DARPA’s Role in Solving Chronic Pain

October 26, 2015 / Thomas Cohn, MD

The Defense Advanced Research Program Agency, known as DARPA, has a new project. DARPA is the agency that first fostered the development of the driverless car and a number of robots for both civilian and military purposes. It is the research wing of the military and it works on developing new technologies that may benefit the military as well as everyone else.

The latest project is the Electrical Prescriptions (ElectRx) program. It is designed to discover the science and technology that will stimulate the peripheral nervous system to detect and fight disease. The goal is to establish a better understanding of the nervous system and how it functions in health and disease.

The government has not spent significant money on pain in the past. Now DARPA is going to push major funding into the research area of understanding the nervous system, how it is injured, and what causes chronic disease. Then they plan to research how to use science and technology to modulate the nervous system. There are going to be seven research teams working over the course of four years to move the needle to improve our understanding of what goes wrong in injury and disease and to develop new technologies in treatment.

DARPA’s Plan

According to program manager Doug Weber, DARPA hopes to create fundamental changes in how we manage diseases and injuries.

“Through the combination of a growing understanding of how the nervous system regulates many aspects of our health and advancing technology to measure and stimulate nerve signals, I believe we’re poised to make fundamental changes to the way we diagnose and treat disease,” said Weber.

To that end, seven teams of researchers have been selected to research and demonstrate a way to modulate the nerves artificially so a healthy signal flow can be maintained for self-healing.

DARPA hopes to implement therapeutic stimuli when unhealthy activity in the nervous system occurs as an alternative to traditional treatments for chronic pain, inflammatory diseases, and PTSD among many possible conditions. The influx of a significant funding and research into the understanding of the nervous system in health and injury hopefully will lead to new and better treatments of pain. This appears to be a very positive step forward for the field of pain, however it will be several years before we know the results.

Tai Chi May Help Relieve Chronic Pain

October 21, 2015 / Thomas Cohn, MD

Research published in the British Journal of Sports Medicine suggests that people who suffer from chronic pain may find relief by practicing Tai Chi.

Medical researchers conducted a meta-analysis of 34 studies involving nearly 1,600 patients to better understand Tai Chi’s effectiveness in treating chronic health conditions, like pain, heart disease, chronic obstructive pulmonary disease, osteoarthritis and some cancers. Participants ranged in age from their mid-50s to early 70s, and they took part in 2-3 Tai Chi sessions each week over the course of 12 weeks.

After looking at the results, researchers concluded:

Participants in the Tai Chi group exhibited improved physical capacity, muscle strength, walking ability, bending and flexing range and ability to go from a seated to a standing position.

In patients with COPD, breathlessness was reduced for those in the Tai Chi group.

Patients with osteoarthritis who took part in Tai Chi saw improvements in pain and stiffness.

“The results demonstrated a favorable effect or tendency of Tai Chi to improve physical performance and showed that this type of exercise could be performed by individuals with different chronic conditions,” researchers said.

Tai Chi and Pain

Tai Chi helps relieve pain and stress through choreographed movements that build muscle and improve balance and posture. The exercise technique also works to relax the individual through patterned breathing techniques.

The results of the study fall in line with previous research on the benefits of Tai Chi. The earlier study suggested preforming Tai Chi over the course of just 8 weeks can reduce fibromyalgia symptoms. Researchers also concluded that it can improve sleep quality and physical function while reducing anxiety and fatigue.

So if you’re suffering from chronic pain, back soreness or just seem overly anxious, give Tai Chi a try. We’ve already discussed the benefits of exercise at great lengths on the blog, but relaxed, coordinated movements can produce similar results. For more information about Tai Chi, or to check out some exercises for beginners, click here.

Desk Workers Have High Rates of Lower Back Pain

October 20, 2015 / Thomas Cohn, MD

A three-month study that examined back problems of sedentary and active workers found that desk workers were more likely to end up in the doctor’s office with back pain.

The study examined employment data from 1,300 people who said they deal with spine-related pain. Researchers said that desk workers outnumbered field workers by a rate of 4 to 1. Additionally, one in four participants with a desk job had more than one spine-related problem, like neck and back pain, or shoulder pain and finger numbness.

“Our data shows that half the patients with sedentary jobs had lower back pain,” said Dr. Garima Anandani of Qi Spine, the clinic that conducted the survey.

Growing Epidemic

According to the World Health Organization’s Global Burden of Diseases study, which was conducted in 2010, lower back pain caused by a person’s job is a growing problem. Lower back pain was the leading cause of absenteeism from work in 2010.

“People sit on chairs for 10 to 12 hours,” said Dr. Anandani. “Moreover, they tilt their heads to cradle a phone while typing. These factors affect the biomechanics of the body.”

Dr. Anandani said the best way to combat back pain during your time at the office is to focus on your posture. Some tips to keep in mind while working your desk job include:

Stand up for five minute every 30 minutes
Keep your back straight, don’t hunch over your computer
Consider a stand up desk
Keep your head positioned over your spine, not out in front of you
Consider a headset for phone calls, so your neck isn’t torqued to the side when you’re on a call
Exercise each day when you get home from the office.

If pain persists and exercise and anti-inflammatory medications aren’t working, consider visiting a back specialist. They’ll be able to diagnose the underlying problem and help chart a course of recovery.

Chronic Pain in the Fall

October 14, 2015May 10, 2016 / Thomas Cohn, MD

The changing seasons can make inflammation and chronic pain flare up, and autumn is no different. Fall brings a host of new activities, like cleaning out the gutters, raking the leaves and putting up Halloween decorations. All of those activities are difficult on their own, let alone if you’re battling chronic pain.

Today, we’re going share some tips for managing chronic pain in the fall.

Autumn and Chronic Pain

Here are some ways to prevent chronic pain flare ups this season.

Stretch and Exercise – Before you jump into an activity, make sure your body is warmed up. If you don’t give your body time to get ready for physical activity, you’ll notice it in your joints. Even it’s something as simple as walking around your house or yard for five minutes before you begin, give your body time to warm up.

Dress Warm – Speaking of warming up, make sure you dress appropriately for the weather. As we saw in the last few weeks, autumn can bring 90 degree temperatures and 50 degree weather, so don’t just assume you’ll be warm enough with a T-shirt and shorts. It’s always easier to overdress and take a layer off than to find more layers if you’re away from your home. Keeping your appendages warm will ensure your blood circulates properly and your fingers and toes get the oxygen they need to avoid cramping or pain.

Ask For Help – If you’re having a particularly painful day, don’t be afraid to ask a friend or family member for help. Attempting to rake the whole yard can exacerbate pain if you overdo it. Additionally, it’s always nice to have a friend nearby if you have to get up on a ladder to reach the gutters or put up decorations. Not only can they stabilize the ladder, but they can take over if the pain is too great.

Pain Relievers – If you know you’re in for a day of physical activity, consider an over-the-counter pain reliever. Ibuprofen, Aspirin and Naproxen can help control inflammation, which is often the root cause of chronic pain. Be sure you know how your body reacts under these medications, and consult with your doctor if you are currently on any prescription medications before taking anything else.

Stop if you Feel Pain – If you’re dealing with chronic pain, odds are physical activity will bring about some discomfort, and that’s actually a good thing. You’re strengthening your muscles and naturally combating chronic pain, but if you start to feel dizzy, nauseous or sharp pain, stop what you’re doing. Take a break for a bit and see if a little rest helps the pain subside. If pain is just too much, schedule a consultation with a pain specialist.

Mental Health and Chronic Pain

October 12, 2015August 25, 2016 / Thomas Cohn, MD

New research published in the Journal of Pain suggests that 1 in 4 teenagers diagnosed with a mental health issue also suffer from chronic pain.

We’ve discussed the correlation between changes in your brain and the onset of chronic pain on the blog before, but the recent study shines more light on the link. For their study, researchers at the University of Basel analyzed data from nearly 6,500 teens between the ages of 13 and 18. They uncovered that more than 25 percent of teens with a mental disorder also experienced chronic pain.

Other findings from the study show:

20 percent of teens suffer from a mental disorder, and 25 percent of them have chronic pain.

Mental disorders developed prior to the onset of chronic pain.

All types of chronic pain were associated with mental disorders.

“All types of pain were related to mental disorders,” researchers wrote. “The most substantial temporal associations were those with onset of mental disorders preceding onset of chronic pain, including those between affective disorders and headaches and any chronic pain; between anxiety disorders and chronic back/neck pain, headaches, and any chronic pain; between behavior disorders and headaches and any chronic pain; and between any mental disorder and chronic back/neck pain, headaches, and any chronic pain.”

Breaking It All Down

Researchers say the results indicate that anxiety and behavioral disorders may indicate that a teen is at a heightened risk for chronic headaches or back and neck pain. It also means that some forms of chronic pain may be preventable if we increase treatment options for mental health issues.

“Future studies should focus on identifying the underlying biological and psychological mechanisms with a view to developing interdisciplinary approaches to prevention and treatment,” said lead researcher Dr. Marion Tegethoff.

I too would be interested in further studies on the subject, but I know that exercise has been proven to be beneficial for both people suffering from depression and for those with chronic pain. So while we wait for more information on how we can combat chronic pain through mental health services, go for a 30-minute jog or go for a long walk with a friend!