sleep loss in chronic pain is the low production of growth hormones. The growth hormone is vital in many body processes including cell development, weight regulation of the body and tissue repair, as well as replacement of collagen and bone cells. Though the growth hormone is released in the body at any time of the day, the biggest bursts come from the moment our bodies fall into deep sleep. But if deep sleep is not achieved, the body may not produce enough growth hormones. Furthermore, lack of sleep makes patient irritable and weary – this makes them even more sensitive to pain.

There are a number of treatments and alternative remedies that can be used to help ease the pain, but NSAIDs are usually prescribed for those who experience severe pain. Other forms of treatment come in natural supplements like glucosamine, chondroitin and curcumin supplements.  Patients with osteoarthritis usually choose glucosamine, but curcumin pills are also becoming more popular among arthritis patients. As for side effects, you can easily search reviews and testimonials in Google.

The bottomline is that chronic pain sufferers are stuck in a vicious cycle and they need to get out of it. In order to help them increase their pain threshold and reduce chronic inflammation, getting enough rest is a must. Here are six tips to use to help achieve a good night’s sleep.

  • Avoid taking afternoon naps. No matter how much you want to rest, it only gives you more energy in the evening. Keep yourself occupied when you start feeling sleepy in the afternoon.
  • Use lamps with warm light instead of ceiling lights. Warm lights have a soothing effect and can help you feel calmer and sleepier.
  • Avoid coffee, tea or any caffeinated products after 3:00 p.m., and never drink alcohol after 9:00 p.m.
  • Keep your waking and bed time consistent every day. This helps your biological clock get used to the routine and will eventually follow that pattern on its own.
  • Eliminate midnight snacking.
  • Do not gain weight, and instead, try to lose more pounds. Excess body fat can put more pressure on your joints. Gaining more weight means your fat cells will expand and your body will eventually start producing more cytokines – a fuel for inflammation.

Katrina Rice is a mom and a freelance writer. She strongly believes in the concept of holistic wellness through healthy and natural living, traveling and immersing one’s self in new activities. A self-proclaimed health enthusiast, she hopes to inspire more people to turn to natural treatments in addressing health issues.

Opioid Dependency and Prescription Length

opioid dependencyA new study conducted by the University of Arkansas on opioid use has been recently published by the Centers for Disease Control. It is somewhat of a curious study since it was based on record analysis of prescription records for opioids. The results will likely be twisted by the press soon to announce how bad these drugs are and how addictive they can be.

The question the study sought to answer was – “If a patient gets a certain amount of drug prescribed on a first visit, will they still be taking that drug a year later?” The numbers are somewhat surprising, but in reality it does not really say anything about opioids, addiction or pain. All it really says is that for some people there may be limited options to treat pain, and maybe it is very effective for some people.

Continued Opioid Use

The patients studied were all 18 and over, cancer free, studied June 2006 through September 2015 and did not have a history of opioid abuse. Here’s a look at the results:

  • A person who received 1-day supply of medication had a 6% chance of being on opioids for a year or longer.
  • With a 5-day supply, they had a 10% chance of being on opioids in a year.
  • With a 10-day supply the odds go to a 20% that they will be still using opioids in a year.
  • A 30-day supply had about 30% chance of being on the medications a year later.

So if you start on opioids, and have it for over 10 days, 1 in 5 of those people may still be on those medications. However, it also means that 80 percent will not still be on those drugs.

Interpreting The Results

Several messages can be inferred from this data. First, acute pain should be treated with the least amount of medication for the shortest length of time. If at all possible, avoid the use of opioids for acute pain and find other less addictive and dependency causing medications. Second, many people do not use these medications long-term and can use them responsibly. Lastly, pain is very complex, and since some medications are highly addictive, try to avoid them and use the multiple other ways to treat pain including everything from chiropractors, to physical therapy, to exercise, and to injections.

The study also may be an analysis of the treatments available for severe pain. Some of the most effective treatments sometimes are the least healthy and can cause dependency. Opioids have been around for hundreds of years. Our knowledge of pain is limited, as are the solutions. Since it is such a huge medical problem, we really need to spend more on research and solutions. We know there is an opioid crisis with addiction. We need research solutions and new treatments. Now is the time to spend on research, as it may provide better solutions for more people than some of the recent government spending recommendations.