More Patients Seeking Chronic Pain Treatments Without Opioids

February 11, 2022 / Thomas Cohn, MD

A growing number of US adults with chronic pain are pursuing a combination of non-drug and non-opioid approaches to control and treat their condition, which is an encouraging sign.

As we’ve talked about on the blog in the past, pain medications can play an important role in a comprehensive chronic pain treatment program, but oftentimes other active treatments provide more benefits and do not pose the same risks as potentially-addictive pain opioids. A recent poll found that 55 percent of adults with chronic pain used pain management techniques that did not involve any opioids at all over the surveyed three-month period. 11 percent of respondents used both opioids and non-opioid techniques, and only four percent said they only used opioids for chronic pain management. However, 30 percent of patients with chronic pain said they did not pursue any pain management techniques over the three-month period.

Other Chronic Pain Findings

Here’s a closer look at some of the findings from the survey:

Complementary therapies were the most commonly used non-opioid pain management technique (35% of adults), followed by physical, occupational or rehabilitative therapies (19%).

5% of patients pursued self-management programs, 4% underwent cognitive behavioral therapy, and 2% sought out peer support groups.

39 percent of adults said they pursued non-opioid chronic pain treatments that weren’t expressly mentioned by the survey.

Participants using complementary and psychological or psychotherapeutic interventions were more likely to be younger women with more education.

Prescription opioid use for chronic pain management was more common among older adults between the ages of 45 and 64 years compared to those aged 18 to 44 years (19% vs 8%).

Prescription opioid use was also more common among women than men (17% vs. 13%), in adults with health insurance compared to those without (16% vs. 6%) and in those with a high school education than those with more than a high school education (17% vs. 14%)

Prescription opioid use was less common among people making more than $100,000 than those making less than $35,000 (9% vs. 20%)

Researchers concluded that the findings were a step in the right direction for curbing the national opioid crisis, and it shows that more patients are working to pursue alternative and active chronic pain treatments instead of over relying on opioids that oftentimes simply mask symptoms instead of treating the underlying issue.

It’s great that so many people are working to take a vested interest in their health and really pursue different treatments instead of just taking pain medications. Opioids can make movements less painful and make it easier for patients to pursue certain active treatments, but there are numerous studies that have found some risks associated with long-term opioid use. The results are encouraging, but nearly one in three people with chronic pain aren’t seeking any type of treatment for their pain, and that number is still far too large. If you know someone with chronic pain, encourage them to connect with a specialist, because oftentimes symptoms can be reduced or even eliminated!

For more information, or for help with your chronic pain issue, reach out to Dr. Cohn and his team today.

Overcoming Chronic Illness And Chronic Pain

December 30, 2021 / Thomas Cohn, MD

Chronic pain is never easy to overcome, and that process can become even more complicated if you’re also dealing with a chronic illness. In fact, the two conditions are often intertwined, as recent research has found that people with multimorbidity (defined as more than one chronic illness) are much more likely to experience chronic pain compared to people who don’t experience a chronic illness.

According to the recent data, for patients with two or three chronic conditions, the likelihood of dealing with chronic pain was 53.8 percent. In individuals with four or more chronic illnesses, that likelihood jumped to 75%. And while there is no specific reason as to why this link exists, medical experts have a number of theories for the connection. For starters, when a patient has multiple long-term health conditions, it can be harder for a medical team to address all issues. Medications for one condition can render other types of medications useless or dangerous, or treating one aspect of their health can cause issues for another condition.

So what is a person with chronic illness and chronic pain supposed to do? In most instances, it pays to connect with a pain management professional.

Combating Chronic Illness And Chronic Pain

If you’re dealing with chronic illness and chronic pain, all you probably want to do is curl up in bed and let the discomfort pass. The problem with that strategy is that long-term rest isn’t typically your best treatment option. Instead of rest and reduced activity, gentle exercise and increased activity are usually a better solution. Activity helps to ensure healthy fluid movement throughout your body, strengthen muscles, loosen joints and it can even change the chemical structure in your brain to drown out signals of pain and discomfort. Controlled activity truly is a wonder for patients with chronic illness and chronic pain.

So too is weight loss. Research has consistently shown that there exists a relationship between chronic illness, pain and obesity, and it doesn’t take much weight loss to see the results. One study found that if a person is 50 percent or greater over their recommended weight, losing as little as 10 percent of their body weight may be enough to see a significant decrease in pain.

It’s clear that increased activity and weight loss through diet and exercise can help mitigate symptoms of chronic illnesses and chronic pain, but those treatments aren’t just something you can easily do, especially with pain and illness complicating the equation. Again, that’s why it’s so important to partner with a pain management specialist. They’ll be able to help develop a care plan that slowly builds up your tolerance and endurance without overloading you from the start. Our goal is the help foster healthy habits, and if you don’t take time to slowly and gently increase activity and dietary changes, it’s unlikely these habits will stick on a long-term basis.

There is also the mental side of chronic illness and chronic pain that often gets overlooked. We understand how mentally draining these conditions can be and how they affect your ability to seek out the physical treatments that can provide relief. Sometimes cognitive treatments are just as important if not more important than treatments to address physical pain, and this multi-faceted treatment approach is oftentimes best overseen by a professional. You’ve got enough on your plate without trying to treat the physical, mental and emotion effects of your chronic pain and illness on your own, so let us help.

So if you are fighting pain and illness on many fronts, reach out to a professional for assistance. Slowly but surely, we’ll help find a solution and increase your quality of life. For more information or for help with your chronic issue, reach out to Dr. Cohn’s office today.

Can Chronic Pain Cause Nightmares?

October 21, 2021 / Thomas Cohn, MD

Your chronic pain condition can feel like a real-life nightmare, but could the physical condition actually increase your risk of having bad dreams at night? According to a recent study, there appears to be a strong correlation between chronic pain and bad dreams. So if we want to put an end to these nightmares, we may need to get serious about treating chronic pain.

Chronic Pain And Bad Dreams

As you might imagine, it’s not easy to thoroughly study bad dreams and the processes that go into why a person has a nightmare. With that being said, bad dreams have typically been associated with:

Stress
Anxiety
Depression
Psychiatric and Emotional Disorders

Some of the side effects associated with a chronic pain condition are, as you might have guessed, stress, anxiety, depression and psychiatric and emotional disorders. In other words, the same emotions that you may be feeling because of your chronic pain condition could put you at a heightened risk for bad dreams.

To test that hypothesis, researchers took a look at the frequency of self-reported bad dreams between two patient groups. One group had chronic musculoskeletal pain, while the control group did not. Over the course of one month, 44 percent of the 191 participants in the pain group reported bad dreams compared to 7.3 percent of the 191 participants in the control group.

That’s not to say that you’ll never have a bad dream again if you take care of your chronic pain condition, but for many chronic pain sufferers, their condition is the biggest source of stress and anxiety in their life, and these sensations can manifest in the form of a bad dream. Working to correct the pain condition or simply educate yourself about the best practices for controlling pain can go a long way in reducing these negative emotions that can contribute to bad dreams.

So while bad dreams are probably pretty low on your list of reasons why you want to put an end to your chronic pain condition, the fact of the matter is that nightmares aren’t an enjoyable experience and they can compound already heightened feelings of stress and anxiety. If you work with a pain management specialist to help alleviate or reduce your chronic pain condition, there’s a good chance your bad dreams will also become less frequent. Even if you can’t fully rid yourself of pain, staying educated and working to control the modifiable factors can put you in a better head space and help reduce the affects of your chronic pain condition, including the frequency of bad dreams.

So if you’re constantly worried, anxious or depressed in part because of your chronic pain condition, let Dr. Cohn and his team find a solution for your mental and physical health.

Targeting The Brain With Therapy, Not Pills, Could Help Eliminate Chronic Pain

September 30, 2021 / Thomas Cohn, MD

Chronic pain conditions tend to be extremely complex, which is why successful treatments are often so difficult to find. Some providers know that certain medications can help to drown out some symptoms, but opioids don’t really treat the underlying issue. According to new research out of Colorado, targeting the brain with psychological therapy could be much more successful at treating the root cause of a number of chronic pain conditions.

The Psychological Side Of Pain

Chronic pain is typically caused by how the brain interprets neurons and other signals from the body, so it stands to reason that our focus should be on working to change how our brain understands the signals it’s being sent. That’s obviously easier said than done, but according to researchers at the Intermountain Neuroimaging Consortium on the CU Bolder campus, it can be done.

For the study, lead author Yoni Ashar, who conducted the study while earning his PhD in the Department of Psychology and Neuroscience at CU Boulder, and team recruited 151 men and women who had back pain for at least six months at an intensity level of at least four on a scale of zero to 10. Participants were divided into three groups, with the treatment group receiving eight one-hour sessions of Pain Reprocessing Therapy (PRT), a technique developed by Los Angeles-based pain psychologist Alan Gordon.

The goal of PRT is to educate the patient about the role their brain has in generating chronic pain, to help them reappraise their pain as they engage in movements that they’ve been afraid to perform, and to help address emotions that can exacerbate their pain. For example, if a person always has pain when they sit down, they’ll be asked to perform the action slowly, pay attention to how it really feels and to acknowledge the action of sitting as being a safe on. They are also asked to pay attention to when pain develops in other parts of their day, because it could be stress or activity induced.

Finding A Solution To Pain

Study senior author Tor Wager said that while pain may be caused by your brain, it doesn’t mean that it’s something the brain is making up.

“This isn’t suggesting that your pain is not real or that it’s ‘all in your head’,” stressed Wager, a former professor in CU Boulder’s Institute of Cognitive Science, now at Dartmouth College. “What it means is that if the causes are in the brain, the solutions may be there, too.”

According to researchers, 66 percent of patients in the treatment group were pain-free or nearly pain free at the end of treatment, compared to 20 percent of the treatment group and 10 percent of the no-treatment group. However, they also noted that this type of treatment should only be considered for pain that’s being caused by a brain misinterpretation, not pain that is rooted in an acute injury or disease with a clear pain pathway.

We’ll keep tabs on this technique, but the idea is there. If the cause is in the brain, a solution can be found there too. If you need help overcoming your chronic pain condition, reach out to Dr. Cohn and his team today.

New Study Suggests Medical Marijuana Ineffective For Most Chronic Pain Patients

September 10, 2021 / Thomas Cohn, MD

A new study published in the British Medical Journal concluded that while some chronic pain patients find helpful relief through medical marijuana, the treatment is unlikely to benefit most patients.

To get a better understanding of the effectiveness of medical marijuana for chronic pain sufferers, an international group of researchers analyzed three dozen medical cannabis studies. Overall, they found that only a small percentage of participants reported “an important improvement” in chronic pain, physical function or sleep quality when taking oral or topical cannabis treatment.

“When we look at the overall evidence for therapeutic cannabis products, the benefits are quite modest,” said lead author Jason Busse, associate director of McMaster University’s Michael G. DeGroote Centre for Medicinal Cannabis Research in Ontario. “So medical cannabis is not likely to be a panacea. It is not likely to work for the majority of individuals who live with chronic pain. We do have evidence that it does appear to provide important benefits for a minority of individuals.”

Chronic Pain and Medical Marijuana

We have talked up the potential benefits of medical marijuana for chronic pain on this blog in the past, but at the same time, we’re not entirely surprised by the findings for a number of reasons. Here’s why:

Chronic Pain Is Complex And Individualized – Chronic pain is not like a broken arm. A chronic pain condition is highly individualized to the patient, and what works for one patient may not work for others. When it comes to chronic pain, there is no one-size-fits-all answer to chronic pain. Expecting medical marijuana to treat all different forms of chronic pain would be foolish.

Medical Marijuana Is Complex – Even though medical marijuana is highly regulated, there are so many different cannabis strains, and they can each affect a user differently. It’s not like taking 400 milligrams of Ibuprofen. Chronic pain treatment effectiveness may simply be lacking because of the differences between cannabis forms and strains.

Early Stages Of Understanding – We’re still in the early stages of learning about the effectiveness of medical marijuana for chronic pain. Moreover, federal regulations oftentimes make it difficult to research medical cannabis. We’re trying to learn more and increase its effectiveness, but we’re in the early stages, and access to data isn’t always easy to come by.

Certain Side Effects – Even if medical marijuana did help with a patient’s pain, the treatment can also come with some side effects that can leave people questioning whether it is the right treatment for them. Minor or mild pain improvements may not be worth it if they find that they are dizzy, anxious or have the sensation of being “high,” which have been reported in some users. Again, more research could help limit these unwanted side effects in some patients, but the research is lacking for a number of reasons.

There are also plenty of benefits associated with medical cannabis. Aside from it’s potential to unlock chronic pain, it’s also much less likely to become addictive or physically harmful like opioids – another common chronic pain condition treatment. Simply put, we’re not ready to give up on this potential solution to chronic pain, and we hope that this study only makes it clearer that more funding and research on the potential benefits and best practices for administering medical cannabis for chronic pain is needed.