How To Deal With Chronic Pain Without Medication

September 11, 2020 / Thomas Cohn, MD

Everybody’s battle against chronic pain is different, so there’s no one-size-fits-all approach to treating chronic pain. However, one thing many patients have in common is a desire to avoid painkillers and opioids at all costs. That’s not to say that opioids can’t be a crucial part of a chronic pain treatment program, but for one reason or another, many patients want to avoid them if at all possible.

If you’re one of those people who wants to try and treat their chronic pain without the assistance of opioids, we want to help. Below, we look at some ways you can work to alleviate symptoms and treat the root cause of your chronic pain without painkillers.

Treating Pain Without Pills

Many chronic pain patients find relief with some form or a combination of the following treatment options.

1. Exercise – Sometimes your chronic pain is derived from instability or your body’s inability to provide ample support for stress that is being channeled through an area. Exercise can help to strengthen weakened areas of your body, but it also helps by pushing healthy blood throughout your body so that oxygenated blood and nutrients can aid in tissue development. If traditional exercises like running or walking are too painful, consider some limited weight-bearing exercises like swimming or an elliptical.

2. Yoga – Yoga can provide a number of the same benefits as exercise, but it can also help treat chronic pain that is causing limited mobility. Yoga can help to expand your range of motion and treat issues like chronic neck pain or frozen shoulder. Find a beginner class near you and drag a friend a long to join in the fun.

3. Meditation and Mindfulness – Sometimes, it’s not about treating just the physical condition, you also need to be cognizant of your mindset and how chronic pain is affecting your mental health. Improving your mental health has been shown to have a positive affect on your physical health, so understand that these two factors are related. Make sure you’re caring for your mental health throughout your battle with a physical pain condition, because that can help spur recovery. Meditation and similar mental health-based activities can help with this.

4. Physical Therapy – Physical therapy is arguably the most commonly recommended form of non-operative treatment for chronic pain conditions, and that’s because it’s often so effective. By working with a physical medicine specialist or a physical therapist, you can develop a therapy routine that targets the underlying cause of pain. Whether it’s chronic joint pain, a muscle issue or loose ligaments that are leading to chronic ankle sprains, a physical therapy program that strengthens specific areas of your body can work wonders.

5. Hot/Cold Therapy – Hot or cold therapy can be beneficial for your chronic pain condition depending on the underlying cause. For example, heat therapy can boost blood flow to an area with limited blood flow due to inflammation, and heat can also help relax painful muscle spasms. Cold therapy can be used to help limit swelling in an area, making joint movement less painful. Consider using this option in combination with other techniques listed on this page.

For help getting control over your pain condition, without or without painkillers, reach out to Dr. Cohn’s office today.

Pain “Catastrophizing” Can Make Chronic Pain Worse

August 26, 2020 / Thomas Cohn, MD

Chronic pain can be a cyclical battle that can be tough to break out of. Pain can leave you feeling discouraged, and this discouragement can have real world implications for your chronic pain treatment. In other words, unless you really focus on beating your chronic pain, it’s only going to get tougher to treat.

Don’t Let Pain Control Your Life

This sentiment was given credibility based on a recent study led by researchers at Penn State. For their study, researchers took a closer look at how people felt about their chronic pain condition and cross-referenced it with whether or not the were physically active later on in the day. In the study that focused on patients with knee osteoarthritis, researchers found that patients who “catastrophized” their pain (classified as feeling an exaggerated sense of helplessness or hopelessness) were less likely to be physically active later in the day. Moreover, this contributed to a domino effect of sedentary behavior followed by even more pain catastrophizing.

So while the results show that it can be hard to break free from chronic pain, it also shines a light on how we can best help patients with chronic pain conditions.

“Reducing daily pain catastrophizing may help older patients to be more active and less sedentary on a daily basis,” said Ruixue Zhaoyang, assistant research professor. “This could help improve their chronic pain condition, physical function, and overall health, and reduce the possibility of hospitalization, institutionalization, and healthcare costs in the long term.”

Nobody looks favorably on their chronic pain condition, but at the same time, if you’re constantly focusing on how the condition is negatively impacting your life, it can lead to pain catastrophizing. Researchers say patients who think that their pain is “terrible and never going away,” or those who say they “can’t stand their pain anymore” may be catastrophizing their condition and subliminally decreasing their likelihood of pursuing active treatment solutions, like exercise and physical therapy.

So if you are struggling with your chronic pain condition, really take a hard look at how you’re viewing your pain condition in your head. Are you constantly negative about your pain, and do you shy away from activity when you’re frustrated by your pain. If so, you’re not alone, and you should know that solutions are right around the corner. We can help change the way you think about your pain condition so you’re more likely to follow through on proven active treatments to help with your condition. For more information, or to learn more about how we can help treat the physical and mental aspects of chronic pain, reach out to Dr. Cohn and his team today.

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.

Researchers Study THC Microdosing For Chronic Pain

August 4, 2020 / Thomas Cohn, MD

If you’ve been following our blog for a while now, you probably know that we’re interested in how cannabis or medical marijuana can be used to help with some chronic pain conditions. Recently, we came across a new study published in the European Journal of Pain that explored how microdosing THC could be used to treat chronic pain. Below, we take a closer look at the findings of that study.

Microdosing For Chronic Pain

Microdosing is the term used to describe the act of taking a subtherapeutic dosage of a drug. More recently, the term has become synonymous with regularly taking small doses of psychedelic drugs like LSD. Some artists and authors say microdosing on these agents can unlock the creativity inside of them, but the study out of Europe wanted to see if microdosing other types of drugs could prove to be a successful treatment option for some health conditions. Considering that cannabis has already been used to treat some types of chronic pain, researchers were interested to see if a THC microdose could offer similar benefits.

The randomized, double-blind study separated 27 patients into three different groups. There were:

One inhaled microdose of 500 micrograms (0.5mg) of THC
One inhaled microdose of 1,000 micrograms (1.0mg) of THC
A placebo group

Participants with neuropathic chronic pain were given the doses on three separate test days and asked about their pain scores throughout the study. Researchers found that both microdose groups experienced some short-term reductions in chronic pain.

“Both doses, but not the placebo, demonstrated a significant reduction in pain intensity compared with baseline and remained stable for 150-minutes,” the researchers wrote in the published study. “The 1-mg dose showed a significant pain decrease compared to the placebo.”

Other findings from the study include:

No signs of cognitive impairment in either active dose group.
Reports of a psychoactive “high” sensation were significantly higher in the 1-mg group compared to the 0.5-mg group.
The 1-mg dose used in the trial is about about 5-10x less than what many consider to be the low-end of a psychoactive dose of THC.

“We can concluded from the study results that low doses of cannabis may provide desirable effects while avoiding cognitive debilitations, significantly contributing to daily functioning, quality of life, and safety of the patient,” says Elon Eisenberg, lead research on the project, from the Technion-Israel Institute of Technology. “The doses given in this study, being so low, mandate very high precision in the treatment modality.”

However, the study did have some limitations. The study was conducted and funded primarily by Syqe Medical, which produces the single microdose inhalers used in the trial, but the study was independently peer-reviewed and published. Also, the trial only involved 27 people, so we’ll need more research on a much larger scale before considering this an option for the right chronic pain patient. That being said, it’s certainly an avenue we’ll be keeping an eye on in the coming months and years!