Psychological Interventions Could Help Chronic Pain Patients

May 22, 2018 / Thomas Cohn, MD

New research published in JAMA Internal Medicine found that patients with noncancer chronic pain can benefit from psychological interventions, which can help to reduce perceived pain levels.

Dr. Bahar Niknejad and colleagues at the Department of Medicine at Eastern Virginia Medical School conducted a systematic review and meta-analysis of the effectiveness of psychological therapies for noncancerous chronic pain. The main factor they wanted to analyze was psychological therapy’s role in managing pain intensity, but they also examined how it influenced pain interference, depressive symptoms, anxiety, negative thoughts, self-efficacy for pain management, physical function and overall health.

The meta-analysis looked at 22 studies involving more than 2,600 individuals, and after looking at the data, researchers concluded that psychological therapies were associated with small decreases in pain intensity, pain interference, depressive symptoms, anxiety and negative thoughts, while there were small increases for self-efficacy, physical function and overall health.

“Psychological interventions for the treatment of chronic pain in older adults have small benefits, including reducing pain and catastrophizing beliefs and improving pain self-efficacy for managing pain,” the authors reported. “These results were strongest when delivered using group-based approaches. Research is needed to develop and test strategies that enhance the efficacy of psychological approaches and sustainability of treatment effects among older adults with chronic pain.”

Types of Psychological Treatments To Chronic Pain

Psychological treatments of chronic pain center around the idea that if we understand our pain and why it’s happening, then we can learn to control or better cope with flare ups. Knowing this, here’s a look at some of the more popular psychological treatments for chronic pain:

Patient education about the condition.
Biofeedback (A technique where patients learn to interpret feedback regarding certain physiological functions).
Relaxation Training.
Operant Conditioning.
Cognitive-Based Approaches.
Acceptance-Based Approaches.
Expectation Management.
Emotional Stress Management.

By helping the patient find new psychological strategies to control or better cope with their pain, people often feel more in control of their symptoms, which in turn can decrease the perception of pain. If you are suffering from chronic pain, talk to your doctor about psychological approaches to best manage your condition. Reach out to Dr. Cohn for more information.

Treating Daily Headaches With Botox Injections

May 7, 2018 / Thomas Cohn, MD

Chronic headaches are an unfortunate reality for many people. These tension headaches can be triggered by a number of different issues, from muscle problems to daily stress and everything in between. There are a number of different ways to treat headaches, and your pain specialist will work to find a solution that works for you.

From changing your diet, getting more exercise or working to reduce stress in your daily life, there are a number of ways you can work to prevent the onset of migraines. Medications are another way to control headaches, but what if none of those treatments work, or you don’t want to take medication? Is there another treatment option you can try?

There is, in fact, another option through which many migraine sufferers have found relief. That treatment involves botox injections in the forehead. These are the same injections that some people using to get rid of wrinkles or laugh lines on their face. Dr. Cohn is very familiar with the injections and has administered them on a number of satisfied patients. In fact, he recently partnered with CDI to help provide some more information about Botox injections for migraines. Check out the video below to learn more about the procedure.

So if you or someone you know suffers from chronic headaches or migraines and hasn’t been able to find a solution, consider reaching out to Dr. Cohn’s office. He can go into further detail about the procedure and see if you would be an ideal candidate. To learn more about botox injections for migraine relief, contact Dr. Cohn at (320) 299-4633.

Chocolate and Chronic Pain

April 30, 2018 / Thomas Cohn, MD

New research presented at the Experimental Biology 2018 annual meeting found that chocolate may have some benefits for chronic pain sufferers.

According to the findings, dark chocolate (minimally 70% cacao, 30% organic cane sugar) can positively affect some factors that contribute to or that make chronic pain worse. Researchers say that dark chocolate has been associated with:

Decreased stress levels
Decreased inflammation
Improved mood
Improved memory
Increased bacterial immunity

“For years, we have looked at the influence of dark chocolate on neurological functions from the standpoint of sugar content – the more sugar, the happier we are,” said principal investigation Lee S. Berk, DrPH. “This is the first time that we have looked at the impact of large amounts of cacao in doses as small as a regular-sized chocolate bar in humans over short or long periods of time, and are encouraged by the findings. These studies show us that the higher the concentration of cacao, the more positive the impact on cognition, memory, mood, immunity and other beneficial effects.”

Dark Chocolate and Chronic Pain

Now, simply sitting in your recliner and munching away on a king size dark chocolate bar isn’t going to cure your rheumatoid arthritis, but in small doses when paired with other treatment modalities like exercise, weight loss and a healthy diet, you may notice some improvements in your condition.

The study looked at a lot of medically-dense responses in the body and brain, and they found that aside from an anti-inflammatory response, dark chocolate also increased brain neuroplasticity. Simply put, neuroplasticity is a good thing that affects our recall, memory and sensory perception. Researchers hope to pursue future studies that will take a closer look at exactly why dark chocolate has this cause-and-effect relationship with the brain and body, but currently they are pleased with what they’ve found so far.

So again, while a candy bar of dark chocolate a day isn’t a good substitute for a chronic pain management plan, adding a small intake of dark chocolate into your diet may help improve your mood and limit some symptom expression. So the next time you’re at the store, pick up a bar of Hersey’s Special Dark and reward yourself with a bite after you’ve completed a physical therapy session or another active pain management treatment. Not only will it taste good, but it can have whole body benefits!

Opioids Are On Trial

April 23, 2018 / Thomas Cohn, MD

In a federal courtroom in Ohio a mammoth court case is being assembled. The victims of opioid abuse are going to be fighting the drug manufactures and distributors of opioids. The battle is for payment for the cost opioids have had on the communities. The injured parties range from individual communities to the federal government, and they are seeking money to cover the cost of all the problems related to the opioid epidemic. Simply put, this is the opioid equivalent to the tobacco lawsuit that sought damages for the effects of smoking. The case is being heard in federal district court in Cleveland, Ohio.

The Court Case

The plaintiffs are suing for relief from all the companies responsible for placing opioid medications into the community. The suit has wide ranging claims from that drug companies created a public nuisance, to that they used deceptive advertising. Others are claiming that companies violated consumer protection laws of many states. Further claims go as far as to suggest that the pharmaceutical companies, wholesalers and distributors acted like a criminal enterprise and had predatory practices to create sales and addiction.

The opioid epidemic is now killing more people than motor vehicle accidents. The big drug manufacturers of opioid medications have a long history of trying to persuade the public that these drugs are safe and rarely cause problems with addiction. They have spent huge sums to create a market for their products. The current cost to the public from the opioid epidemic is now running at $500 billion dollars a year. The costs are being paid by everyone in society. The medical costs are huge and stressing budgets at every level of government. Police and first responders are spending millions on everything from drugs to reverse overdoses to the expense of taking care of the dead. Furthermore, jails are becoming packed due to drug-related crimes, and the loss of productive members to society is staggering.

This is an extremely complex case that is moving forward in court. It is likely that this litigation will go on for years. There will probably be a settlement at some point but there will be no winners. Opioids do have some uses but they have been over-prescribed and have caused huge problems of addiction. As a pain practitioner, my wish is that more money is spent on pain research and non-opioid management. Hopefully we will stop losing lives and money to addiction and gain better pain treatment.

The Daith Piercing and Fibromyalgia

March 14, 2018September 8, 2020 / Thomas Cohn, MD

If you’re a frequent reader of the blog, you’re probably aware of our work with Dr. Chris Blatchey, a specialist in the United Kingdom who is hoping to help us get a better understanding of the link between headaches and the Daith piercing as a potential treatment option. If you haven’t read his report on the subject, or if you’ve undergone the Daith piercing procedure and haven’t yet taken his survey, please consider taking a few minutes to help advance our understanding of the subject.

Fibromyalgia and Piercing Treatment

We’ve been communicating back and forth throughout this process, and recently we ended up on the subject of using the Daith piercing to treat fibromyalgia. Dr. Blatchley said he’s been in contact with some professional piercers who perform the Daith piercing, and they mentioned that they have seen a rise in the number of patients who are seeking out the Daith to see if it can provide some symptom relief from their fibromyalgia.

According to these conversations, Dr. Blatchley said that it seems that the Daith piercing is less effective for treating some fibromyalgia symptoms than it is for treating migraines. He suggests patients with fibromyalgia see improvement in about 50 percent of cases, but he also notes that the relief could be because their fibromylagia pain was actually misdiagnosed. Fibromyalgia is difficult to diagnose and even harder to treat, but if we can find commonalities between individuals diagnosed with fibromyalgia and successfully treated with options like the Daith piercing, we may be able to grow as a medical community and better serve our patients.

At this point, we’re not saying that you should go out and get your ear pierced if you are dealing with fibromyalgia, but it’s an avenue worth exploring if multiple other options have failed. We are just scratching the surface of understanding the true link between the two, but others have had success with the treatment. I just received this message from Angela over the weekend, who just want to reach out and say thanks for continuing to help look for solutions to headaches, fibromyalgia and chronic pain.

“I have fibromyalgia, TMJ (temporomandibular joint dysfunction) and chronic headaches. I got both sides pierced for a total of 20 dollars and haven’t had a headache since. My pain has decreased significantly.”

If you know anybody who has had the Daith piercing, please consider sending them to Dr. Blatchley’s site to help further our understanding of pain pathologies. And if you want to learn more about the Daith piercing, we’ve included some of the blogs we’ve penned on the subject below. The first blog listed has more than 200 comments from readers, and many of them share their experiences with the piercing in the comment section. Feel free to check it out to learn more.

Migraines and Daith Piercings
Early Findings From the Daith Piercing Study
An Update on Daith Piercings

Thanks for reading,
Dr. Cohn