A recent opinion piece in the Star Tribune shined a light on the problem different genders face in the opioid crisis, particularly the challenges faced by women.
One of the main talking points is that deaths from opioid overdoses have increased much faster for women than for men. Female deaths from opioid overdoses have increased 400 percent in recent years compared to 265 percent for men. Both of these numbers are very problematic, but it helps to show that the opioid crisis is affecting each gender differently.
When opioids affect women, it can oftentimes have a bigger trickle down affect than when it affects men. As the article states, in most American families the woman is the primary caregiver, and the woman’s well-being is often closely tied to the health and future of the children. Opioid abuse by the primary caregiver can often lead to problems down the road for the children, and it increases their likelihood of having their own battles with substance abuse. When opioids negatively affect women, it rarely impacts just one person.
Fixing The Problem
The article went on to suggest some ways to reduce opioid disparity and the larger problem of gender-based health disparities in the United States. Some of the proposed solutions include:
Addiction risk education for doctors and patients
More education has led to fewer opioid prescriptions and in some places, a downturn in overdose deaths
Better emergency room treatment
Education campaigns to change dosage standards for women
Increased doctor education in states where women disproportionately suffer from conditions like obesity, high blood pressure, diabetes, chronic pain and heart problems
Stop cutting insurance coverage for certain programs like Medicaid and Medicare
It’s clear that there’s no one-size-fits-all answer for fixing the opioid crisis and gender-based healthcare disparities throughout the country, but the first step is to help spread awareness that a problem exists. Then we need to put a plan of action in place and stop making the bottom line a higher priority than the health of the patient in our office.
Opioids certainly have a place to help patients when properly assigned and administered, but far too often they are being blindly prescribed and without safety measures in place if abuse begins. The Star Tribune article is a step in the right direction by calling attention to the problem, but now we need doctors, patients and our legislatures to follow through. For the sake of women and families across the country, I hope we can work towards a solution.
It’s the beginning of a new year, and we all need to be realistic and open to looking at ways to improve ourselves. It is not an easy proposition, but with a little devotion it can be done. Take sometime now and begin by writing down tangible things you want in the next year, and then begin planning how you will achieve those goals. Look at the different aspects of your life from work to home life, and figure out what would you like to see change.
How To Make These Changes Happen
The first thing about change is to be realistic. Weight loss and exercise are some of the most common areas people want to be change. If you gained 50 pounds over the last five to ten years, it is unlikely that in 3-6 months that you will permanently lose the weight. However, losing a pound a week with a plan that involves changing your food intake, exercise, and having support of others and more knowledge of what has led to weight gain, may lead to success.
To be successful one also has to make the time for the change to happen. If exercising daily is a goal, sitting for an hour watching TV may have to change. You need to look at your current schedule and see what can be changed to make something happen. Further, do not fight with yourself. If you are not a morning person, do not try to wake up extra early to exercise since it is unlikely to happen. Find a time like after work and make it a priority, and combine it with something you like doing, such as watching TV at the same time or maybe listening to audio books.
Having help to make a change in your life is useful and motivating. Being part of a community with similar goals can help drive you through positive social connections. Sharing the challenge of exercise or weight loss with others who have the same desires can push you forward when you may have doubts. A team of support and friends to share the triumphs can make the grind easier since it is not only about you.
Finding Motivation
One of the hardest things to make a change is having motivation. Everyone has something different that makes one tick. Finding what keeps you going is tough and usually you need multiple reasons. Exercise makes almost everyone feel better overall, but that is often insufficient. For many, without exercise, their pain increases, stress increases, energy levels go down, sleep deteriorates, and for some if they stop, surgery may be the next treatment option. Further, some people are self-motivated while others need to be with others to be consistent and be part of a community or team.
Lastly, change is difficult, and consider a secondary plan if the goals are not being met. Sometimes there are a variety of factors that interfere with meeting a new goal. Do not get stuck with negative thoughts of failure. Change the targets and keep trying to move forward. Look for a different strategy and seek out help to make change. No one is alone in this world and there are numerous resources for help to meet almost any reasonable goal. Think positive and move forward, do not try to change too many aspects of your life at once. Choose just a few things and make it point of achieving them, and then add in new challenges.
Sciatica is a painful condition that occurs when your sciatic nerve becomes damaged or compressed. Your sciatic nerve runs down your leg, and when it becomes compressed, symptoms can range from mild discomfort to major pain.
Sciatica is a condition that we see pretty regularly in our office, so when our colleagues at Pain Management & Injury Relief reached out to us about sharing an infographic they created that focuses on sciatica treatment, we thought it would be a great addition to our blog. A stretching routine combined with regular exercise is one of the best ways to control and combat sciatic nerve pain, so if you are dealing with shooting or tingling pain in your legs, check out the infographic below.
Also, for more information on treating sciatica pain or other chronic conditions, be sure to swing on over to PainInjuryRelief.com
Complex regional pain syndrome is often seen as a weird and devastating problem. One of the biggest issues is the lack of identifying it as an issue and beginning the right type of pain management. Fortunately, in my practice, we are known for being able to deal with it and often find good solutions to manage it. Treatments can range from simple to complex. In the educated pain community, a better understanding is occurring. Unfortunately, it seems that some pain doctors are not furthering their education when it comes to CRPS.
Improving Treatment of CRPS
The good news is that we are starting to get a better with diagnosis and treatment of CRPS. The prognosis in general is that the symptoms in most people will resolve within a year; this occurs in 75 percent of people. The understanding of CRPS is better nowadays, and it does not just occur spontaneously. It is not an entity without a cause. It occurs in context with some sort of injury.
Usually it occurs in either the arm or leg, and it is often related to either surgerical trauma or actual physical trauma. Examples include an arm with multiple fractures or a hand injury coupled with carpal tunnel syndrome. In the leg it is often associated with multiple fractures or an ongoing sprain in the foot and ankle. It is also more common in people who already have a sensitized nervous system, such as someone with a neck or low back problem, a diabetic, or someone with fibromyalgia. The research is also showing that there may be a genetic component (there may be 80 or more genes that are involved) and some people may be prone to this occurring, but there is no test yet available.
The answer to why a person has uncontrolled pain is that there are too many sensory “pain” type signals going to the brain for too long of a time period. With most injuries, healing rapidly occurs, especially when treated promptly. Injuries to the foot and hand are more complex since there are multiple tendons, ligaments, bones and nerves present and many of these can be damaged. The medical community often does a great job of fixing the obviously fractured bones, however, if the trauma is with sufficient force to fracture a bone then it can damage surrounding things like tendons, ligaments and nerves.
These “soft tissue” structures are much harder to see and to determine if they are damaged. Repairing them also may be hard and sometimes things like damaged nerves are not really possible to surgically treat. All these structures in the hands and feet must work in a very complex manner; one part not moving correctly often will send messages back to the brain that all is not well. These continuous error messages to the brain start becoming amplified and a short circuit occurs telling the pain signals that there is a problem in the area and something needs to be done to stop the problem. The amplified pain signals is what we perceive in CRPS.
The Goals Of Treatment
The goal of CRPS treatment, if identified early, is to find and fix the issues present. As a medical provider, the goal of understanding CRPS is not that the patient is crazy, it is that something is wrong and what can we do to fix and address the problem. To control the pain, a patient with signs of CRPS must first determine what are all the issues that may be contributing to the problem. A comprehensive evaluation is necessary and all the patient’s medical history can be extremely important. Everything from concurrent medical problems to psychological issues can contribute to the problem.
More frustrating may be that not all of the medical problems contributing to the CRPS may be treatable. Sometimes the fracture damage of an arm or leg cannot be fully corrected. Damaged ligaments, bone misalignment and nerve injury are not able to return to normal function. The signals that tell our brain that something is wrong cannot be turned off since there is no mechanism to shut them down completely. This is especially true in severe trauma or where there are secondary conditions reinforcing the signals like spine problems or diabetes. For the physician, the first mission is to find out what are the problems causing the abnormal signals and correct them. A team approach is often the best since it may take an expert in pain to identify all the problemed areas and the expertise of a variety of specialists to intervene if a fix is available. As noted above, 75 percent of the people will experience symptom relief within in a year, meaning successful management strategies can be implemented.
Identifying CRPS early within the first few weeks to months leads to the best treatment. If pain after an injury does occur, is severe and continues past normal healing time, seek the help of a good pain physician. The mark of good pain physician is one who frequently sees and treats complex problems. Many pain physicians confine their practices to the simple straightforward pain problems; these tougher issues need the physicians that know medical and interventional treatment options and are active in ongoing evaluation and management including high levels of intervention. Physicians who do mostly medical or interventional managements and not both are unlikely to have a full knowledge of the complex issues contributing to CRPS. Understanding and communicating with the patient is essential. Find a good physician that does understand CRPS and the strategies to have the best chance at finding pain relief.
Multifaceted Approach To Treatment
Not all CRPS cases can be easily resolved. Obviously, not all injuries can be corrected and when there are multiple problems contributing to CRPS, it may be an ongoing issue. The treatment plan often needs to include physical therapy to improve functional problems associated with the body parts involved. With any significant injury, it often takes a lot of exercise for a long period of time to restore function, and it may involve complex strategies to retrain the body. The efforts with physical therapy need to be continued on your own, and stopping the exercises does not work for recovery.
Psychology is another important aspect to manage and improve when it comes to CRPS treatment. The pain is not imagined, and psychologists can help the patient understand how the brain decides to perceive the pain signals and how patients interpret them. The brain can only do a couple of things at one time and psychologists often can help train the brain not to pay attention to these pain signals. Recognizing the associated cognitive issues like the perception of pain and that depression is not a sign of being weak leads to more successful outcomes.
CRPS is a complex phenomenon and involves understanding of all parts of the syndrome. There are now a variety of medications used for treatment. Common medications include those that affect nerve signaling like Gabapentin and Lyrica. Some depression medications also decrease nerve signaling. Cymbalta does this well, and older medications like amytriptyline and nortriptyline can also be very helpful, and they may also help with related sleep problems. Newer medications that have found to be helpful range from those used to treat osteoporesis like Boniva (or many of the other drugs in this category know as biphosphonates), to Botox, Viagra, and odd blood pressure medications like clonidine. Ketamine, an anesthetic, is used occasionally but is difficult to safely administer, works for a limited amount of time, may have significant side affects, is costly and often insurance does not cover its use.
Spinal Cord Stimulators For CRPS
For the most refractory cases of CRPS, implantable devices are one of the best and most cost effective treatments. These devices are primarily spinal cord stimulators (SCS) but sometimes may include intrathecal pumps to deliver medication directly to the spine. A good pain physician will be able to coordinate and make sure all the conservative medical issues are addressed prior to working with implantable devices.
If this is the first suggestion without working with a team to address all the other issues, be careful with proceeding forward. SCS systems are wonderful treatments, but there is a lot of marketing being done toward physicians with these devices so an experienced implanter is needed since treatment with these systems may need to be aimed at multiple targets. There are systems that can be used just for a specific target known as DRG spinal cord stimulators and they are good when there is absolutely no other problem contributing to a foot or ankle CRPS that is not fixable (they are not used for hand and arm CRPS).
Multiple companies make SCS units. It is debatable who has the best unit, but other factors like manufacturer support and MRI scan safety also need to be considered. Properly placed, a SCS’s effectiveness can usually be determined after a trial period of about 5-7 days. Improved function, improved ability to stand, walk, do activities, and sleep are the goals associated with a SCS. If nothing is working, implantable pain pumps are reasonable. These do have risks but they can greatly improve the patient’s quality of life. A variety of medications can be delivered to the spine and the best medication may not be an opioid, but Ziconitide, which is a snail toxin.
CRPS is a complex issue, in reality it may affect the whole body due to the impact of the pain. It takes a team to treat and help the patient through this medical problem. A good pain physician will help one navigate the treatment path of CRPS. It is a very tough medical problem, and its not only in your brain. Treatment needs to be an interaction with your provider who fully understands and helps with coordinating and providing care for all the issues. CRPS does feel like a scary medical problem, but good pain physicians can lead one to a successful outcome.
Chronic pain has many obvious drawbacks, but it also has many hidden consequences. We know that chronic pain can be costly to treat, but new research suggests that it can have a severe impact on your buying power or your ability to secure credit.
According to a new study published in the National Pain Report, a survey of 840 chronic pain sufferers found that a whopping 63 percent were unable to secure credit. As you might have guessed, this has far-reaching consequences for pain sufferers.
Chronic Pain and Your Credit
Researchers said that there were a number of different reasons why chronic pain sufferers had difficulty securing credit. Some of the most common challenges individuals with chronic pain run into credit-wise include:
Difficulty obtaining credit because chronic pain makes it hard or impossible for them to maintain employment.
High interest on credit cards or loans that they are able to secure.
Difficulty getting a cell phone contract.
Inability to get approved for a home loan or apartment rental.
Inability to secure utilities, like electricity, propane or gas.
Difficulty getting automobile or life insurance, and when they do, rates are often very high.
“The inability to secure credit brings a long list of challenges, particularly for those who also suffer with medical conditions, like pain,” said Jim Shanahan, President and CEO of Prepaidian, Inc, a company who specializes in Prepaid debit cards that are intended to provide buying power for people who are unable to secure credit. “You may be unable to get a checking account, or pay exorbitant fees on those accounts, in addition to trying to manage medical bills.”
How To Improve Your Credit While Dealing With Chronic Pain
Improving your credit score while you deal with chronic pain isn’t always easy, but there are things you can do to improve it bit by bit. For example, always try to make your payments on time, even if it’s just the minimum amount. Paying on time helps to improve your credit score. Secondly, don’t be in a rush to close your accounts. Closing accounts, even ones you don’t use, negatively impacts your credit score because it limits your buying power. If you absolutely have to close out an account, see if you can increase your line of credit on a different account. Even if you don’t plan to spend that much, your credit score improves when you have more potential buying power at your disposal.
Secondly, try to settle up past due accounts. Odds are if you’re willing to pay at least a portion of the bill, the credit card company will be willing to erase the debt, because getting some money is better than getting nothing. You can call in and see if they’ll waive late fees or some interest charges, because it never hurts to ask, and if waiving a fee gets the credit card company their money, oftentimes they’ll be willing to compromise. It never hurts to ask.
Lastly, if medical bills from chronic pain are stacking up, try to get on a payment plan with your health center or insurance company. Making regular payments and working towards a zero balance will do wonders for your credit score. Explain your situation, and people may be more willing to help.
A recent opinion piece in the Star Tribune shined a light on the problem different genders face in the opioid crisis, particularly the challenges faced by women.
It’s the beginning of a new year, and we all need to be realistic and open to looking at ways to improve ourselves. It is not an easy proposition, but with a little devotion it can be done. Take sometime now and begin by writing down tangible things you want in the next year, and then begin planning how you will achieve those goals. Look at the different aspects of your life from work to home life, and figure out what would you like to see change.
Chronic pain has many obvious drawbacks, but it also has many hidden consequences. We know that