The Link Between Chronic Migraines and Dementia

August 14, 2019 / Thomas Cohn, MD

New research published in the Journal of Alzheimer’s Disease found a link between chronic migraines and the eventual onset of dementia, especially in women.

For the study, researchers examined 7,400 study participants between the ages of 60 and 80. Half of the group said they suffered from regular migraines, while the other half were migraine free. The goal of the study was to see if a migraine diagnosis could impact a person’s likelihood of developing dementia within 10 years of the migraine diagnosis, independent of any other medical issues the individual had.

At the conclusion of the 10-year period, researchers uncovered that over five percent of individuals with migraines had been diagnosed with dementia, while just over 3.5 percent of those without migraines received the same diagnosis. Moreover, when examined by sexes, nearly six percent of women who suffered from migraines went on to develop dementia within 10 years.

“Our results indicate that elderly people with migraine headaches should be regularly screened for cognitive decline and dementia,” researchers concluded. “Furthermore, offering adequate treatment and management to migraine patients is important, as it may help prevent the subsequent development of dementia.”

Not only does there appear to be a link between migraines and dementia, but previous studies have found an increased risk of heart attacks, strokes and cardiovascular issues in women that suffer from migraines, so proactive treatment is important.

Migraine Treatment

Migraines and headaches are two conditions that we help treat, and we recommend seeking professional help if you suffer from chronic headaches because every case is different. We’ll provide you with a comprehensive diagnosis and then walk you through some treatment options. If a treatment isn’t providing relief, we’ll move on to different techniques until we find one that works for you. Some common treatment options that have helped patients find relief include:

Exercise
Weight loss
Relaxation Therapy
Diet Changes
Monitoring and Adjusting Caffeine or Beverage Consumption
Acupressure
Daith Piercing
Muscle relaxers
Other Medications

We won’t stop until we find a solution that works for you. For many individuals, their migraines may also be linked to a chronic pain condition, which we can also help treat. Pain is a complex issue that is best handled through a team approach, so do right by your body and contact Dr. Cohn and his team today.

What Science Says About CBD Oil For Chronic Pain

August 5, 2019 / Thomas Cohn, MD

cbd oil Cannabidiol, commonly referred to as CBD, is a compound found in the cannabis plant that many people swear by for its benefits when it comes to pain management, anxiety, stress or other health issues. We want you to find relief with whatever works, but what does science say about CBD’s effectiveness for pain management? Let’s take a look.

CBD and Pain Relief

If you’re like me, you can’t go a couple blocks it seems without seeing another business offering CBD products. Pizza places, movie stores, bakeries and wellness shops are all places where we’ve seen CBD being offered, but just how effective is it for your health condition? Scientifically, the jury is still out, but researchers are cautiously optimistic.

One of the reasons why we don’t have a lot of scientific data on CBD’s effectiveness for different pain conditions is because up until December 2018, cannabidiol was classified as a Schedule I substance. Now that it has been removed from that list, we’re quickly working to figure out its medical capabilities. Early studies have come to mixed conclusions, with some saying that the right combination of CBD products can help calm symptoms, while others say there exists a lack of good evidence that CBD can help with chronic neuropathic pain.

With that said, many researchers are still hopeful about CBD and it’s health uses in the future. The previous studies have had many limitations, so their conclusions may not be as accurate as we’d like. For example, many of these studies looked at the short-term impact of CBD in patients with a number of different pain conditions. Pain is the most unique health condition in the world, and everyone’s pain is unique to them.

We very well may eventually learn that CBD can help treat symptoms of certain types of arthritis or nerve pain, but it takes time to isolate all the variables and make these breakthroughs. In fact, a study published this year in the journal Pain found that CBD interacts with serotonin receptors in animals, which are believed to play a role in pain, depression and anxiety. By building on these studies, we may be able to come to stronger conclusions and better help patients in the not so distant future.

So as it currently stands, the jury is still out on the effectiveness of CBD oil for a variety of pain conditions. But as we said above, if you’re dealing with a pain condition, we want you to be able to find relief one way or the other. Some people find relief with diet and exercise, others with physical therapy, and others with CBD. What we will say is that while CBD may help your pain condition, it shouldn’t be your only form of treatment. Substances like CBD are a passive treatment, and they need to be combined with active treatments like stretching or exercise therapy to really help the underlying problem. Here’s hoping we learn more about CBD so we can best help our patients.

The Benefits and Drawbacks Of Extended Release Opioids

July 29, 2019 / Thomas Cohn, MD

We are always looking for new ways to make painkillers safer for those individuals who suffer from acute or chronic pain conditions, and one such improvement was the shift to extended release opioids. These types of pills were promoted as safer than traditional opioids, and while they are in some aspects, they are far from a perfect solution. In today’s blog, we take a closer look at the benefits and drawbacks of extended release painkillers.

Extended Release Painkiller Benefits and Drawbacks

Here’s a look at some of the benefits of extended release painkillers, as well as some reasons why these benefits may not be a perfect solution to the problem.

Abuse Deterrent – Some painkillers were redesigned, making them harder to crush and snort. While this has been successful in preventing abuse of some opioids, it has led some abusers to try even more dangerous methods to get their quick fix, like in the form of injections with shared needles. Other types of abuse deterrent drugs actually were designed such that if they were crushed, the active ingredient would fail and the user would not be able to experience the drug’s effects, which helped prevent abuse.

Overdose Deterrent – Extended release formulas of some opioids mean that the individual taking the medication gets a mild amount of the drug over an extended period of time, as opposed to a quicker feeling of pain relief that patients might feel with normal formulas of the drug. This also means patients may need less of the drug because it provides longer and consistent relief instead of a stronger relief that fades over time. That being said, some people may be expecting quicker pain relief, and when they don’t achieve that soon after taking the pill, they could end up taking additional pills to quell their pain. This can lead to an increased likelihood of abuse, addiction or accidental overdose.

Easy To Find – Many companies were forced to invest in developing abuse-deterrent versions of their drugs, so there are a number of different ER opioid options. However, since companies needed to invest more time and money into developing these drugs, they are often more costly than the normal pills. Many patients don’t want to spend more on painkillers than they need to, meaning many opt against the extended release options.

Effective – The good news is that for many patients, ER opioids are effective at helping them manage pain. One thing many pain sufferers want is consistency, and a consistent, long-release drug can do all that. This can help them plan their day, including when they need to take the pills in order to participate in physical therapy or other active treatment options. The only issue is, like any drug taken over a long period of time, the body gets used to the drug and a higher dose is needed to achieve the same level of relief. ER opioids are great in the short-term when working towards a longer recovery goal, but like any opioid, should not be viewed as a long term solution if at all possible.

Relearning How To Sleep With Chronic Pain

July 22, 2019 / Thomas Cohn, MD

Chronic pain can make daily tasks seem impossible, and one of the most common areas of your life affected by chronic pain is your ability to fall asleep and stay asleep. For many people, they need to relearn how to achieve quality sleep because it no longer comes naturally thanks to their pain condition. In today’s blog, we share some tips for relearning how to get restful sleep, because quality sleep plays an important role in controlling chronic pain.

Getting A Good Night’s Sleep With Chronic Pain

Here are some tips for falling asleep and staying asleep if you deal with a chronic pain condition.

1. Regular Bed Time – Get in the habit of going to bed around the same time every night. You body has what’s known as a circadian rhythm that helps regulate awake and tired periods for your body, and if you get up and go to bed around the same time, this will help you body find a good circadian rhythm. Even if you struggle to fall asleep right away, going to bed and laying down around the same time at night will help your internal body clock.

2. Lose The Distractions – The bedroom needs to be a place for sleeping, not for reading on your iPad or clicking around on Netflix. Research has shown that the bright lights of screens in dark rooms can stimulate our brain at a time when we want to be winding down. Read or watch TV out in the living room so that the bedroom becomes a place where you focus on achieving quality sleep.

3. Avoid Caffeine and Alcohol – In the hours before bed, avoid certain liquids that can inhibit restful sleep, like caffeine and alcohol. Even though alcohol may help you fall asleep, it disrupts your ability to achieve REM sleep, the deep and quality type of sleep you need to receive. Avoid these liquids as the sun begins to set.

4. Water Intake – If you’re looking for something to drink, go with water, but make sure you’re cognizant about your water intake. If you’re even slightly dehydrated when you go to bed, it can cause your mouth and nasal passages to become dry and lead to disruptive snoring. However, drinking too much water can lead to the need to get up and go to the bathroom in the middle of the night. Play around with your water intake in the hours leading up to bed so you are hydrated when you crawl into bed.

5. Temperature and Noise – Finally, the key to quality sleep is to stay asleep once you’re out. You don’t have a lot of control over this, but you can help by ensuring your bedroom has the right temperature and noise level. Keep the room cool and use blankets to get comfortable, and find out if noise helps or hinders your ability to fall asleep. Some people like white noise machines, others like the drum of a fan, while others need complete silence. See what helps you fall asleep and stay asleep, and then recreate those conditions each night.

For more tips on falling asleep if you have chronic pain, or for help with your specific pain condition, reach out to Dr. Cohn’s office today.

Chronic Pain Patients Struggling To Find Primary Care Services

July 15, 2019 / Thomas Cohn, MD

A 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.