New Findings on Medical Marijuana For Chronic Pain

October 9, 2015 / Thomas Cohn, MD

New research out of Canada suggests that medical marijuana may help people with chronic pain control serious side effects, but it may lead to an increase in minor side effects.

Lead researcher Dr. Mark Ware said medical marijuana appears to be a relatively safe option.

“In terms of a side effect profile, we felt the drug had a reasonably good safety profile, if you compare those effects to other medications,” said Dr. Ware, director of clinical research at McGill University Health Center in Montreal.

Medical Marijuana Study

For their study, researchers tracked 215 patients with chronic pain who used medical marijuana. Participants were studied for one year, and they were compared to a control group of 216 individuals who did not use medical or recreational marijuana. Individuals in the medical marijuana group were given leaf marijuana containing 12.5 percent THC, and they were allowed to smoke it, eat it or vaporize the substance.

At the conclusion of the study, researchers uncovered:

Those who used medical marijuana to ease their chronic pain did not have an increased risk of serious side effects, compared to those who didn’t use pot.

Medical marijuana users were more likely to experience minor side effects, like headaches, nausea, sleepiness and dizziness. They saw a 73 percent increase in less-serious side effects.

Researchers suggest medical marijuana users saw some pain relief through the use of the drug, and they also had better moods and reported a higher quality of life.

Dr. Ware said the study was the first and largest in terms of the long-term safety of medical marijuana, and it could help people who are deciding whether or not to try medical marijuana for their chronic pain.

“This is a paper they should bring to the attention of their physician or health care provider,” Ware said. “Anybody who is interested in using cannabis to treat pain should know this information, as it can influence the decision-making process considerably.”

Dr. Ware also said patients who have never tried marijuana my have a different experience when first getting used to medical pot

“For somebody reading this who’s never tried it, the effects they experience might be different,” Ware said.

Daith Piercings For Migraines

October 2, 2015February 7, 2023 / Thomas Cohn, MD

The internet is a weird place. Back in March, I penned a short, 4-paragraph blog post on the correlation between daith piercings and migraine relief. You can check out the full blog post here, but I’ll provide a short summary for those who want to stay on this page.

In essence, a daith piercing is a type of piercing located in the ear cartilage midline toward the front of the inner ear. You can see a picture of the piercing on the right side of this blog. Although the science behind the piercing hasn’t been fully researched, the location of the piercing has actually been targeted by acupuncturists to help cure headaches. Acupuncturists target this area during sessions, and many people experience short-term headache relief after treatment.

Anybody who experiences frequent headaches or migraines can tell you just how debilitating the pain can be, and odds are they’ve tried numerous treatments to solve the problem. Could a daith piercing be the answer they are looking for?

Long Term Headache Relief

In the beginning of the blog I mentioned that the internet is a weird place. That’s because that blog on daith piercings went viral, and our site saw more traffic in a week than we did in all of 2014. People really wanted to learn more about Daith piercings, and they had a lot of questions. The most common question was, “Which side of my head should I get the piercing on?”

There is no specific answer, but thankfully, just like a brand new car, you can try it before you can buy it. What I mean by that is you can visit an acupuncturist and see if needles in certain parts of your cartilage provide some relief. If you find that it works, maybe it’s worth considering a permanent piercing.

For those of you who are needle-adverse, locating the daith piercing location may still help provide relief. If you begin to have a migraine, take your thumb and middle finger and gently massage that location on your ear. Switch ears after a few minutes, or massage both at the same time. If you notice significant relief, and you deal with regular headaches, a daith piercing could be a worthwhile solution.

Lastly, as I pointed out in the beginning of the article, there isn’t a lot of hard science behind the correlation between daith piercings and headache relief. Some people have found relief with this method, but it certainly won’t work for everybody. But, if you suffer from regular headaches and all other solutions have failed, it may be worth investigating further. I’ve read comments from readers who have said the procedure has helped to control their headaches, so if you pursue the procedure, I’d love to hear from you. Let me know how you are feeling in the days and weeks after the operation, and I’d be willing to let a few of you share your thoughts in a guest blog piece. I really just want people to find relief from pain, and your insights can help.

Being Accountable For Your Health

September 21, 2015 / Thomas Cohn, MD

Taking control of your health requires daily management, and it’s not always easy to do on your own. Sometimes help comes in the form of a gym buddy, but recently we’ve seen a rise in the number of people who wear a fitness tracker to help them track their activity, which is a great start towards a healthy lifestyle. That’s because people who wear some sort of fitness tracker tend to exercise more regularly and they are more accurate in reporting the time and amount of exercise. In the end, it all comes down to holding ourselves responsible for our health, but if these devices can help you stick to a schedule, it seems well worth the investment.

The boom in activity trackers hopefully will lead to higher rates of compliance with fitness. For my patients with pain, those who have included the use of a fitness tracker to monitor activity have been more consistent in exercise. They have also tended to be more motivated in performing an exercise routine, use less medication and have better control of symptoms.

One of the most important actions necessary to control pain is exercise. One needs to perform muscle strengthening and aerobic conditioning on a regular basis to control symptoms. Working with a physical therapist to learn how to perform the correct exercise is a good start, and after learning how to exercise appropriately, consistently being active is critical. The use of an activity tracker can significantly help a person stay the course of appropriate exercise.

The cost of a good fitness tracker runs about $100. As medicine goes, this is a relatively cheap investment into your own health. If pain is a factor in your health, get a fitness tracker, use it and get active.

The Importance of Pain Awareness Month

September 17, 2015September 17, 2015 / Thomas Cohn, MD

Pain affects up to 80 percent of the population at some point in their life for at least a short time, and across the world, 40 percent of the population suffers from chronic pain. The financial impact of pain is in the billions of dollars a year, and is thought to be more costly than all other diseases combined. However, the amount of money spent on research to treat pain is less than 5 percent of all the dollars spent on health research. Changing the face of pain is left to a very small group of medical providers who work in this tough field.

Pain practitioners are found in many medical professions, from dentistry and acupuncture to traditional medical physicians. Research is often left to those who are treating patients daily, and there are very few dedicated to spending most of their time performing ground-level analysis of causes of pain and associated conditions.

Unfortunately, some of the best clinicians who treat pain are so busy managing the many patients who need their services that they do not have the time to transform their knowledge into meaningful studies to pass on to the rest of the world. Most of us would love to have a dedicated staff to transform our ideas into meaningful studies to develop better systems to treat complex pain problems, but no one is providing money for this work.

Pain is a complex problem that affects both psychological and physical aspects of our lives. It is a billion dollar problem and virtually no money is being spent on research. This is why Pain Awareness Month is so important, so we can help bring the problem to the forefront and bring more dollars to research and treat of this prolific problem.

Your Chronic Pain Doesn’t Define Your Life

September 14, 2015August 25, 2016 / Thomas Cohn, MD

Having chronic pain is tough both physically and emotionally. Pain at times seems to control your life. In reality, one needs to become the captain of the ship and take control of your pain and your life. Everyone has problems in life, but if you deal with pain, you need to learn how to manage it and move forward with life. Do not wallow in pity and do not expect others to suffer with you. Taking control of your life involves managing your pain and your emotional status. It also means not using pain as an excuse for doing nothing in your life.

Pain is complex. Once it is chronic, it may be functioning independent from the original cause. It also may be due to constant stimulation of the pain sensors in the body and develop into a central sensitization type of pain status. Over time, the brain may become overly stimulated by pain reception, and in a practical sense, a short circuit develops in pain reception and the brain is overwhelmed by the pain signals.

The Brain and Pain

One of the main functions of the brain is to perceive and interpret all the signals it is receiving. There are conscious and subconscious levels on which the brain translates signals. Some sensory impulses are translated on a reflex level without significant interpretation, while others have extensive cognitive and emotional components. A person has tremendous cognitive control over many aspects of brain function, including the power to modify the meaning of pain signals. The brain can choose to ignore pain signals, especially when they are the chronic background pain signals.

The brain perceives unpleasant sensations in the body. The perception of direct pain signals from painful sensory stimulation can be considered as primary suffering. Overlaid upon this are the feelings, emotions and memories associated with the pain. The feelings associated with pain lead to anxiety, stress, depression and are the secondary suffering felt by a person. Over time, the primary suffering may be minimal and the secondary suffering becomes the major component of pain.

Anxiety and Stress

After years of practice and noticing that pain seems to never improve in the patients who have high anxiety, stress and depression, science has actually helped explain the problem. Using special functional MRI scans of the brain, a psychologically normal person with acute pain has only a couple areas in the brain that enhance. A stressed, depressed and anxious person with pain will have multiple areas of enhancement and abnormalities on a functional MRI scan. Other studies have also shown a normal person exposed to pain can endure much more stimuli, and those who are already stressed have a much lower threshold to similar stimuli. Thus, anxiety, stress and depression have a very negative impact on pain control.

The next level of research that has been done has been focused on treating the anxiety, stress, emotions and depression in the pain patient. A variety of techniques have been used to decouple suffering and treat these components of pain. Techniques have included mindfulness, hypnosis, cognitive behavioral therapy and medications. When the emotional secondary suffering has been treated, often the physical perceived pain can almost be eliminated.

Different people will respond to a variety of techniques. Most people who have chronic pain do have emotional suffering components to their pain. Treating the emotional suffering often becomes more important to solving pain control issues as time passes than finding traditional medical interventions. Further, most people are in denial of any emotional components of pain. However, when the patient is withdrawing from activities of life, it is evident to everyone around the pain patient that there are components of emotional suffering.

When pain becomes an excuse not do something, and one starts withdrawing from life, you are emotionally suffering. Stop asking for pity. At this point, you need to find your solution to your psychological problems and get help to solve them. Solve the psychological issues, and it is amazing how much better the chronic pain issues become. The patients who have a healthy psychological status function and move forward in life. These are also the people who do not make excuses for themselves and have very little dependence on addictive substances. If the stress of life is affecting pain, then get help and find the solution that helps you treat and eliminate the negative behaviors in your life. Stop making excuses and start moving forward in treating the right problems, your stress, anxiety, and emotional well-being.