How Does Chronic Pain Affect A Marriage?

August 19, 2020 / Thomas Cohn, MD

Chronic pain affects many aspects of a person’s life, but it’s not just the individual dealing with the pain condition that has to bear the burden. According to new research, chronic pain can also significantly affect the relationship between a patient and their spouse.

The study published in the European Journal of Pain decided to take a closer look at the impact chronic pain had on households, spousal relationships and marital satisfaction. As you can probably guess, chronic pain can really put some stress on a relationship.

For the study, researchers questioned 114 couples where one spouse was a chronic pain patient at a clinic in Spain. Nearly 60% of participants were female, and the average age was 55 years old. The most frequent locations for chronic pain were the lower back (79.8%), neck (46.5%) and the knee (15.8%).

What Spouses Are Saying

After being asked about their lifestyle and martial satisfaction, here’s what patients and spouses had to say about how chronic pain was impacting their life.

Spouses reported an average of just over 90 minutes of caregiving duties each day.
65.8% of patients reported an occupational change because of their chronic pain, with some going on permanent disability and others quitting without compensation.
Of 24 listed chores, patients said they performed an average of 18 before chronic pain began but were limited to an average of 12 tasks after pain.
On the flip side, spouses said on average that they took on two more chores after their spouse developed chronic pain.
52% of spouses reported a high to severe degree of burden, and roughly 1 in 4 patients and spouses reported having a troubled relationship.

There’s a lot to sort through with these findings, but the main takeaway is that chronic pain can really stress a marriage. Not only can it financially affect the relationship in the form or lost or reduced income, but it can also require the spouse to take on a much bigger caretaker role. Being both a caretaker and a spouse can be stressful and can lead to relationship dissatisfaction, but it doesn’t have to.

There are a number of ways to help mitigate the stress brought on by chronic pain, and we don’t have all the answers here because chronic pain is so unique to the individual. However, one of the best things you can do is talk about your concerns, your fears, your wishes and your goals. Speak up and communicate with your doctor, your care team and your spouse about what concerns you and what you can do to help improve your relationships.

Relationships take work, and relationships involving chronic pain can take even more work, but they are far from doomed. Work to correct your pain issues and to foster an open dialogue between you, your partner and your doctor, and we’re confident your relationship will move in the right direction. And for help with any aspect of your pain care, reach out to Dr. Cohn’s office today.

Why Added Stress Can Make Chronic Pain Worse

August 10, 2020 / Thomas Cohn, MD

stress Everyone is adjusting to the new normal. Life has been turned upside down and inside out, and there is a new agenda every day. Most of us are locked in at home, with the new goal being trying to stay safe and healthy. If you are a parent, now you have to become a teacher alongside all your other responsibilities. If you are a senior citizen, you may think you are young but now you have a new target on your back and the challenge is to stay alive. If you are lucky you still have a job. However, almost everyone is worried about what is next, whether it is financial issues, the ability to obtain food or toilet paper shortages. Beyond these, one still has the regular health concerns and for many their chronic pain is now compounded by added stress.

The normal now is everything is likely to change, and constant change is stressful to most people. Not knowing what tomorrow will bring and the fear of the unknown is common nowadays. Everyone is stressed since life has radically changed. Having chronic pain from any source now can feel worse. It is not a part of your imagination; it is due to the fact that many of the centers in the brain that help transfer pain signals are adjacent to the stress and anxiety centers. Therefore, stress and anxiety can be perceived by the brain through a short circuit caused by added stress. As one becomes stressed about change, pain increases.

Treating The Physical And Emotional Components Of Pain

Treating physical ailments has always been the strength of the medical profession. Recognizing a broken bone or a cervical or lumbar disc issue is relatively easy, since we can see it on an imaging test. The pain a malady causes is more complex since it requires a sensory nerve to be stimulated and the brain to perceive and interpret the signal as an abnormal event. The act of interpreting sensory transmissions is partly based on a person’s experience of similar signals and their emotional responses to those types of sensations in the past.

For many people, the emotional components of pain in the past are neutral in importance. For others, the signals have strong negative stressful associations with traumatic experiences and then pain and stress become linked in the brain as the same events. Recognizing this association of pain and stress becomes vital in the management of controlling chronic pain.

The pain everyone suffers is real. However, most pain has both physical and emotional factors. identifying and treating the physical aspects of pain is much easier. Treating these aspects of pain are in ways the simple “cookbook” parts of management strategies, i.e. if you are having X symptoms, do Y, and so forth. When pain becomes more chronic, understanding and working with the emotional components to pain are often critical to its control. Treating the person’s perceptions and emotions associated with the pain become critical. A person is much more than just a broken bone or spine problem, and treatment often needs to include managing the brain’s perception of sensory signals.

Successful pain management often involves dealing with not only the physical generators of sensory signals, but also how the brain is responding to those signals directly and emotionally. A person is not weak or crazy when there are emotional components to pain. Using cognitive and psychological techniques to treat these parts of pain is challenging but very important in being able to reduce the intensity of signals. When successful treatment of central interpretive components of pain occurs, the relative intensity of signals markedly diminishes.

So as the world seems to be collapsing in the throes of a pandemic and stress and anxiety are increasing, it is common to see those with pain issues having increased intensity of symptoms. The brain is a complex structure, and everything that it perceives is often subject to interpretation. Pain is no different and stress has a large impact on the perception of sensory signals, especially those delivering messages of trauma and inflammation. Treating the brain and how it is interpreting sensory signals often becomes the key necessary to unlock the successful management of pain.

How To Parent A Child With Chronic Pain

July 7, 2020 / Thomas Cohn, MD

As a parent, you want to shield your child from pain, which is why watching them deal with a chronic health condition can be so difficult to stomach. You want to remove their pain and the burden it is placing on them, and there are some steps you can take to help increase your likelihood of successfully treating their condition. Below, we share some tips for parents who want to help their child overcome a chronic pain condition.

Parenting A Child In Chronic Pain

There is no perfect playbook for parenting a child with a chronic pain condition, but there are some ways to help improve your child’s odds of overcoming their condition or helping reduce their symptoms. Those steps include:

Professional Help – Finding a professional who is willing to work hard to uncover the true source of pain is a must for any parent of a child with a chronic pain condition. If the doctor is treating the symptoms or the wrong underlying issue, your child will not find relief. Find a doctor who is invested in your child’s health. It may take a few visits to different clinics (or just one call to Dr. Cohn’s office), but don’t stop until you find someone who is willing to go the extra mile for you and your child.

Focus On The Positives – It can be easier for both parent and child to focus their attention on the negatives of a health condition. They may dwell on the fact that pain forced them to miss school, or that playing sports is too uncomfortable. Instead of focusing on what pain may be taking away from you, try to focus on the positives as it pertains to treatment. Focus on all the things you’ll be able to do again if you work hard to get control over your condition. Think about what they have to gain from treatments like physical therapy or exercise, and really try to motivate your child to follow through on their daily treatment regimen.

Give Them Independence – A chronic pain condition can rob a person of some of their independence, and this can be especially hard for kids and teens who are growing into their own person. We know that you want to help them when things get tough, but it’s imperative that you let them do things on their own, even if it’s harder for them. They’ll be better off trying and failing and learning to succeed on their own than having you do things for them because of their pain condition. Obviously there are times when assistance is needed, but you’ll both be better off if you keep their independence in mind.

Not Just A Physical Problem – Whether you’re young or old, you need to realize that a chronic pain condition may be causing physical symptoms, but it’s not just a physical issue. A chronic pain condition can have serious implications for your mental health, and these issues can be amplified in young and impressionable minds. Don’t be afraid to talk to your doctor about mental health resources or if talking to a therapist could be beneficial. Make sure you monitor your child’s mental health just as much as you monitor their physical health.

Listen – Finally, make sure that you do just as much listening as you do talking when it comes to helping your child with their pain condition. Sometimes all they need is a person to vent to, or maybe they want to open about about what’s bothering them. Instead of trying to jump in and provide solutions, just listen. You’ll be amazed at how helpful you can be when you don’t say anything.

For more tips, or for help with your child’s chronic pain condition, reach out to Dr. Cohn’s office today.

Five Daily Ways You Can Prevent And Treat Arthritis

June 4, 2020 / Thomas Cohn, MD

Arthritis is one of if most common health conditions that affects individuals over the age of 50. In fact, roughly 1 in 4 Americans over the age of 54 have been diagnosed with arthritis, so odds are you know someone in your life who is battling the condition.

The tricky part about arthritis is that there’s not a lot that can be done to turn back the clock on your joints once the problem has developed. We can help reduce symptoms and make daily life more bearable, but given that it is a degenerative condition, it’s difficult to restore your joints to a younger, healthier version of itself. Instead, we always preach that prevention is preferred to treatment. Below, we take a closer look at five things you should strive to do each day to help ward off arthritis in your knees, hips, shoulders and wrists.

Daily Arthritis Prevention Activities

Here’s a look at five things you can do each day to reduce your risk of arthritis.

1. Exercise – Exercise may seem like it’s hard on your joints, but regular, moderate-intensity exercise is one of the best things you can do to keep your joints healthy. Exercise helps to prevent joint stiffness and muscle atrophy that can contribute to joint dysfunction. Protect your joints by working to strengthen them through daily exercise.

2. Weight Management – Exercise can also help you keep this factor in mind. Weight management is key for preventing arthritis. If you’re carrying extra weight, your joints are going to be the ones feeling this stress. Losing just a few pounds can take a lot of stress off your joints. Considering that we take roughly 8,000-10,000 steps a day on average, that’s a lot of stress on your knees that can be avoided if you just strive to maintain a healthy weight.

3. Eat Healthy – Now, every meal doesn’t need to be perfect, but if you can have more bad days than good when it comes to your diet, you’ll be putting yourself in a good position to stave off arthritis. A poor diet can lead to excess weight, which as we talked about above will challenge your joints. It can also contribute to joint inflammation, making certain movements painful and contributing to a reduced likelihood to exercise and strengthen your joints.

4. Prevent Joint Injuries – Not all acute injuries are preventable, but you can reduce your risk of an injury by taking time to stretch before activity and avoiding overstressing joints with too much activity in too short a time period. Know your limits when it comes to certain physical activities. Overexerting yourself can put excess stress on your joints, which can lead them to break down and become arthritic.

5. Avoid Smoking – Finally, ditch the tobacco products if you want to get serious about reducing your arthritis risk. Studies show that smoking increases your risk of rheumatoid arthritis, among other health issues. Give up smoking or stay away from the habit if you want to reduce your arthritis risk.

And if you believe you’re in the beginning stages of arthritis, talk to a pain specialist like Dr. Cohn. Early intervention can prevent symptoms from getting worse, so reach out to his clinic today for more information.

What Weather Makes Chronic Pain Worse?

May 20, 2020 / Thomas Cohn, MD

The weather can affect your mood, but can it also affect how pain is expressed and felt in your body? According to new research out of the United Kingdom, certain whether patterns may make your chronic pain condition worse. Below, we take a closer look at what the study uncovered, and we explain why certain weather patterns may lead to a chronic pain flareup.

Chronic Pain and The Weather

To better understand how weather systems affected individuals with pain, researchers from the University of Manchester conducted a 15-month study involving more than 13,000 people living with chronic pain. Patients were asked to record their pain intensity each day with the help of a smartphone app. GPS location data was also used to record the weather data for the individual’s location. Researchers ranked all tracked days, and the most painful days saw 23 percent of participants report an increase in pain, whereas only 10 percent said the same on the days ranked as the least painful days.

Researchers took the 45 highest ranking days for pain and averaged the weather conditions to determine the weather patterns that were present on the days when the most amount of people were in pain. The same was done for the 45 lowest ranking days. Here’s what they found:

On the most painful days, the jet stream was aimed right at the UK, with below-normal pressure over the UK.
On the most painful days, the humidity and precipitation rate were both above-normal.
On the least painful days, there was above-normal pressure over the UK.
On the least painful days, the humidity and precipitation rate were both below-normal, and winds were weaker.

Co-lead researchers Professor David Schultz, Department of Earth and Environmental Sciences at the University of Manchester, and Professor Will Dixon, had this to say about the study:

“Over 2400 years ago, Hippocrates wrote that different wind directions could bring better or worse health to individuals,” said Professor Dixon. “The belief by people living with long-term pain conditions, such as arthritis, that their pain is affected by the weather remains prevalent today, with about 75% of people with chronic pain believing this to be true. Yet, there is disagreement over what weather condition makes their pain worse.”

“Part of the reason for this lack of consensus is that previous researchers have treated the different measures of the weather such as pressure, temperature, humidity separately, which assumes that one could vary the temperature while holding all of the other weather measures fixed,” said Professor Schultz. “Of course, the real atmosphere does not behave like this, as all the variables are changing simultaneously. A simple analysis clearly won’t do to get at understanding how weather affects pain.”

The leading theory is that when low pressure systems arrives, the pressure against your joints drops as well, which can make swelling and inflammation worse. Our bodies then react to this inflammation, which can lead to an increase in pain sensations. It’s far from a concrete science, but this study seems to provide more proof that there is at least a correlation between certain weather conditions and an increase or decrease in chronic pain.