chronic pain

Chronic Pain In College Part 4 – Pain and Your Social Life

/ Thomas Cohn, MD

Chronic pain Social College Minneapolis(Below is Part 4 of a four-part series on chronic pain in high school and college. It was penned by a college student who has dealt with chronic pain throughout her academic career. The four-part series will cover four important aspects of college life – Academics, Dating, Employment and Social Life.

Here’s Part 4 on how to manage chronic pain and your social life during an important stage of your life. Click these links for Part 1 and Part 2 and Part 3.

Chronic Pain and Your Social Life

Pain can dominate your life, or you can make it just something that is part of your life. It starts with how you interpret life. If you take charge, you can change the way you interpret your pain and take back the control of how you live your life. The key is to find what you enjoy in life and to never loose sight of it. Make that your motivation through the tough days and a perk to enjoy on the good days. Make social events/time with other people a regular part of your week. It is really easy to isolate yourself from society when you have health problems, but life is a lot more manageable if you don’t.

If you’re in college, consider joining a club you’re passionate about. Clubs are a great way to get involved with your university, gain leadership experience and meet new people. Clubs can be social, professional, community service driven, or a combination. Most universities are also open to students creating their own clubs, so if you have an idea and want to implement it, you can do that too. I’d suggest being involved in at least one student organization in college. If you have chronic pain or are in a tough major (or both), joining a club can help give you multiple things in your life to distract you from the unpleasant aspects.

Friends Are Key

Good friends are a lifesaver. Having buddies that live with and know you well can be extremely helpful as you cope with chronic pain. It’s important to have someone to be able to go to (physically or a phone call) and be able to connect with, vent, or just distract you from what is going on. If pain prevents you from doing “extreme sports” then plan fun activities that will be less strenuous: game nights (board or video), movie nights, watching a TV show with others, playing pool or going to an arcade, going to a bar or out to dinner, going to a movie or comedy show, doing open skating, going for a walk with a dog or just with your friends exploring the city. I’ve found being surrounded by good company is enough to take my mind off the pain for a few hours and allow my life to have some normalcy. Just because you have chronic pain doesn’t and shouldn’t mean that you shouldn’t have a social life if you want one. Yes, you might have to make some adjustments, but here again, if you put your mind to it, you can make it what you want to.

All in all, these are the things I’ve learned and I hope you consider. Firstly, humans are generally kind, considerate, helpful, and understanding. It’s in our nature to help each other out, so don’t be afraid to lend a hand or ask for a hand when you need one in return. We (especially people with pain) catastrophize present and future situations, often assuming much worse outcomes will happen than are realistic. Don’t let this prevent you from trying new or different things in life. Humor and distraction can make an awful day a good one. Surround yourself with people that know you well and make you happy, don’t waste your time and energy with people that bring you down or make you feel bad about yourself. Be there for others the way you want them to be there for you. And LIVE the life you want to, don’t try to restrict your life to “fit” what you think you have to because of your pain; instead, do the things in life you want to do, and make the adjustments you need to in order to make sure you can indeed do what you want. Don’t let pain and others define your life—define your life how YOU wish to.

Chronic Pain In College Part 3 – Pain and Your Love Life

/ Thomas Cohn, MD

Relationships and Chronic Pain(Below is Part 3 of a four-part series on chronic pain in high school and college. It was penned by a college student who has dealt with chronic pain throughout her academic career. The four-part series will cover four important aspects of college life – Academics, Dating, Employment and Social Life. Here’s Part 3 on how balancing a relationship and chronic pain can sometimes be overwhelming. Click these links for Part 1 and Part 2.

Chronic Pain and Dating

If you want to be in a relationship, you can. I’m not going to say it won’t be complicated at times, but you are still a human being and can enjoy being in a relationship. Some common concerns and reasons to justify avoiding relationships include worries about “burdening others with your health,” worrying about how your pain can affect the time and things you can comfortably do with your partner, and that you won’t be able to enjoy a relationship when your health isn’t stable.

I’ve thought one or more of these things at different points of my life (before, during, and after relationships), I’ve even used my health as a reason to end a relationship, but I’d also like to point out the many good parts about relationships and why you shouldn’t dismiss a relationship opportunity for the “what-if” fears associated with your health. If someone you like asks you out, I would suggest you give it a try before saying no. You’ll never know what you can or cannot do in life unless you try it. Also, don’t assume any two people or relationships are the same. People grow and change throughout life, and as such relationships are and will be different.

Being Honest About Your Pain

Honesty is EXTREMELY important in ALL concerns you may have about how to handle a relationship with at least one individual with chronic pain. Whenever I’ve been in a relationship, the person I’ve dated either knew before or relatively early on that I had back pain. I’ve often thought of my pain as a “burden to others,” but the more people I meet, the more faith I have in humanity and less I think like this. My friends, family, and those I’ve dated have all told me they are there for me whenever I need them, I’m not a burden, and they want to be there for me through the difficult times.

Because I’ve met enough people like this, I believe there is a person of this belief out there for you as well. I made sure to make it clear that I have good and bad days and sometimes that can affect what I’m up for doing (whether that is school, homework, work, or dates). Being open about how you feel when you’re with your significant other can help avoid hurt feelings if there is a time that it would be uncomfortable to go bowling or cuddle or whatever it is. Honesty early on can also allow your date to leave a relationship early on if they can’t handle being in a relationship with someone with health problems. For a different spin on things – you can consider your health as your “baggage.” After all, everyone brings something into a relationship that can complicate things, and there is no shame or avoiding it, so accept it, be honest, and move forward.

Find Support

If you have chronic pain, you will know the strength you need to get through the day. It takes a similar strength to be supportive to someone else in pain, but life is easier when you are with someone who is supportive. Personally, I often find distraction as a great pain-reduction technique; so being with others (even while in intense pain) can actually be helpful. Whether I’m with a group of good friends or with a significant other hanging out, allowing my mind to be on living and enjoying what’s going on in the present has helped me get through some tough times. There are also times that my pain can prevent me from leaving my room. Knowing this about myself has allowed me to enter a relationship, inform my partner, and maintain that communication in the event plans need to change last minute. Nurturing—maybe it’s simply helping others—is an archetypal part of human nature. Professors, friends, family, and significant others are generally helpful and will look for ways to help you through whatever you are dealing with if you share what’s going on. People will be there, don’t ever feel like you have to get through everything by yourself, there is no reason to make yourself do that.

I’m guessing the next biggest problem many young adults with chronic pain worry about in relationships is being physically close with others. I know I’ve struggled with this before. I have times that whatever position I’m in, I’m in pain, or times that my body is painful without even being touched. I’d be lying if I said I’ve never been uncomfortable when hanging out with a significant other. However, I have also learned that being honest and setting those boundaries or voicing when you can or can’t or don’t want to do something (whatever the reason) is always the better route. If your significant other truly cares about you, they will understand (they may be disappointed), but they would rather look out for your health, safety, and well being than satisfy a momentary pleasure. In today’s pleasure-seeking culture, maybe this sounds outrageous, but I still think many people that are in relationships (rather than one-night-stands) are people that do care about people in a long-term way rather than just the present. When you’re in a lot of pain, it can be hard to think of the times you aren’t in pain, or think of all the good things and fun things you can do with friends or significant others.

Part 4 will be published early next week.

Chronic Pain In College Part 2 – Pain and Your Job

/ Thomas Cohn, MD

(Below is Part 2 of a four-part series on chronic pain in high school and college. It was penned by a college student who has dealt with chronic pain throughout her academic career. The four-part series will cover four important aspects of college life – Academics, Dating, Employment and Social Life. Here’s Part 2 on how holding a job while in school can be difficult if you deal with chronic pain. Part 1 on Chronic Pain and Academics can be seen here.

How Chronic Pain Affects Your Job

Working With PainIf you struggle with chronic pain, I’m sure the thought about getting and keeping full-time employment will have crossed your mind at some point or another. From my experiences I can offer suggestions and a few pieces of advice.

As you search for a job, search for a company that is employee-focused and cares about everyone in their company. Many companies will have similar positions for people of a certain major, but one of the biggest differences in the job you have comes from the company and culture at your workplace. Companies that stress work flexibility and employee support are the places to seriously consider because they will be more likely to offer flexible work hours (allow for doctor appointments, leave early on a bad pain day and work late another, etc), flexible working location (home or in-office), ergonomic work stations (sit-to-stand desks, supportive chair, etc), and other services for employees such as a gym, nurse, or physical therapists on-site.

During an interview, it is perfectly appropriate to ask questions that relate to company culture, how employees are treated and any other specific questions you have to help give you an idea of whether or not that company goes out of their way to make sure employees can comfortably and effectively get their work done. Once you have the job offer, you can ask HR more specific questions, including any concerns you might have or if they can make any accommodations before you accept the offer. When you start working (whether it’s a summer job, part-time position, internship, or full-time role) speak to your boss and project manager about your health and how it can sometimes affect how you need to work. If you don’t share this information, you won’t be able to ask for working accommodations and they won’t be able to understand what’s going on and how to help you to be successful at work.

Personally, I have found being up-front and honest really helped me because my project manager was able to look into ergonomic work stations and was very understanding if I had to leave in the middle of a day for a physical therapy appointment, go home early or even work from home on a day that my pain was bad. If you put in the effort to research the places you want to work at on sites like Glassdoor, Business Insider, and the company’s website, and you speak to your HR representative about work accommodations, I have no doubt you will be able to work in the field of your choice even while dealing with chronic pain.

Part 3 on Chronic Pain and Social Life in College will be published on Wednesday.

Chronic Pain In College Part 1 – Pain and Your Grades

/ Thomas Cohn, MD

Minneapolis Grades Pain School(Below is Part 1 of a four-part series on chronic pain in high school and college. It was penned by a college student who has dealt with chronic pain throughout her academic career. The four-part series will cover four important aspects of college life – Academics, Dating, Employment and Social Life. Here’s Part 1 on how Chronic Pain can make studying for exams and getting good grades even more of a challenge.)

What can I say, chronic pain sucks sometimes. That said you can still live an “almost normal” life as a young adult with chronic pain. Personally, I’ve been dealing with chronic pain in my neck and back since 2008 when I had my first of four back surgeries to correct my severe scoliosis. Over the last almost eight years, I’ve grown into a young adult, and I am attending college to obtain an engineering degree while dealing with a plenitude of medical appointments in addition to trying to enjoy college and life in general. I intend on addressing the following topics of concern among young adults with pain—getting through school (high school, college, technical training, etc.), working and keeping a job, having a significant other, and day-to-day life enjoyment.

Chronic Pain and College Grades

Having any medical condition that can affect class attendance and performance can be difficult and daunting for many as they think about pursuing higher education. Throughout grade school, middle school, and high school your parents can work with the health office to create a 504 plan in order to address your needs. I found it helpful to have a second set of textbooks so I could keep a set in my locker and a set at home so I wouldn’t have to carry a heavy backpack. If your pain causes problems during exams you may want to look into extra time or extended breaks for exams to be added to your 504 plan. While many teachers at the high school level will allow you the time needed to finish an exam, if this could affect standardized tests such as ACT/SAT and others, you will need 504 documentation in order to apply for these accommodations on standardized tests.

If you are in the process of touring colleges or looking up universities and know you have chronic pain, look into the resources the school offers for “students with disabilities.” At my university, we have a “Services for Students with Disabilities Office” that helps everyone with anything from a temporarily broken arm, to ADHD and chronic pain. Personally, I’ve found the office very helpful in providing documentation to professors and needed accommodations.

Some helpful things to consider as you begin college while dealing with chronic pain include:

  • Getting notes from the professor or using a scribe to take notes for you in class.
  • Talking with your teacher at the beginning of the semester about the possibility of getting extra time for assignments & excused class absences in the event you have a pain flair.
  • Extra time or stretch breaks during classes and exams.
  • Book scanning services (to have a digital version of textbooks to reduce backpack weight).
  • Look into scholarships to purchase an iPad (light-weight computer alternative).

After looking into a combination of the above-mentioned accommodations, I find myself much more easily able to meet the academic demands at a top university. Being proactive about your chronic pain from the moment you step foot on campus will help prepare you for an inevitable flare up, will help professors learn of potential issues before a problem arises (this is key), and help prevent symptoms from worsening. It’s not easy, and you’ve got enough on your plate as a new college student, but it’s crucial to be proactive.

Part 2 can be viewed here.

Opioid Success Rates in Women With Chronic Pain

/ Thomas Cohn, MD

Women opioids in MinnesotaA recent study has found that using opioids to treat chronic pain in females is often not helpful. The study found that less than 20 percent of females receive pain relief with the use of narcotic-type medications. The article was published in the July 2015 issue of the Journal of Woman’s Health, and it indicates that women often do not receive any significant chronic pain relief pain from the use of an opioid. About 50 percent of men receive adequate pain relief from opioids, but only a small percentage of women have a response.

Chronic pain is a complex problem. There are often multiple problems occurring that cause the pain, and it is rare that there is a simple solution. Pain is complex and a multitude of different techniques and methods are necessary to treat these types of problems. Not only are there multiple peripheral generators of pain signals, the interpretation by the brain of pain is often short-circuited.

Opioid Use and Women

The brain, when it receives multiple pain signals, develops what is called “central sensitization.” Both abnormal and multiple pain signals are interpreted as significant pain, and normal signals can be also perceived as pain. Central sensitization and many of the peripheral receptors are not responsive to opioid medications. When looking at the big picture, it’s not surprising that women don’t respond well to opioid therapy.

As noted above, chronic pain is a complex condition. Simple solutions like opioids often do not work to help with pain. New research is being done to better understand all aspects of pain, and we’ve made huge gains of the last few years. That said, pain care has not received a lot of research funding, but hopefully that will change. Research can lead to better solutions to prevent and treat pain, we just need to put in the time, money and effort.