Resolve To Care For Your Mental Health This Year

January 28, 2019January 28, 2019 / Thomas Cohn, MD

Making New Year’s resolutions has always seemed to be a tradition. This year, instead of resolutions, I thought to myself, “What is something important to my health that I should be doing more on a daily basis?”

What change can I make in my life that would be positive? Is there something I need to do regularly? Lastly, is it something only I should care about? I came up with two things:

Be responsible, and;
Take care of myself mentally

As I grow older, the one truth that seems to be so important is to have good mental health. In general, it is easy to care for one’s physical needs. Exercise, eating, sleeping and those things are more straightforward. Keeping going mentally is more challenging. Everyone has a lot of responsibilities. Taking time to relax and enjoy the world and do things that make one happy are important. Remembering not to get upset about the petty stuff and things that are not controllable is also key. Spend time with family and friends, and do things besides work. Look for the beauty that surrounds us. Maybe consider more time away from work.

Caring For Your Mental Health

Mental health seems to be critical for physical health. All sorts of mental problems, especially stress, anxiety and depression adversely affect how one feels. With prolonged mental stress, physical health is almost impossible to achieve. Once stable mentally, physical problems can be much more easily addressed. If one has significant mental health issues, one often does not have insight into the relationship of those issues to physical problems. This is especially true with regards to pain and anxiety.

All physicians generally want to help their patients feel better. In Pain Medicine, we often want to try to cure the pain. However, pain is more complicated than something like sprain or a bruise. Almost all pain that lasts a length of time has emotional components. It is not just a physical sensation, but it is also tied to how we feel and often is associated with stress, anxiety and depression.

This is not a coincidence, and it is due to the fact that areas of the brain that interpret sensations related to painful stimuli are located next to emotional centers. Sensory input and emotions become entangled and then the brain stops being able to distinguish between them. Emotions soon are perceived as a variety of pains in the body. When this happens, solving physical sensory stimuli that produce pain is not helpful and the psychological issues must be addressed to move forward.

The recognition by a patient of the entanglement of stress, anxiety, and depression and the perception of having pain is a major milestone for people. Once an understanding of the role of emotions becomes evident to a person and how it influences physical well being, progress can often be made toward better treating abnormal sensations that may be considered painful. Improving anxiety and depression almost universally helps in the management of pain. It is not because you are “crazy” and the pain is all in your head, but it is that the painful sensations are entangled with emotions and these feelings need to be treated as importantly as the physical symptoms. Treating only the physical is only treating half of the problem and not solving the whole situation. However, patients have to admit to themselves that the other problems exist and need help. It is amazing how physical problems improve when emotional problems are treated.

The best wish for the new year is to improve both physical and mental health. If one treats oneself correctly mentally and emotionally, our physical health is much easier to work on. Without being stable emotionally it is hard to have the energy to solve other problems. Usually, it is much harder work to solve emotional trauma than physical problems. The first step is recognizing that there may be emotional issues and then seek out help. It is not a sign of weakness to have help solving mental health problems. These are very tough and often complex situations with difficult and less than perfect solutions. If physical problems exist and are not improving, take some time and look for the entangled emotions. Both probably exist and at least one of the areas is being ignored. Seek out help and amazing results often occur.

4 Benefits Of Virtual Reality For Chronic Pain

January 16, 2019 / Thomas Cohn, MD

Virtual reality has made waves in the gaming community in recent years, but it has another potential use in the chronic pain community. These virtual reality headsets can provide patients with detailed information about how their pain condition is affecting their body, which in turn helps patients understand why certain movements or actions lead to pain, and they can also teach relaxation and breathing techniques. As a pain specialist, I can’t tell you how important mental health and mindfulness is during a flareup.

But virtual reality can be beneficial for more reasons. In fact, we’ve highlighted four benefits the therapy technique can provide for patients dealing with a range of pain conditions.

Benefits of VR for Chronic Pain

Here’s a look at four ways virtual reality therapy may be helpful for your pain condition.

1. Better Pain Management – Research into virtual reality has shown that it can help to alleviate or distract the pain from a wide variety of pain conditions, including burns, wounds, surgeries and some chronic pain conditions. In fact, virtual reality headsets are becoming more popular in emergency departments to help distract patients from pain who are dealing with acute injuries. By helping to take our mind off of our pain condition, virtual reality can help to improve pain management.

2. Opioid Reduction – Virtual reality may not be able to put a stop to your pain condition for good, but it can help train your brain to relax, which is key during a flareup. By being able to better control your breathing and keeping yourself relaxed, we can take control over our pain. This in turn can lead to a reduction in pain medications, as instead of reaching for your prescription bottle during a flareup, you may be able to reach for your VR headset or implement the strategies you’ve learned from the device.

3. Decreased Patient Costs – Other studies have shown that the use of VR headsets in medical settings can help to reduce costs on the patient. Instead of being billed by a doctor or a therapist for their time spent educating the patient about their condition, these headsets can provide an immersive look into your condition without tacking on extra expenses. And as we noted above, if it reduces your need for medications, it will also save you money on your prescription.

4. Increased Activity – Finally, virtual reality can be a game changer for patients with chronic pain because it can help lead to exercise, movement and active treatment techniques. These devices can also teach patients breathing and meditation techniques, which can help them manage symptoms and in turn leads to more activity participation. As physical activity increases, so too do healing rates, as movement helps to lubricate joints and promote healthy blood flow throughout the body.

Are CBD Gummies Effective For Treating Chronic Pain?

January 9, 2019 / Thomas Cohn, MD

Every once in a while a new product splashes onto the market claiming to be a miracle cure for chronic pain. Recently, cannabidiol or CBD oil has become that product, and odds are you’ve seen an advertisement for CBD oil, CBD gummies or CBD products on the radio or in a magazine. CBD oil is derived from the cannabis plant, but unlike medical marijuana, CBD products do not contain THC, the primary psychoactive compound in the plant.

Like a lot of passive treatment options in the chronic pain community, CBD oil has earned mixed reviews. Some patients are calling it a wonder drug, as they say it’s been able to rid them of arthritis pain, calm their anxiety and help them sleep. Doctors on the other hand are a little more skeptical of the actual science behind the drug, but then again, since CBD products have been shown to have fewer side effects than traditional opioids, who are doctors to condemn a product that appears to be working for some people?

Is CBD Effective?

By most scientific reports, the jury is still out on whether or not CBD oil has a causal relationship with reducing chronic pain. A study involving rodents found that CBD helped to lower arthritis-related pain and inflammation in rats, but that same study has yet to be conducted on humans. Another recent study published in the journal Pain suggested that low-dose CBD may be effective at reducing pain and anxiety by interfering with a neurotransmitter linked to both. However, Dr. Gabriella Gobbi, who conducted the second study, said more research still needs to be conducted on how CBD really affects the body.

“[CBD] should be more thoroughly studied by doctors and scientists, and then go though the drug development stages and approved by regulatory agencies before being commercialized,” said Gobbi.

The problem is we’ve kind of skipped those middle steps, and that can be dangerous. Even if CBD oil is effective for some, there’s always the chance that we’re missing a potential side effect because the product hasn’t been thoroughly vetted by medical research. There’s also the possibility that the effectiveness is largely a placebo effect in a number of individuals, but again, placebos have been used to treat a myriad of health conditions in the past, so if it’s working for someone, it might be worth continuing.

With that said, if you’re considering beginning or continuing a CBD product regimen, run it by your primary care physician or pain management specialist. While it has shown promise for some conditions, it certainly won’t help certain ailments caused by physical problems, like a herniated disc or spinal stenosis. Don’t waste your time with a passive treatment that will not work if you’re dealing with these conditions. Talk to your doctor, uncover the root cause of your pain, and then determine if CBD oil could be effective for your condition. If you’re a candidate, odds are your doctor will be open to helping you explore the benefits of CBD oil.

One last thing of note – CBD oil is governed differently across the US. It is illegal in some states, while others allow it. Here in Minnesota, hemp products are legal so long as the THC concentration is below 0.3. So while CBD oil may be legal at the state level, it’s actually illegal at the federal level. The U.S. Drug Enforcement Administration considers all cannabinoids, including CBD, a schedule 1 drug, which means it’s as illegal as heroin from the federal government’s perspective. The federal government isn’t activly enforcing CBD’s illegal status, so while it’s unlikely you’ll get in trouble for purchasing or using it, it’s worth remembering that it’s not completly legal in the US, and it could affect your employment depending on where you work.

For more information on CBD oil or your chronic pain condition, reach out to Dr. Cohn’s office today.

New Exercise Guidelines Can Help With Chronic Pain

January 4, 2019 / Thomas Cohn, MD

New federal health guidelines want Americans to move more and get kids active, and this advice can also help to prevent and treat chronic pain. The three main talking points from the new guidelines, which are the first update to government physical activity guidelines in a decade, suggest that we need to move more, sit less and get kids active at a younger age. We take a closer look at all three of those talking points below.

Get Kids Active

The biggest update to the guidelines centers around when parents should really start encouraging their kids to partake in physical activities throughout the day. The old guidelines said six was the target age to encourage kids to be active, but the updated guidelines says you should push kids to move at the age of three. There are no strict guidelines, but they said about three hours of interactive activity and physical movement of various intensity is a good start. That would put us in line with the average amount of activity observed in kids in other countries at this age.

Once they hit the age of six, the activity should be a little more vigorous. At least an hour of moderate-to-vigorous activity a day is recommended, from activities like brisk walking, biking, running or playing on a playground.

Sit Less

Another point that was stressed in the updated guidelines was to have people sit less. Sitting can be especially harmful for your health if it leads to a sedentary lifestyle, and while you don’t need to swap out sitting with activity, at least make it a point to move around regularly or consider switching to a standing option. Find ways to break up your sitting, whether that’s by taking a phone call on your feet at the office, walking around during your lunch break or simply going for a walk instead of plopping down in front of the television after dinner. Strive to sit less in the new year.

Move More

Along a similar vein, movement for adults is emphasized under the new guidelines. The duration for movement and activity remains the same – at least 2½ to 5 hours of moderate-intensity or 1 ¼ to 2 ½ hours of vigorous activity a week, but they also added that aerobic exercise, even in short bursts less than 10 minutes are helpful. Even a single episode of activity can help to lower blood pressure, reduce anxiety and improve sleep.

All of these pieces of advice are also helpful for patients with chronic pain. If we take care of our body when we are young, we can reduce our likelihood of developing a pain condition down the road. And if we pursue active treatments, like movement and exercise over options like rest and opioids, odds are we’ll see more improvement. So try to follow these guidelines in the new year, regardless of whether or not you have chronic pain, and your body will thank you for it.

Can Using A Sauna Be Considered Exercise?

December 4, 2018 / Thomas Cohn, MD

sauna Scandinavians have had healthy lifestyles for centuries. One of their traditions has been saunas, often followed by the quick jump into the snow bank or into a cold lake. New research published in the Mayo Clinic Proceedings indicates that frequent sauna use can have the same effect on the body as regular exercise. Yes, sitting in a sauna is similar to a workout. To be beneficial like exercise, however, it has to be done about five times a week. Occasional saunas do not have a benefit.

How Saunas Simulate Exercise

A typical sauna is heated upwards of 175 degrees Fahrenheit or hotter. Spending five to twenty minutes in the sauna will normally get the heart rate to increase to 120 to 150 beats a minute. This is the same range that the heart would beat at when exercising moderately. At the same time that the heart rate increases, blood flow also increases to the skin, and that is an important factor seen in cardiovascular exercise.

The health benefits of sauna baths were studied in Finland. In the people who frequently used saunas, the same benefits of exercise were noted. These people had a 60 percent decease in heart disease and stroke. There was also evidence of improvements in other diseases such as some pulmonary conditions, arthritis, headaches and the flu. Direct findings included decreased blood pressure and decreased artery stiffness.

The effects of frequent sauna sauna use are the same as aerobic exercise. For those with pain and difficulty walking or exercising, the use of a sauna may have a significant benefit to improve cardiovascular fitness. The extreme heat forces increased heart rates and peripheral vascular flow. Since this is pushing your heart rate up, starting a sauna routine should involve the same cautions as an exercise program. Make sure that your heart can tolerate the increased heart rate and the extra work. Consult your physician and get approval to be exercising before you start using a sauna. Other precautions include drink plenty of water and do not drink alcohol.

For more information about using a sauna for your pain condition, reach out to Dr. Cohn’s office today.