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.

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.

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.

Exercise Accountability and Pain

September 2, 2015 / Thomas Cohn, MD

A recent study in Medicine and Science in Sports and Exercise points out whether we are reliable in reporting our exercise. The answer is that most of us tend to over report our activity level. When using an objective measure of activity, such as a monitoring device of steps and pulse, the record is much more accurate. The best way to keep healthy and reduce pain is to stick to a regular exercise routine. If you are not being accountable, the activity is usually not being done. Very few people have the self-discipline to be consistent with exercise on their own.

Up until recently, the best way to be accountable is to have an exercise partner. Whether it be a yoga classmate or a running partner, if you had to meet someone else, it was much harder to skip the exercise.

Currently, the electronic age can become out partner, as most people now own a smartphone. Both the Android and the Apple phones have fitness apps built into the phone and have electronics that can monitor motion. As long as one has the phone in hand (or pocket), the phone will record your steps. Most people should be aiming at obtaining at least 10,000 steps a day to maintain general cardiac aerobic fitness.

Fitness Trackers and Exercise

A fitness tracker, such as a Fitbit, Vivofit (by Garmin) or Jawbone can be of great benefit. There are now multiple brands of trackers, those at about $100 dollars tend to monitor:

Steps

Distance

Calories burned

Steps climbed

Sleep patterns

The more expensive ones will add in heart rate monitoring, sometimes blood oxygen levels, and may connect to smartphone notifications. All the fitness trackers have apps that chart your daily, weekly and monthly statistics. Keeping a record of your activity tends to make one more responsible toward meeting fitness goals.

The importance of maintaining physical activity is very evident in the pain patient. My patients who are the most active have the best control of their symptoms and tend to use the least amount of drugs and other interventions. For myself, the fitness tracker keeps me more active, maintaining my aerobic conditioning goals. The more intense aerobic exercise, even for just 15 minutes every day, definitely increases my endorphins (the body’s own pain killers) and decreases my back and leg pain. Without the tracker, I know I would be lazy, and definitely would think I am doing more activity than I actually perform.

Aerobic activity does need to be combined with strengthening and stretching for most pain patients. The areas that are causing pain often need more physical muscle support to prevent symptoms, and strengthening and keeping these muscles healthy is another priority.