foot pain

Chronic Pain Linked To Dementia, Stroke and Alzheimer’s

/ Thomas Cohn, MD

dementia

A new study published in Regional Anesthesia & Pain Medicine found that untreated widespread pain has been linked to an increased risk of other cognitive and cardiovascular disorders, like dementia, Alzheimer’s disease and stroke.

Widespread pain is a subtype of chronic pain that involves musculoskeletal disorders and related conditions. Previous studies have found an association between widespread pain and conditions like cancer, peripheral arterial disease and an increased death risk, but the latest study puts an even greater emphasis on the importance of working to successfully treat chronic pain.

Chronic Pain Research

For their study, researchers relied on data from 2,464 second-generation participants of the Framingham Heart Study. After an individual assessment, participants were grouped into three subsets:

  • Those with widespread pain (defined as pain above and below the waists or on both sides of the body).
  • Those with other pain (defined as pain in on or more joints).
  • No pain.

Lifestyle factors like BMI, employment status, depression scores, medication history, marital status, education level and other relevant health data were also collected, and then participants were continuously monitored for the beginning stages of cognitive decline, clinical dementia or their first stroke. During the monitoring period, 188 participants were diagnosed with dementia, and 139 people had a stroke.

After analyzing this data based on the previously created groups, researchers concluded that patients with widespread pain were 43 percent more likely to develop any type of dementia, 47 percent more likely to develop Alzheimer’s disease and 29 percent more likely to have a stroke than patients without widespread pain. When only looking at patients over the age of 65, those numbers changed to 39 percent, 48 percent and 54 percent respectively.

And while the study only found a correlation, not causation, researchers felt the findings were strong enough to conclude that “these findings provide convincing evidence that [widespread pain] may be a risk factor for all-cause dementia, [Alzheimer’s disease], and stroke.”

Simply put, if you are dealing with widespread or chronic pain, it’s imperative that you work with a pain management specialist or another professional to help treat the pain. You may think that it’s no big deal to just put up with annoying discomfort, but other areas of your health are in jeopardy if you don’t treat the problem head on. For more information, or for help diagnosing or treating your chronic pain, reach out to Dr. Cohn’s office today. We’re confident that we can find a solution to your chronic pain issue.

The Effects Of Alcohol On Chronic Pain Management

/ Thomas Cohn, MD

pain alcoholAt the end of a long hard day, many people just want to put their feet up and relax, and some also choose to kick back with a beer or a cocktail. Alcohol can affect our mood and our stress level, and it can even help to take our mind off the stressors of the day. However, it’s far from a perfect crutch to lean on if you are battling a chronic pain condition. In today’s blog, we take a closer look at the effects of alcohol as it pertains to someone dealing with a chronic pain condition.

Alcohol and Chronic Pain

Even when used responsibly, alcohol can cause problems with our bodies. It can lead to nerve damage and increase our risk for certain types of cancers. However, research shows that a large portion of chronic pain patients are turning to alcohol to help cope with their pain condition. According to the National Institute on Alcohol Abuse and Alcoholism, roughly 28 percent of chronic pain patients self-medicate with alcohol. That’s more than 1 in 4 pain patients.

The reason many people turn to alcohol is because of the short term relief it appears to provide. It helps to drown out pain signals from nerves and mental stressors like anxiety and depression. The problem is that it doesn’t do this in a healthy way. The short term relief can eventually give way to long term issues, including worsening chronic pain conditions. Nerve signals can become more problematic as the nerves are damaged from alcohol consumption, and relying on alcohol can also push a person further away from healthy treatment options.

For example, drinking alcohol is easier than getting regular exercise, but the benefits of exercise far outweigh the benefits of alcohol. Many people can find the same relief through each option, but one option does this in a positive, healthy way and the other does it in a way that jeopardizes our short- and long-term health. Alcohol intake can also cause problems if you are taking medications, making them ineffective or increasing your risk of dependence, abuse or overdose.

Interestingly, the effects of alcohol on chronic pain have been studied by researchers in the past, and they have found that mild to moderate alcohol intake (1-2 drinks per day) was associated with a slight reduction in anxiety and pain scores. However, researchers don’t believe that this was due to the physical effect alcohol had on the body. Instead, they believe it had to do with the social effects it had on patients, lowering inhibitions and making patients more socially active. Long term it can cause nerve damage, but in the short term it can trick your brain into getting you into a better mindset, and there are positive associations between improved mental health and similar improvements in physical health.

At the end of the day, please use alcohol responsibly if you have a chronic pain condition. Alcohol should never be used as a coping or treatment strategy, because there are so many healthier and more effective options. If you’re struggling with a pain condition and are trying to find a healthy way to treat it, reach out to Dr. Cohn’s office today.

The Daily Challenges Faced By Those With Chronic Pain

/ Thomas Cohn, MD

chronic painLiving with chronic pain can be extremely frustrating, and for a number of reasons outside of the actual pain. There are so many daily challenges faced by those with chronic pain that often go overlooked or ignored, so we wanted to bring awareness to the reality that many individuals with chronic pain go through on a regular basis. Here’s a look at some of the daily challenges faced by those with chronic pain outside of the pain itself.

Life With Chronic Pain

Chronic pain is so much more than physical pain. Here’s a look at the struggle of trying to get through your day with chronic pain.

1. You Don’t Look In Pain – A cold can take the color from your face and a broken arm will require a noticeable sling, but for many patients battling chronic pain, there are few outward symptoms. They may put on a brave face, but their neural network inside their body may be telling a different story. Because they may not look like they are in pain, many people without chronic pain can’t relate to the pain you’re dealing with on the inside. They may think you’re faking it or playing up your pain because you “look fine,” but that couldn’t be further from the truth. Chronic pain patients are often stuck between a rock and a hard place. They either have to pretend like everything is alright when it’s not or be accused of faking or embellishing their pain.

2. Treatment Isn’t Always Straightforward – For a lot of medical conditions, we have a standard care plan in place. If you sprain your ankle, you RICE (Rest, Ice, Compress and Elevate), or you take antibiotics for certain infections. However, chronic pain is so unique to the individual that there’s no one-size-fits-all care plan. Patients often have to see multiple doctors and try a range of treatments before they find something that works for them. This process can be very exhausting and even compound the problem.

3. Social Effects – Chronic pain can also wreck havoc on your social life. Pain can keep you from wanting to head to the movies or play Frisbee in the park with some friends, but pain doesn’t even have to exist to cause these concerns. The possibility of a painful flareup is enough for some people to play it safe and stay home, which can lead to further feelings of isolation. Oftentimes patients with chronic pain want to participate, but their pain or its potential hinders their ability.

4. Pain Is So Inconsistent – It would be a lot easier to plan your life if you knew when a flareup was going to occur and when your good or bad days were going to be. Unfortunately, chronic pain doesn’t work like this. The inconsistency of chronic pain can really affect your mental and emotional state, furthering the problem.

These are just a few of the ways chronic pain can impact a person’s daily life. If you or someone you know is struggling with chronic pain, reach out to Dr. Cohn’s office to see how we can help.

The 10,000 Step Legend

/ Thomas Cohn, MD

10,000 stepsMost people have now heard of the daily 10,000 steps goal. It is the baseline average set for most fitness trackers on the market these days. This seems to be a magic number, but there is actually no scientific evidence behind it. The actual science pushes for 30-45 minutes a day of aerobic conditioning, which is recommended by the American Heart Association. There are numerous studies supporting aerobic conditioning for cardiovascular health and overall positive well-being. The 10,000 step goal was actually was just a marketing scheme for a Japanese pedometer first made in 1965. The pedometer had a Japanese name that translated to 10,000 steps, and the advertising campaign pushed that concept.

Walking To Better Health

The reality of walking a certain amount does have some merit. Monitoring your step count and standing every hour has the incentive to increase your overall activity level. A normal person will walk somewhere between 3,000 and 6,000 steps in a day with routine activity such as work, shopping, and moving about the home. Adding in 30 minutes of aerobic activity hopefully adds another 3,000-4,000 steps or more and pushes a person over 10,000 steps. Therefore the push to about 10,000 steps helps most people to get their extra aerobic workout as recommended for good cardiovascular fitness.

The overall goal of tracking activity is to motivate you to maintain a higher level of fitness. Being able to check your step count is feedback and accountability for being active. Some people can maintain activity levels without tracking themselves and others do group activities so they are accountable to more than just themselves. Many people unfortunately just do not care and let their physical fitness slide. Keeping active and exercising is one of the best ways to stay healthy. It is easier to be lazy, but to feel more healthy, exercise along with eating right and sleeping is essential. If you want to improve your health, it may pay to start tracking your habits, including activity, eating and sleeping. Using a fitness tracking device and the associated computer or phone app may greatly improve your success.

The benefit of exercise cannot be forgotten for anyone who has chronic pain. Keeping the body fit reduces pain in a number of ways. A good program will include stretching of the body to help maintain proper muscle length and function. Strengthening keeps the muscles strong and permits us to continue activity. Lastly, aerobic conditioning provides the endurance to tolerate activity as well as increasing the body’s own endorphins, which help reduce pain.

Becoming consistent with exercise is the aim of using a fitness tracker. If you are self motivated to exercise and are consistent that is wonderful. Using any tracker, from the one that is in any smart phone to those tied to a phone app like a smartwatch or a Fitbit may also be helpful. Find out what works for you and get moving.

FDA Declares Kratom An Opioid

/ Thomas Cohn, MD

kratom fdaWe’ve blogged about Kratom in the past, but now the FDA is chiming in on the subject. According to the FDA, Kratom is more than a plant, it is an opioid.

“As the scientific data and adverse event reports have clearly revealed, compounds in kratom make it so it isn’t just a plant — it’s an opioid,” said FDA commissioner Scott Gottlieb. “And it’s an opioid that’s associated with novel risks.”

Kratom, which has been credited with giving users feelings of euphoria, strength and pain relief, has now been linked with 44 deaths. Aside from its obvious dangers, the FDA decided to classify the plant as an opioid because the drug taps into some of the same brain receptors as opioids.

The Dangers of Kratom

Like a number of drugs in their infancy, the dangers of kratom stem from the fact that we haven’t had much time to scientifically study the substance. Despite never gaining approval from the FDA, kratom was advertised as a concentration booster and workout enhancer in largely unregulated supplements. Because of its properties, it also made its way into the pain management community as a potential option for individuals with chronic pain. And ironically, it’s also been touted as a treatment option for opioid addiction.

“Patients addicted to opioids are using kratom without dependable instructions for use and more importantly, without consultation with a licensed health care provider about the product’s dangers, potential side effects or interactions with other drugs,” Gottlieb said in a previous statement.

Now that we’ve had more time to study the substance, researchers are realizing just how dangerous unregulated kratom use can be. After studying the chemical structures of the 25 most prevalent compounds in kratom, researchers discovered that they all shared similarities with opioids like derivatives of morphine. Moreover, two of the five most prevalent compounds in kratom latch onto the brain’s opioid receptors, just like other opioid painkillers do.

“The new data provides even stronger evidence of kratom compounds’ opioid properties,” Gottlieb said.

Some states have already taken steps to ban the substance, and it wouldn’t be surprising if Minnesota followed suit in short order. Kratom is already banned in Alabama, Arkansas, Indiana, Tennessee and Wisconsin.

At the end of the day, we have to remember that there is no miracle pill that can cure us of our pain or treat our opioid addiction. Trust that doctors have your best interests at heart, and that clinically tested and proven methods are best.