Understanding Chronic Pain in Children

chronic pain childrenPreventing chronic pain is a daily battle for many adults, and the symptoms can be even tougher to control in children and teens. Interestingly, new research published in Health Psychology suggests that adolescent pain may be linked to previous experiences with pain, and if we can improve these initial experiences, children may be less likely to experience future pain.

It may sound complicated, but the research wanted to see if there was a link between a previous pain experience and how pain is felt and managed in the future. To do this, researchers examined children who had undergone a major surgery, as these experiences, even if they go as expected, may be traumatic to the child and are likely accompanied with some pain or discomfort.

“This is not to say that every child who has chronic pain had a surgery that led to it,” said study author Melanie Noel. “Rather, it’s that surgery is the only context where we can catch these kids before they develop chronic pain. We know that 15 to 20 per cent of children who undergo these major surgeries will develop chronic pain. So, if we can catch them early and begin to understand the factors leading to their chronic pain, maybe we can prevent it from happening in the first place.”

At the conclusion of the study, researchers found that a child’s memories of pain following major surgery actually influenced their recovery and was associated with an increased risk of the development of chronic pain down the road.

“We’ve discovered that the way children are remembering their pain is an underlying factor in the development of chronic pain,” Noel explained. “It’s not the pain they actually experience so much as the way they process those memories of the pain which is driving whether or not they’re improving, right around the time that pain can transition into chronic pain. At a certain point, these children should be feeling better but those who develop chronic pain are not.”

Managing Adolescent Chronic Pain

The study, which was conducted in Canada, suggests that anywhere from 15-40 percent of Canadian children experience chronic pain at some point during their childhood. Moreover, 60 percent of these children eventually develop chronic pain in adulthood, so it’s important to control chronic pain while kids are young to prevent it from becoming a problem when they’re older.

Researchers believe the findings can help point doctors and parents towards solutions. They believe that psychological and language-based interventions may be able to help kids better cope with post-surgical pain, which will help re-frame their memories of the pain and in turn decrease their likelihood of developing chronic pain in adulthood.

“We can teach kids how to reminisce and talk about their pain experiences in a way that emphasizes anything positive about it,” said Noel. “Maybe the child coped with something well, maybe there was a really friendly nurse. It’s getting them to talk about things that aren’t just focused on the awful after effects of the surgery. It’s a way of catching it, a talk-based intervention that can possibly re-frame the memories. This may actually alter the pain trajectory. It’s one thing we can do to make the recovery and future experiences of pain better.”

This is fascinating research, and I hope the findings are considered by pain professionals when helping children get to the bottom of their chronic pain.

September Is Pain Awareness Month

pain management awarenessIf you don’t deal with pain on a regular basis, odds are you don’t realize how big of a problem pain is in our society. That being said, there’s a good chance you do deal with pain, because roughly one in three adults is the United States is battling a pain condition. Whether it’s from arthritis of the hips, carpal tunnel in the wrist or another painful conditional, pain is very prevalent here in America.

To help bring awareness to the pain problem, September has officially been declared Pain Awareness Month. Today, we hope to share some facts about pain and bring attention to the problem so that we can work towards a solution.

Everyone’s Pain Is Different

Pain is unique to the individual. Even though you may share a diagnosis with thousands of other people, your pain is going to be unique to you, so it should come as no surprise that treatments can differ greatly even if two people are diagnosed with the same pain condition. For some, physical therapy, exercise and a diet change can help keep pain at bay, while others will find relief with acupuncture, yoga and anti-inflammatory medications.

The key to treating pain is to treat the underlying condition, not the symptoms. Some passive treatment techniques like opioids or pain injections help to decrease pain levels in the short term, but they do nothing to treat the underlying problem, which means these patients will never truly be rid of pain. Pain specialists are great at finding the underlying cause and developing treatment strategies to fix the true source of pain. It’s not always going to be easy, but trust us when we say it will be worth it in the long run.

Treating pain also needs to be a two-way street. There is no magic pill to cure your of your pain, so while a doctor can help diagnose your pain and suggest treatment options, we can’t force you to take part in therapy or eat a healthier diet. The desire to get rid of daily pain needs to come from the patient. We will do everything possible to help you on your journey, but we can’t do it for you. Meeting with a pain specialist is a great way to set and manage expectation between doctor and patient.

Facts About Pain

To better explain just how prevalent chronic and acute pain is in today’s society, check out some of the facts about pain below.

  • Over 75 million Americans deal with a pain condition, more than those diagnosed with cancer and diabetes combined.
  • 30 percent of adults between the ages of 45-64 experience pain that lasts longer than 24 hours.
  • The estimated annual cost of chronic pain in the US is more than $100 billion.
  • 1 in 5 people experience pain that disrupts their ability to sleep.
  • Back pain is the leading cause of disability for people under the age of 45.
  • Less than half of pain sufferers feel like they have control over their pain.
  • More than 75 percent of individuals with chronic pain say they suffer from depressive thoughts or anxiety.
  • Headaches were the most common type of pain that led to lost productivity in the workplace.
  • Only 15 percent of people with a pain condition go to a pain specialist. Most prefer their primary care doctor.

If you are dealing with a pain condition, consider setting up an appointment with a pain specialist. Your doctor has a wide range of medical knowledge, but they lack the depth of knowledge about specific pain conditions that a specialist has. If you want to set up an appointment, reach out to Dr. Cohn’s office today.

Let’s Focus On The Pain Epidemic, Not The Opioid Epidemic

pain opioid epidemicA recent article in the Star-Tribune noted that every three weeks, the death toll from opioid overdoses matches the death toll from the attacks on the World Trade Center on September 11, 2001. Not only is this a concerning number, but trends show that the death toll from opioid overdoses is continuing to skyrocket. The government and even President Trump have stated that the opioid epidemic is a problem that needs to be solved, but are they looking at the problem in the right way?

The opioid crisis is a huge issue, but it’s only a symptom of a larger problem, which is the pain epidemic in America. More people are turning to opioids in the United States because more of them are fighting a losing battle against pain. We need to be finding solutions to the pain problem, because the opioid crisis is a symptom of the problem of pain.

Stopping Pain

Think of it this way. Let’s say you’re in your house and you see smoke. You run to the kitchen and notice a fire behind the stove. You quickly fill up some water from the sink and douse the flames with water, stopping the fire in its tracks. It’s great that you stopped the fire, but you wouldn’t just go back into your living room without investigating what caused the fire to start in the first place. If you don’t fix the faulty wiring that caused the fire, you’re prone to another fire in the future.

In the above instance, throwing water on the fire is like trying to treat the opioid epidemic. It is a problem that needs to be addressed, but unless we also focus on the root problem, which is pain (or faulty wiring in this case), then the problem is only going to continue to be cyclical. Eliminating opioids may reduce the number of overdose deaths, but it will also hurt patients who use them responsibly to manage their pain, and severely cutting back on opioids will do NOTHING to solve the pain problem.

What We Need To Do

Enough about what’s wrong with the current system – here’s a definitive list of what we as a nation need to do in order to fix the opioid crisis and the pain problem in America.

  • We need to educate both patients and doctors about how opioids work in conjunction with a multi-faceted approach to pain management.
  • Opioids can play a role in pain care, but they can’t be the only treatment option. They can help manage pain, but they are not a long term solution to treat pain. Anybody who is only taking pain medications for their condition is at a high risk for dependency and has a low chance of ever recovering from their pain.
  • We need to open up insurance coverage to other non-traditional methods of pain management. Let’s get creative with pain management, because what works for some will not work for others.
  • We have to pound home the message that there is no magic pill for pain, but tangible solutions are within your reach.
  • Doctors need to do a better job of pushing people towards tangible solutions instead of quick fixes. Things like physical therapy, aqua therapy, cognitive behavioral therapy, yoga, etc. over writing a quick prescription.
  • We need to invest research funding into pain treatments, whether it’s medical marijuana or new diagnostic tools, we need to spend money on solving the problem of pain. Invest in pain solutions like we’re investing in treating cancer or diabetes.

If we can check off all the items on this list, I’m confident we can find new ways to treat pain, and in turn combat the opioid crisis in America.

The Truth About Chronic Pain

When it comes to chronic pain, one thing is clear – You are not alone. In fact, chronic pain affects roughly one in three people in the world. Whether it’s a sore back, neck pain or complex regional pain syndrome, we all deal with different kinds of pain. But just because our pain is different, doesn’t mean we’re not all going through something similar.

To help illustrate this point, we turn to our friends at WallMassagers.com. They specialize in pain management tools and they’ve created this wonderful infographic to help explain just how widespread chronic pain is in the United States. Check out the infographic below!

chronic pain infographic

Updating The Daith Piercing Survey

migraine surveyWe wanted to give you another quick update on the Daith piercing survey that a colleague of mine is running in order to help us better understand how the Daith piercing may help individuals with chronic headaches. This update won’t have a lot of information, but that’s a good thing. Medical journals are pretty picky when it comes to publishing studies that have already been published in another source, so in order to ensure the findings get shared in a major medical journal, this update can only speak in generalities.

Daith Piercing Update

That being said, this update is also encouraging. Over 1,000 people have taken part in the survey so far, and you still have time to do so if you haven’t taken it yet. You can participate in the survey by following this link and answering the questions on that page.

The results show very promising results when it comes to successful management of certain headaches with the Daith piercing. To be safe, that’s all we can really say right now, but we still need your help. My colleague Dr. Chris Blatchley, who is running the study, has created a second version of the Daith piercing survey to address some areas that he felt the first version did not adequately cover. If you are willing, please click here to take the second version of the survey. Regardless of whether you completed version one or not, it would be wonderful if you could take a couple of minutes to fill out the new version of the survey. The first version of the survey is no longer available, to the two links we’ve posted in this blog will take you to the same place.

Thank you so much for taking the time to help us get a better understanding of the Daith piercing and how it may be able to help certain patients. We promise to keep you updated about future studies, this study’s results, as well as when and where the full data analysis will be published. Thank you for your continued support, and please reach out to Dr. Blatchley if you have any questions. You can visit his website by clicking here.

Thanks!

Dr. Cohn