back pain

PTSD An Approved Condition For Medical Marijuana In Minnesota

/ Thomas Cohn, MD

PTSD medical marijuanaThe Minnesota Department of Health added post-traumatic stress disorder as a qualifying condition under the state’s medical marijuana program on Thursday.

“PTSD presented the strongest case for potential benefits and a … lack of treatment alternatives,” said MDH Commissioner Dr. Ed Ehlinger.

PTSD comes in many forms, and there’s no one-size-fits-all treatment for individuals who are dealing with the psychological condition. Medical marijuana will not work for everyone, but like we mentioned in our post on Daith piercings for migraines, medical marijuana will provide another potential low-cost treatment option. Medical marijuana is by no means cheap, but trying the initial treatment is much less costly then certain therapy sessions or countless doctor visits, so it opens a new door for individuals with PTSD.

Coming In 2017

Although PTSD has been added to the list of approved conditions for medical marijuana in the state, it was not granted immediate approval. PTSD won’t be considered an active condition until August 1, 2017. However, this doesn’t mean that it will be easy to get clearance from a doctor for PTSD. Military veterans will need to get a doctor’s diagnosis and approval in order to be eligible, but that recommendation cannot come from any Veterans Affairs hospital because marijuana is considered illegal under federal guidelines. They will need to get approval from another physician, and oftentimes it’s difficult to get a new physician to declare you eligible for the medical marijuana program, as doctors are leery of patients jumping from doctor to doctor to try and find a doctor that will grant them approval.

PTSD was the only condition added to the list of approved conditions on Thursday, as Ehlinger and the Minnesota Department of Health shot down proposals for other conditions like arthritis and depression.

Preventing Back Pain During Thanksgiving Travel

/ Thomas Cohn, MD

Thanksgiving is nearly here, and if you’re like most people there’s a good chance you’ll be spending some time tomorrow or this weekend in the car. Traveling to see family and friends can be an enjoyable experience, but not if the ride is plagued by spine pain.

Thankfully, there are a number of things you can do to help prevent painful flareups during the long road trip. For tips and tricks to beat back pain in the car, we turn to our friends at the Back Clinics of Canada, who designed this lovely infographic about spine pain and road trips. Their site is filled with helpful information about preventing and treating back pain, so when you’re done reading the infographic, be sure to head over to their website to learn more about keeping your back pain free. Check out the infographic below, and we hope you have a wonderful Thanksgiving!

 

The Politics Of Pain

/ Thomas Cohn, MD

Politics PainkillerThe problems with opioids have been all over the news. Now it is the political season, and the politics of pain have occasionally been making news. It’s generally about how awful the pharmaceutical companies have been and how they have been behind the current problems. Whenever we try to point blame, it is worth remembering that both the problems and solutions are complex. Drug companies may have recognized the market for pain medications but without a demand for the product, even with the best sales, the problems would not have developed. Further, doctors have also been blamed, always over prescribing pain medications.

The treatments for pain are as varied as the causes, as there is not a single treatment that works for all. Unfortunately, the culture in the U.S. often wants a quick fix, and if a pill helps, most want that solution. The harder solutions of modifying activity and exercise often have few takers. The easy solution is taking an opioid medication, and when people started to realize that it helps temporarily, many people have insisted on being prescribed these medications.

Patient rights and quality care have also been an issue in prescribing medications. Countless times patients have said it is their right to take certain medications and that if a patient has pain, it is the obligation of a healthcare provider to prescribe opioids to control their symptoms. Now with multiple sites providing online evaluations and ratings of care providers, patients dissatisfied with not being prescribed certain medications will rate a provider badly.

Prescribing Opioids

The politically correct position currently, at least for healthcare managers, politicians, and lawmakers, is to say opioids are always bad and doctors should not be prescribing these medications since they only cause addiction and death. The truth is obviously more complex, but these medications are appropriate for certain people, especially when all other treatments for pain have failed.

Years ago, the pharmaceutical companies were notably behind the push to have opioids more widely prescribed. Today, we have a better understanding of the problem with these medications, and we have some alternatives in management of pain. As cynical as it was for drug companies to push for prescribing medications, now the push for more addiction management due to opioid problems. One of the most important solutions to reducing opioid usage is to fund research for better treatment alternatives and to discover more about what causes ongoing pain.

The opioid crisis is real and it affects an alarming number. Yes, there is a need for stemming the crisis, but most of the money being proposed is to go for addiction treatment, and often people who directly profit are behind the treatment programs. Another group is pushing for legalizing marijuana for the treatment of pain, and many of those pushing the hardest will again directly profit if this is legalized. Those in the trenches trying to appropriately diagnose and treat pain, and those who are suffering from pain currently have little financial support. Even though a third of the population struggles with pain, very few resources are being targeted towards a better understanding of the mechanisms behind pain and new treatment alternatives. Pain is not glamorous, and there is no high profile celebrity pushing the cause for better treatments. Unfortunately, there are many people pushing causes related to pain for personal profit, from addiction treatment centers, pharmaceutical companies, to disingenuous entrepreneurs pushing for legalizing marijuana. When looking for solutions, they need to be based in the best interest of those in pain.

Yoga Has Benefits Similar To PT For Low Back Pain

/ Thomas Cohn, MD

Yoga Chronic Back PainNew research suggests that yoga can be as beneficial as physical therapy in reducing chronic low back pain, according to a study out of Boston.

Both yoga and physical therapy have similar mechanisms in that they work to increase our range of motion and strengthen areas of our bodies that may not always get worked, but this study wanted to see if yoga could potentially be a substitute for targeted PT for chronic low back pain.

“We know that yoga is effective, we know that PT is effective, but we don’t know their comparative effectiveness,” said Robert Saper, director of integrative medicine at Boston Medical Center. “To get a complementary health practice into mainstream health care, I would say that (at minimum) it has to be as effective as the conventional therapy, and perhaps offer other benefits, like cost-effectiveness.”

How Effective Is Yoga For Back Pain?

Due to its obvious cost-effectiveness, researchers wanted to learn just how effective yoga was at treating chronic low back pain compared to physical therapy. They started by getting 320 patients in the Boston area who suffered from chronic low back pain with no obvious anatomic cause. The average pain score from their pain was a 7 out of 10, and nearly 75 percent reported taking pain medications for their discomfort.

Patients were then split into one of three groups:

  • Yoga
  • Physical Therapy
  • Education

The yoga group attended a 75-minute yoga session each week and were given tools to perform some yoga exercises on their own in their home throughout the week. The PT group consisted of 15, hour-long sessions of individualized physical therapy, while the education group received a comprehensive book on back pain. The yoga and PT sessions lasted for 12 weeks, then patients were tracked for a year, with random sessions assigned throughout the year.

At the end of the study, researchers noted that individuals in the yoga and PT groups reported similar levels of function, and both scores were higher than the education group. Individuals in the yoga group also reported high levels of satisfaction with their pain and their progress. Yoga also proved to be a pretty safe option, with only a few patients reporting flare ups of pain during or after a yoga session.

Saper concluded that while the findings were interesting, patients received a highly targeted form of yoga, and individuals with chronic low back pain may not see similar results if they just head to the yoga studio down the street. He hopes to conduct more studies down the road to better understand the best yoga techniques for handling spine pain.

5 Pill-Less Treatment Options For Chronic Pain

/ Thomas Cohn, MD

Opioids and other pain medications can certainly help people cope with problems associated with chronic pain, but it should not be your only method of treating your pain. Pain pills are a passive treatment option that can be successful in controlling pain in the short term, but they lose their effectiveness and leave patients at risk for dependence and abuse in the long term. Today, we take a look at five pill-less treatment options for chronic pain that can be used on their own or in conjunction with other strategies to help keep your pain away.

Treating Pain Without Pills

We’ll offer a short blurb on five pill-less treatment strategies below. Click on the link in each article to learn more about each treatment option.

1. Exercise – Exercise is one of the best treatment options for chronic pain. It helps get healthy oxygenated blood flowing to painful areas of our body, helps us keep off excess weight, and it helps off push away the stress in our daily lives. Even if it’s low-intensity workouts, regular exercise is one of the best things you can do for your body, especially if you have chronic pain.

2. Yoga, Tai Chi or Meditation – These techniques also help get blood flowing and strengthen areas of our bodies that are in pain, but they also are great for the mind. Most people don’t recognize just how mentally and emotionally draining physical chronic pain is, but these treatments can help you keep your mind healthy while you’re battling your physical pain. If you have a healthy mindset, you’ll find that the physical pain is often less debilitating.

3. Massage Therapy or Acupuncture – These two techniques are similar in that they focus on the pain pathways in our body. These techniques haven’t been emphatically proven to be effective, but some people have found relief with these options. They should be used in conjunction with other strategies because they too are passive techniques, but both massage therapy and acupuncture have been shown to be successful for some patients with chronic pain.

4. Physical Therapy – Sometimes our chronic pain is caused by an easily identifiable problem, like a pinched nerve or bulging disc. When the pain pathways can be clearly identified, physical therapy to strengthen the areas or free damaged nerves can be a great option. Ask your doctor about what stretches you can do as part of your physical therapy, or better yet, see if they’ll refer you to a physical therapist that can assist you in person.

5. Daith Piercing – If your chronic pain is in the form of constant headaches or migraines, the daith piercing may help provide relief if other options have continually failed. Our blog on daith piercings has been far and away our most popular blog, and while there is no direct evidence that the piercing can provide full relief, numerous commenters have tried the technique and noticed a reduction in headache symptom and prevalence.