Could This Be The Next Big Thing In Pain Management?

June 10, 2019June 10, 2019 / Thomas Cohn, MD

Last Sunday in the science section of the newspaper there was an article about research on a new pain drug. The scientists behind the drug are convinced they have the next great drug. The skeptic in me hopes but doubts it. The reason the news has not made the traditional rounds in in all the reputable medical sites that spread news of discoveries. Furthermore, the work to date is only in animals and there has not been definite evidence this will transfer to humans.

The article discusses the work of Dr. Bruce Hammock, an entomologist at University of California-Davis. In the 1970’s he was working on an enzyme that converted a corn ear-worm to an insect. Removing the enzyme essentially killed the insect before it converted to the moth and was able to breed. Overall this was not found to be a cost effective strategy for this insect to be controlled. Since that part of his work did not pan out, he started looking for how the enzyme or related enzymes might occur in other species. especially humans.

Eventually Dr. Hammock found these compounds in humans and they supposedly reduce pain. Of note, he does not specify what these compounds are, but only says they are chemically broken down rapidly in the body naturally. He then found a way to keep them from being broken down in the body as quickly. Dr. Hammock believes this compound can somehow help relieve pain.

Believe It When We See It

The reason to be skeptic is that naturally this compound that reduces the intensity of pain is very transient in the body by the description given. This makes me believe it is likely easily broken down by chemicals in the body and is in a very limited location. This type of compound is very hard to deliver conveniently (like a pill) into the body and be absorbed. It is also likely to be easily broken down no matter what one does. Lastly, the chemical sounds like it may be something that exists in the nervous system, and thus isolated by something like the blood-brain barrier.

The researchers behind this new novel compound are just looking at starting human trials. So far there has been little funding toward the research from what has been said in the regular press. Further, as noted earlier there is no information in the extensive research pain literature on the animal-level studies discussing this compound. If the research was really promising, more money would be involved without question since pain treatment is a billion dollar industry with huge potentials.

The bottom line is that there is research going on in the field of pain medicine trying to develop new treatments and medications. However, whether any of the current research will lead to new drugs is difficult to guess. A lot of treatments have been proposed but most die as they are tested. Human studies usually take between five and 10 years to complete. Only time will tell if this research will ever lead to a new drug that is useful to treat pain.

Work Can Be Exercise

June 3, 2019 / Thomas Cohn, MD

Adding an exercise to a busy person’s life is sometimes difficult. Many people claim that their daily activities give them enough exercise to stay healthy, and in some cases this may be true. Physicians are beginning to recognize that what we do as part of our regular routines may count as exercise. For meeting the goal of aerobic conditioning, the movement we do routinely is helpful.

Aerobic conditioning is one component of exercise. Any activity that increases the heart rate and increases the body’s use of energy is good. A term given to this is “non-exercise activity thermogenesis,” or NEAT. It is also the exertion of daily living for many people. People who are up on their feet and walking all day are performing exercise. Among the professions that are known to have high levels of activities include waitresses, preschool teachers, maintenance workers, and mail carriers that have walking routes. Monitoring step counts on these people, they often have well over 10,000 daily steps.

Daily Activities and Physical Fitness

Regular activities of daily living can also be helpful in aerobic conditioning. During the summer, cutting the lawn and performing yard work keeps many busy for hours on end and adds 5,000-10,000 steps to a day’s routine. Doing household chores such as cleaning, laundry, vacuuming and doing dishes all require standing and motion. When shopping, park a little further away from the nearest door and walk the extra distance. To make it worthwhile, track how much you actually do with a fitness tracker. Good fitness bands that track heart rate and steps are now less than $100, and almost every smart phone has a built-in step counter that can be activated.

If you have chronic pain, aerobic conditioning is just one aspect of needed exercise. Conditioning maintains cardiac health, improves endurance and the ability to perform activity, and increases the body’s own painkilling compounds known as endorphins. However, most with chronic pain need to do more than just conditioning and need to also do routine stretching and strengthening. Physical fitness for everyone requires the combination of the above three routines. “NEAT” is a great way to meet the conditioning component of fitness. Developing a routine to meet stretching and strengthening goals to maintain function and decrease pain can be the focus of time spent exercising beyond aerobic activities.

Get Your Vitamins and Minerals From Food, Not Supplements

April 23, 2019 / Thomas Cohn, MD

Many people ask about taking dietary supplements, vitamins, minerals, and various natural compounds to improve their pain and their life. These are not officially regulated as far as how well they work. They are regulated only to the level that they cannot be toxic when ingested and they have become a billion dollar business.

Are They Effective?

Recently, a large study was done with regards to multiple dietary supplements, with an extra emphasis on medications with claims of helping with heart disease and natural degeneration caused by aging. Simply put, nothing had any positive impact on health for any of the compounds being pushed. The study was published in JAMA in January 2019 and looked at many different compounds. Included were ginkgo balboa, coenzyme Q10, coral calcium, and many others. These are all found in the vitamin and supplement aisle of many stores. None of these promoted items had any impact on cardiac health, dementia, cognition or any general component of health. Basically, none of these vitamins, compounds or minerals made a difference.

The answer of what really works is eating healthy. All these various compound are found in our fresh foods. Eating fresh food provides nutrients in a way through the gut that the appropriate vitamins and minerals are absorbed correctly and can be used by the body. In pill form or other concentrate, the body often will not be able to utilize the compound successfully. Many times the form of the compound in a pill is not absorbed or is destroyed by the body’s digestive processes. When we eat our food, our digestive system can find the nutrients and make sure they travel to the correct areas of the body. All the studies show that nutrients that come from eating a good diet are helpful, and adding a variety of supplements shows no benefit.

The best suggestion based on all these medical studies is save the money spent on supplements and spend the money on eating a healthy diet with fresh fruit and vegetables and low fat protein. Highly processed foods with high carbohydrate loads often do not have a high nutritional value. Develop a diet that comes from the outer aisles of the grocery where the fresh foods are found. None of the claims for supplements have really be proven, so save your money for now.

Chronic Pain and Its Impact On The Workforce

April 18, 2019 / Thomas Cohn, MD

Many people have a vested interest in helping to solve the problem of chronic pain, and a new study suggests that you can add employers to the list.

According to a new study published in Integrated Benefits Institute, more than one-third of US workers take prescription pain medications. Interestingly, those workers who take prescription medications take significantly more sick days than those who don’t, and those who have problems with those medications take even more sick days. The study found:

Compared to those who don’t take prescription pills at all, painkiller users took an average of twice as many sick days.
Problematic painkiller users took more than three times the number of sick days on average as a healthy adult.
Prescription pain medications were associated with approximately 261 lost workdays per 1,000 workers per month.

For the study, researchers looked at the amount of time lost at work connected with prescription pain relievers when viewed in the contest of other substance use disorders in the American workforce.

“The high rates of prescription pain medicines among employees indicates a much larger issue for employers than lost productivity,” says IBI researcher Erin Peterson, MPH, the report’s first author. “The significant number of sick day absences by employees who use pain relievers without problems likely doesn’t represent the full impact. As most people abusing opioids started with prescribed medications, this is a very large number of people at risk for developing problematic behaviors associated with pain relievers.”

Chronic Pain and Lost Days of Work

If you suffer from chronic pain, regardless of whether or not you take opioids to help with discomfort, you know firsthand how difficult it can be to get out of bed on some mornings, let alone get through the work day. That’s one of the reasons why it’s so important to work with a pain specialist to get control of your issue or help to minimize the days when pain becomes overbearing. It’s not always going to be easy, but if you truly want to do whatever you can to get your pain under control, it’s worth it.

Dr. Cohn and his team have helped numerous workers get a handle on their pain and thrive in the workplace, and he can do the same for you. To set up an appointment so he can get to the bottom of your pain and chart a course for recovery, click here or give his office a call today. It’s never too late to take back control of your life from chronic pain.

The Importance Of A Support System When You Have Chronic Pain

April 4, 2019 / Thomas Cohn, MD

Whether you’re off pursuing your dreams of being a musician in New York City or trying out for the varsity basketball team, everybody wants to have a strong support system that they can turn to in a time of need. Another group of people who need a strong support system in their life are those individuals with chronic pain, but those with a chronic condition know that a good support system can be hard to find. Today, we share some tips for finding and building a strong support system if you have chronic pain.

Chronic Pain Support System

All of the following tips may not apply to your situation, but we’re confident at least some of them will. Here’s how you can build and learn to rely on a support system if you’re dealing with a chronic illness.

1. Find A Few Close Friends – You probably have one or two really close friends or family members that you can rely on when things get tough, and it’s important to lean on them when you need help. Just because you have a large family or a large network of friends doesn’t mean they are all going to be sympathetic to your cause and be reliable in your time of need. Recognize that not everyone is going to be part of your support system, so focus on the really reliable members of your support system instead of trying to involve a larger network of people.

2. Online Support – The rise of the internet has made it much easier for people to connect with other individuals who are going through the same thing. You can find highly specialized support groups that can allow you to talk to people who know what you’re dealing with. Try a simple google search and see what groups are out there. Find one or two that seem supportive and consider joining.

3. Share Your Experiences – A number of people find it helpful to share their stories with others. Whether you’re talking to your best friend on the phone or writing out your daily struggle on an online forum, it can be extremely helpful to talk about your experiences. Find a place where you can vent or be vulnerable, and let your story be heard.

4. Support Yourself – It’s also important to remember that you are the most important member of your support group, and you need to take care of yourself. You need to be getting regular exercise, eating a healthy diet and partaking in activities that contribute to a healthy physical and emotional well-being. If you have self-destructive tendencies, your support group may fall apart because others may think “Why should I care about them if they don’t seem to care about themselves?” Be your biggest supporter.

5. Professional Help – Finally, don’t be afraid to reach out to a professional for help. Whether you need a chronic pain specialist to help you get a grip on your condition, or you want to talk to a mental health counselor about your feelings and your concerns, please reach out for help. We want to be part of your support team, but we can’t get you help unless you connect with our office. Let us help you.

For more tips on building and maintaining a healthy support system if you have chronic pain, reach out to Dr. Cohn’s office today.