Chronic Pain Patients Struggling To Find Primary Care Services

opioids care doctorA new study published in JAMA Network Open found that chronic pain sufferers have a harder time finding primary health care because they have an active prescription for opioids.

According to the study, 40 percent of the nearly 200 primary care clinics contacted as part of study said they would not accept a new patient who takes Percocet daily for chronic pain as a result of a past injury, no matter what type of health insurance they had. An additional 17 percent of clinics said they would want more information about the patient before deciding if they would take them on, with two-thirds of this subset saying the patient would be required to come into a preliminary appointment before a decision could be made. Despite these findings, all of the clinics said they were currently accepting new patients.

The findings suggest patients with a history of chronic pain could face health care access problems.

“Anecdotally, we were hearing about patients with chronic pain becoming ‘pain refugees’, being abruptly tapered from their opioids or having their current physician stop refilling their prescription, leaving them to search for pain relief elsewhere,” said study lead researcher Pooja Lagisetty, M.D., M.Sc. “However, there have been no studies to quantify the extent of the problem. These findings are concerning because it demonstrates just how difficult it may be for a patient with chronic pain searching for a primary care physician.”

Slippery Slope

Dr. Lagisetty said for patients with chronic pain conditions, getting access to primary care goes beyond just checkups and preventative care. Having a regular physician could allow them to receive other pain-relieving treatments, and in some cases, work with the new provider to gradually and safely taper off their use of opioids. Primary care providers can also help recognize the signs of opioid use disorders or addictions, so not accepting patients simply because they are trying to manage their pain only works to further the crisis.

“We hope to use this information to identify a way for us to fix the policies to have more of a patient-centered approach to pain management,” said Dr. Lagisetty. “Everyone deserves equitable access to health care, irrespective of their medical conditions or what medications they may be taking.”

It’s easy to accept the healthy young adult at your clinic, and it can be harder to take on the patient managing multiple health conditions, but both should be guaranteed access to primary care providers. We need more doctors who are willing to take on the harder patient.

Could Man’s Best Friend Help With Your Chronic Pain?

dog painA recent article posted in Physician’s Weekly posited if dogs should be prescribed for chronic pain patients. The piece went on the say that roughly 1 in 5 U.S. adults deals with a chronic pain condition, and that dogs may be able to help them with their pain condition. Although many of the claims are not linked to scientifically backed studies, it’s not hard to see how a dog could help with some aspects of your pain condition.

How A Dog Can Help With Your Pain

For starters, there’s the idea that a dog can help you maintain an active lifestyle. Staying active is certainly something that we preach as physicians, because exercise helps to strengthen crucial structures and ward off potentially problematic inflammation. Dogs require daily exercise, so if getting a dog will get you outside and keep you active, there’s reason to believe it could end up being helpful for your pain condition. That being said, you don’t need to get a dog in order to go for a daily walk.

Next, there’s the idea of caring for your mental health. Many physical ailments are connected to your mental well-being. According to the article, the presence of a dog and petting the dog can help distract chronic pain sufferers from their pain and combat feelings of loneliness. Dogs can do wonders for our mental health, but at the same time, if you’re struggling to care for yourself, adding a pet to the equation may only add to your burden and leave you feeling even more stressed. There are mental health benefits, but there can also be drawbacks, so don’t just head out and buy a puppy without doing some research.

Another area that was discussed in the article was sleep health. Sleep is imperative for chronic pain patients, as its a restorative process for our body to heal from the stresses of the day. The article mentions the “overwhelmingly positive” health effects of chronic pain patients who co-sleep with their dog. While a dog may help you feel less anxious or lonely and in turn help you fall asleep, it’s not all positive. Adding a dog to the bed can cause disruptions as you or the dog move throughout the night. Even if you don’t let them sleep in your bed, odds are a puppy isn’t going to be able to make it through the night without going to the bathroom. If you find it hard to fall asleep or stay asleep because of your pain condition, adding regular nighttime potty sessions to your schedule may only make the pain condition worse.

At the end of the day, there certainly may be some benefits to adding a four-legged companion to your home if you have a chronic pain condition, but there are also plenty of drawbacks that you’ll want to acknowledge before picking out a dog. A new dog or puppy can add financial or physical stress to your daily life, which may make chronic pain flareups even worse, so make sure you’ve addressed all potential pitfalls before considering your own therapy dog.

Tips For Managing Chronic Pain During The Summer

summer heatThe summer should be one of the most enjoyable times of the year in Minnesota, but for many people who deal with chronic pain, the summer heat can make their condition worse. So how can you not only survive, but thrive, during the summer months if you have chronic pain? Consider this blog your playbook to managing your pain condition this summer.

Handling Chronic Pain in the Heat

Here are a number of ways to fight back against your chronic pain condition during the summer:

Exercise During Non-Peak Hours – As we talk about on this blog all the time, exercise is very important to help strengthen key structures and treat chronic pain conditions. However, if you’re exercising when it’s hottest out, it can trigger a flareup or lead to a less than successful exercise session. Wake up early or exercise when the sun goes down to avoid the heat.

Dress For What’s Ahead – Becoming overheated can trigger a pain flareup or make your CRPS worse, so look ahead at the weather and plan accordingly. Wear appropriate clothes for the day and try to be inside when it’s supposed to be the hottest to avoid problems with your pain condition.

Swim – Swimming is one of our favorite exercises during the summer, because not only does it get the heart pumping and strengthen supportive muscle groups, but it also helps to keep you cool. On days when you don’t want to do a traditional workout outdoors, head to the community pool or a nearby lake to do some swimming. If you want help developing a water-based exercise routine to treat your pain condition, reach out to our office today.

Stay Hydrated – Pain conditions can also trigger if you’re dehydrated, as can other problems like an increased risk of muscle strains and sprains. Make sure you bring water if you’re going to be outside for long periods or if you’re going to be sweating.

Stay Inside – Finally, if you don’t have to go outside and take on the heat, stay inside where it’s cool. Do your workout inside where it’s cool, or go for a run indoors on your treadmill. It’s important to stay active even when indoors to help keep healthy blood pumping throughout your body, but don’t go out in the heat if you know it’s going to cause problems for your pain condition.

If you follow these tips, we’re confident that you’ll be able to take control of your pain condition even in these hot months. And if you need additional assistance with any aspect of your pain condition, reach out to Dr. Cohn’s office today.

Just How Effective Are PRP Injections For Pain Conditions?

prp injectionThe field of regenerative medicine has been booming over the last several years. It includes the use of injections of stem cells and the use of platelet rich plasma (PRP) to hopefully cure many muscle, joint, ligament and tendon issues in the body. However, it is a fairly unregulated medical field. Most procedures have little scientific data to support their efficacy and therefore are rarely paid for by insurance. There is a lot of case report-type success but very little truly scientific studies to prove the success of these procedures. Many physicians recommend these procedures, knowing the research results would probably change many people’s mind.  

Recently, research on PRP was presented at the American Academy of Orthopedic Surgeons by Dr. Herman Johal, MD.  He performed a comprehensive review of the literature, especially of studies that were well designed control trials. The findings were surprising for the supporters of these procedures, and somewhat predictable. The procedures may be helpful for conditions like tennis elbow, lateral epicondylitis and knee pain. However, for tennis elbow it was no better than dry needling of the elbow tendons and it was significantly more expensive. For knee osteoarthritis, it did work, but again it was no better than hyaluronic acid treatments that are well researched, and are scientifically proven effective and covered by insurance.

PRP and Its Effectiveness

The use of PRP in all other areas of the body including the spines discs, muscles and other joints, especially the shoulders, was not effective. Traditional treatments such as physical therapy and exercise, anti-inflammatory medications as well as steroid injections were more successful. These new techniques pushed by many legitimate physicians are just not helpful. This is a stark reminder that placebos, otherwise known as sugar pills or sham treatments, will work in about 30 percent of people no matter what.  

The message for many pain patients is that there often is a reason for a procedure not to be covered by insurance. If Medicare has approved a procedure and it has an approved specific billing code, then the procedure has scientific studies demonstrating its safety and effectiveness. Currently, the use of platelet rich plasma does not have the designation and it appears to be due to a lack of proven effectiveness. Unless one is independently wealthy, caution should be noted when a procedure is done strictly on a cash basis in our society, like PRP often is.

4 Ways You’re Incorrectly Treating Your Chronic Pain

pain treatingWhen you’re dealing with chronic pain, you’re willing to do almost anything to find respite. You’ve probably done some research online or talked to others with similar issues and come up with a plan. But what if you’re treating your chronic pain condition incorrectly? Not only can this prevent you from finding pain relief, in some cases, it can actually make pain worse. Below, we take a look at four ways you may be incorrectly treating your pain condition.

4 Wrong Ways To Treat Pain

It is in your best interest to talk to your doctor about how you can manage your specific condition, but in general, here are four ways that you may be mistreating your pain condition.

1. Not Exercising – You might think that rest is the best thing you can do for your body, and while it may be good in the short term, it may not be the best bet for your long term health. Exercise helps to increase healthy blood flow throughout your body and strengthen key structures that can help prevent pain. For example, if you’re dealing with back pain, although it may cause some discomfort to exercise because of your spine pain, strengthening your core and your back muscles can help to treat the underlying issue. Don’t just assume that rest is what you need to take care of your pain.

2. Over-Reliance on Opioids – Opioids certainly have a place in a pain care management plan, but they shouldn’t be your only source of treatment. Many people assume that because opioids help dull or eliminate their pain, that it is their best source of treatment. However, opioids do nothing to treat the underlying cause of pain. They may make it easier to exercise or fall asleep, but they need to be paired with active treatment options in order to be the most effective. Make sure you follow through on your other treatment options if you are given painkillers to help with your condition.

3. Isolation – There are times when it can feel great to have the house to yourself to do as you please or to shut out the world for a night, but if you’re constantly isolating yourself from others, it’s not going to help with your pain condition. Some people with pain problems avoid group settings or cancel plans because they don’t want to feel like a burden for others, but there have been studies on the importance of human and social interaction when it comes to pain management. We’re not saying you need to take up public speaking or be the office chatterbox, but social interaction, even if it’s just talking with a family member on the phone or having a friend over for dinner one night a week can really help your mental and emotional state. You’d be amazed at how much your mental and emotional health affects your physical health, so don’t shut out the world because of your pain.

4. Not Seeing A Specialist – The rise of the internet has made it much easier for people to research their symptoms and come up with a diagnosis and care plan of their own. The problem is that it’s easy to fall down a rabbit hole of misinformation or incorrectly diagnosis yourself based on inaccurate or surface level symptoms. If you truly want to get a grip on managing your pain, visit a Pain Management Specialist like Dr. Cohn. He’ll be able to provide a comprehensive diagnosis and set you up with an individualized care plan. Contact his office today to learn more about your options.