More Outrage Over Prescription Painkillers

March 17, 2015 / Thomas Cohn, MD

A recent editorial by Charles Lane of the Washington Post detailed the catastrophe that prescription painkillers have caused in the United States due to opioid overdoses. According to the story, in 2013, opioids played a role in over 16,000 deaths. Since 1999, they have had a role in more than 175,000 deaths, more than the number of people killed in the Vietnam War. While traffic accident deaths have declined, opioid deaths have climbed. According to Charles Lane, the blame for this uptick in deaths is due to the government and medical professionals who over-prescribe when treating non-cancerous pain.

The article goes on to site countless statistics about how often opioids are prescribed for pain, especially in the United States compared to the rest of the world. The article clearly indicates that modern medicine is to blame for the increase in prescription painkiller overdoses. Not once in the article is it mentioned how widespread pain is in this country and the world. The complexity of pain management is never mentioned either.

Pain Misconceptions

Pain affects roughly 43 percent of the population of the United States. Pain is the number one cause of people visiting a physician. Information from the National Institutes of Health published in 2011 by Martin Cheatle indicates that 40 percent of the opioid overdose deaths may be related to pain and suicide. The conclusion drawn is that pain is widespread and not being adequately treated.

Pain physicians are a small group of physicians who are actively trying to change and improve the management of this complex problem. Pain is a both a physical and psychological phenomenon. Every year we are developing new strategies to treat numerous conditions that cause chronic pain. Opioids have been only one small tool in the complex arena of pain management. Patients have become more sophisticated over time and everyone wants their pain to be treated immediately and completely. Most doctors do not have the sophisticated training and knowledge to deal with all the complexities of pain, so they try the easy solution prescribing opioids. Since pain is so wide spread, bad outcomes are inevitable until more people are educated about pain and more research and new solutions can come to market.

Shame on Charles Lane for throwing blame all over the place. Pain is a complex issue, as are the overdose deaths caused by opioids. Outrage should be focused on the lack of treatments available for those who have pain. Outrage should be focused on industry and the government for the lack of research spending on pain. Outrage should be focused on medical training programs that do not educate new physicians about pain management. Pain physicians and researchers are making tremendous strides in pain management, but it will take time. Mr. Lane is showing only ignorance about the problem of pain and casting irresponsible blame without looking towards a solution.

Water Therapy for Chronic Pain

March 11, 2015March 18, 2016 / Thomas Cohn, MD

People are always asking about things they can do to relieve their chronic pain on their own time. We’ve talked about plenty of home remedies on the blog before, but one avenue we haven’t explored is water therapy.

Water therapy is growing in popularity as a treatment for chronic conditions because of its numerous benefits, including:

Chronic pain relief

Reduced recovery time

Increased movement function

Decreased load bearing

Decompression of inflamed joints and discs

Relaxation

General exercise

What is Aqua Therapy?

Aqua therapy, otherwise referred to as pool therapy, involves preforming an exercise program or a set or exercise in the water. Oftentimes patients with chronic pain can’t preform regular exercises because the movements serve to exacerbate the pain, but aqua therapy can provide the relief they need. Because the load bearing in joints is decreased while in the water, patients can move their body without putting extra stress on painful areas of the body.

Aqua therapy is beneficial for patients with numerous health conditions, including:

Chronic and acute pain

Back pain

Neck pain

Fibromyalgia

Arthritis

Nervous system disorders

Joint or muscle pain

Muscle weakness

Migraines or headaches

As we’ve mentioned before, chronic pain affects more than 50 million Americans every year. A chronic pain specialist can help you with injections or other hands-on treatment options, but it’s going to take some work on your own to rid yourself of your pain. If other home treatments have failed, or you simply want to explore a new exercise technique, give water therapy a try.

6 Tips To Avoid Pain While Driving

March 9, 2015March 18, 2016 / Thomas Cohn, MD

Now that the weather is warming up people are getting outside and planning roads trips. Cross country or day trips can be a lot of fun, but not if you’re plagued by chronic or acute pain. Today, we share six tips to help you control and alleviate pain during a long road trip.

1. Break Up The Trip – This point is probably the most obvious tip. If it’s painful to sit for hours on end, do yourself a favor and break up the trip with some stretching. Find a rest stop every hour or so and move around for a couple minutes. Doing this will keep your joints from getting stiff.

2. Plan Ahead – Banking off point number one, plan ahead so you have time to get out and stretch during a particularly long road trip. Leave a little earlier so you have time to get out and stretch your legs.

3. Medication Management – Once again playing off the above tip, use some foresight when it comes to managing your pain medications. Make sure you pack enough of your prescription to get you through the trip, and if you’re running short on supply contact your physician to ensure you don’t run out mid trip. As always, when traveling with medication, keep them away from children in child-safe containers.

4. Take Turns – If you’re traveling with friends or family, take turns driving. Consider switching every time you get out to stretch, eat or go to the bathroom. Although you’re still stuck in a car, having a little more room and being able to take your eyes off the road can help keep pain from setting in during the trip.

5. Eat Right – If you’re planning on eating on the road, pack a healthy lunch or opt for a healthier fast food option. Certain foods can trigger flare ups, so don’t just load up on junk food.

6. Pack a Mix-Tape – As my colleague Dr. Lance Silverman recently shared on his blog, audio therapy is helping children control pain after surgery. Audio therapy can help take your mind off the pain and put you in a better state of mind. So cue up your CD player or iPod and jam out on your cross country trip!

Spider Venom Could Help Chronic Pain Sufferers

March 4, 2015 / Thomas Cohn, MD

Although I’ll be the first to admit that I’m not the biggest fan of spiders, new research suggests that spider venom may actually hold the key to unlocking chronic pain.

According to the study conducted by researchers at the University of Queensland’s Institute for Molecular Bioscience, certain spider venoms contain seven compounds that could be therapeutic for some chronic pain sufferers. Study co-author Professor Glenn King said the key to alleviating chronic pain lies in the Nav1.7 channel, and area associated with pain and inflammation in humans.

“A compound that blocks Nav1.7 channels is of particular interest for us,” said King. “Previous research shows indifference to pain among people who lack Nav1.7 channels due to a naturally-occurring genetic mutation — so blocking these channels has the potential of turning off pain in people with normal pain pathways.”

Spider Venom Benefits

Now if you’re suffering from chronic pain, I don’t recommend that you go out and get bit by any old spider, but the science behind spider venom for chronic pain is intriguing. There are more than 45,000 species of spiders in the world, all with hundreds or thousands of different proteins in their venom. Some of these proteins have the ability to block nerve activity, but scientists haven’t conducted a lot of research on these compounds or their medical potential. Dr. Julie Kaae Klint, co-author of the study, said we need to continue testing all these available compounds.

“A conservative estimate indicates that there are nine million spider-venom peptides, and only 0.01% of this vast pharmacological landscape has been explored so far,” said. Dr. Klint.

Examining all nine million peptides individually would take years or decades, so researchers came up with a simpler solution. The screened venom from 206 different species of spiders and found that nearly half of the venom contained at least one compound that blocked human Nav1.7 channels. Seven specific compounds proved especially promising, and one of these compounds actually showcased chemical, thermal and biological stability. These three stabilities are necessary when designing a new drug.

Considering that chronic pain affects one in five people worldwide, this natural resource could be a huge gamechanger for those suffering from chronic conditions.

“Untapping this natural source of new medicines brings a distinct hope of accelerating the development of a new class of painkillers that can help people who suffer from chronic pain that cannot be treated with current treatment options,” said Dr. Klint.

Related source: Medical Daily

New App Helps Chronic Pain Sufferers Manage Meds

February 25, 2015 / Thomas Cohn, MD

A first-of-its-kind app aimed at helping chronic pain sufferers manage their opioid consumption is now available in the App Store.

Among other things, the My Opioid Manager App helps patients track their prescription drug intake and ensures they don’t over or under medicate. The app has numerous features, including:

Details about specific medications, including their side effects and risks.

A calendar to schedule and track their opioid consumption.

The ability to create pain diaries, complete with body maps to visualize and note areas of pain.

The ability to share consumption details with the patient’s medical team.

Dr. Andrea Furlan, co-author of the app and a physician/scientist at Toronto Rehab, University Health Network, said the goal of the app is to help patients better understand the pills they are putting in their bodies.

“Patients need to know the risks, and better understand their dose, potential complications, and the interaction opioids have with other medications they may be taking,” said Furlan. “Patients are often very fearful of how their body will react to opioids or that they will become addicted. The app is designed to educate and hopefully dispel some of their fears.”

Furlan noted that the app is only designed for people with chronic pain with conditions like osteoporosis, low back pain, neck issues and muscle spasms. The app is not equipped for patients battling cancer who are taking pain management meds.

Amy Robidas, a registered nurse at Toronto Rehab and co-author of the app, said the tool helps patients take a more active role in their treatment.

“Chronic pain often makes patients feel like they don’t have control over their body and how they’re feeling,” said Robidas. “Having the ability to track opioid use themselves, gives patients the ability to be partners in their own care.”

Robidas said one of the unique aspects of the app is that it allows the patient to communicate and share medical information with their doctor.

“There can be a lot of stigma around opioid use. This is a tool that can help patients develop trust with their physician and allow for more time to discuss questions and concerns and set functioning goals,” said Robidas.

The My Opioid Manager app is available on the iTunes App Store and on Google Play for iOS and Android devices. The app is free of charge and comes with a free iBook which helps patients understand more about opioid use.

Related source: News Wise