New Chronic Pain Care Guidelines Recommend Ditching Medication

April 8, 2021 / Thomas Cohn, MD

The National Institute for Health and Care Excellence (NICE) recently released some updated guidelines for how pain practitioners should help their patients deal with their chronic pain condition. The most notable suggestion is that NICE is advising doctors to avoid prescribing pain medication for a pain condition and instead believes they should recommend exercise or psychological therapy for the most effective treatment. For chronic pain sufferers who rely on pain medication as part of this treatment process, the news may cause anxiety and fear over whether or not they’ll have their access to these medications restricted.

We’re here to let you know that while these recommendations certainly have merit, no physician worth his salt is going to take medications away from someone who is using them responsibly and progressing in their rehab. In today’s blog, we take a closer look at the recommendations and explain how they’ll likely be implemented going forward.

Exercise Over Medication

If we just look at the headline and start to draw conclusions from there, it’s easy to get worked up over the latest recommendations. We’re here to help calm your fears and explain that although the recommendations are rooted in sound science, applying them unilaterally to a condition so unique as chronic pain is a terrible idea. Pain is unique to the individual, which is why there is no one-size-fits-all treatment for chronic pain. Even when two people are suffering from the same diagnosis, their treatment regimens may be different. That’s why we can’t just say that medications should never be used for effective pain care.

Nobody is saying that all you need to do to rid yourself of your chronic pain condition is to lace up your running shoes and go for a jog, but as we’ve talked about on the blog in the past, there is extensive research behind the idea that exercise and movement can be a key factor in helping fight back against a chronic pain condition. Exercise is an active solution that improves muscles, helps to control inflammation and works to stabilize joints that could be contributing to your pain issue. Medications, on the other hand, are a passive treatment that work to mask pain instead of treating the underlying issue. Medications alone will not cure your pain condition, but exercise and strength training or psychological therapy could.

With that said, painkillers and active treatment modalities can absolutely compliment one another, and this is when we’re all for prescribing medication to patients. If medication can make it easier for you to follow through on a physical therapy routine or to stick to your exercise program, then we’ll gladly walk you through a responsible painkiller management plan. We want to give patients all the tools they need to take control of their pain condition, and pain medications can certainly be part of that equation, so long as the patient is educated on their purpose and continues to prove that they can use the medication responsibly.

So in spite of the new recommendations, know that your pain physician will only recommend tapering off your medications if they aren’t actually promoting your recovery. If they aren’t doing any good and are putting you at a heightened risk for dependency or overdose, any good physician will adjust treatment to find a more effective method.

If you have been unable to find an effective solution for your pain, or you just want to talk to a physician who will take the time to get to know you and your diagnosis to provide the best level of care, reach out to Dr. Cohn’s office today.

Can You Fool Your Brain Into Chronic Pain Relief?

April 1, 2021 / Thomas Cohn, MD

Happy April Fool’s Day! We thought we’d try to keep on topic by talking about how you can “fool” your brain into helping you overcome your chronic pain condition. So even though we’re sharing this on a day reserved for tricks and pranks, know that this is actually a real idea with real science behind it!

Your brain helps dictate how pain is perceived in your body, but it also performs countless other tasks, so if we can take its attention off our pain, we may be able to help drown out some of those pain signals that are causing discomfort. That’s why we always preach on this blog that chronic pain is both a physical and mental task. Your brain needs to heal and help fuel recovery just like the area of your body that’s causing pain. And you can help do that by distracting it.

Now, that’s not to say that every time a flare up develops that you should just go for a run or work on a crossword puzzle to help distract your brain, but engaging your brain has been scientifically proven to help reduce pain sensations. Find outlets that really engage your mind, and odds are you may notice that you’re not noticing your pain as much. Bonus points if it’s an active activity, because exercise and movement can also help drive home physical recovery.

Setting Expectations

Your brain is also in control of setting expectations for things, including pain. If a nurse says a shot is going to hurt, all of a sudden your brain starts to anticipate this pain and it could actually lead to you being more perceptive to pain, which isn’t a good thing. Conversely, it’s why it may take a second longer to realize you’re in pain if you accidentally have the sink running too hot when you go to wash your hands. It’s still going to be painful, but the expectation wasn’t there, and that plays an interesting role in how you perceive pain.

Expectation setting is very important in how you manage your chronic pain condition. It’s why we always preach that you work towards a good head space and focus on the positives instead of the negatives. If you wake up every day expecting chronic pain to dictate your life, you may actually be more perceptive to this pain. It can be a self-defeating cycle, but if you’re aware of how your expectations affect your perception of pain, you can fool your brain into making chronic pain less of a problem.

This is easier said than done, and oftentimes it’s easier to do with a pain management specialist by your side. We can talk over your concerns, your goals and the biggest challenges chronic pain is causing in your life. Then, we’ll work on how to focus on the positives and your goals instead of the negatives and your shortcomings. This individualized assessment can help you get to a great mindset to tackle any challenges your chronic pain condition throws your way.

So if you are dealing with a chronic pain condition and you want help tackling either the mental or physical side of the problem, reach out to Dr. Cohn’s office to see what we can do for you.

Is Dehydration To Blame For Your Headaches?

March 23, 2021 / Thomas Cohn, MD

Headaches comes in a variety of forms for a number of different reasons. One such common cause of chronic headaches is due to dehydration. In today’s blog, we take a closer look at why dehydration can cause headaches to develop, and the best ways to prevent these types of headaches.

Your body operates optimally when it has the correct level of fluids in it. Your body does a pretty good job of getting rid of excess fluid through sweat and urination, but it can’t force you to consume more liquids. The thirst sensation is the best your body can do to help tell your brain that you’d benefit from hydrating. But why exactly is a dehydrated body more prone to headaches?

Why Dehydration Causes Headaches

If you are running low on fluids and electrolytes, it can cause a physical reaction in the brain. Being dehydrated can cause the brain to temporarily contract due to fluid loss. When this happens, the brain pulls away from the skull, which can trigger a pain sensation that manifests in the form of a headache. Once your body is rehydrated, the brain can return to its normal state, relieving tension and helping to control headache symptoms.

Symptoms a dehydration-based headache include but are not limited to:

Pain in the forehead region
A throbbing sensation
Lowered blood pressure
Dizziness
Confusion
Rapid heart rate
Sensitivity to light

Your body will send some passive signals to tell you to increase your fluid intake, like by creating the thirst sensation or with dark colored urine. This is a sign that all bodily functions would operate better if you increased your fluid intake.

Preventing and Treating Dehydration Headaches

If you’re suffering from headaches, one of the simplest ways to see if they respond to conservative care is to really work to increase your fluid intake and stay hydrated. Your headaches may not stem from a major neurological issue, you could just be dehydrated. This is a good thing, because it’s easily fixable. Some ways to remain hydrated throughout the day include:

Drinking More Water – Strive to drink 6-8 glasses of water a day to help stay hydrated. Better yet, invest in a large water bottle or canister that makes it clear how much water it can hold. Make it a goal to finish a certain amount of refills every day.

Eating Fiber-Rich Foods – Fiber-rich foods like fruits and vegetables, especially things like cucumbers and watermelon, have very high water content. You can stay hydrated through your food choices so reach for fiber and limit salt intake.

Avoid Caffeine and Alcohol – While on the surface it may appear that these beverages are helping to increase your fluid intake, they actually promote urine output, which can put you at risk of becoming dehydrated.

Be Mindful of Fluid Output – If you’re sweating a lot during a workout or losing fluids because you are in the bathroom frequently with a stomach bug, know that you need to replenish these fluids. Monitor your fluid loss and really work to increase your intake if you’re losing more than normal.

If you can do all these things, you just may find it a little easier to get control over your chronic headaches. However, if they don’t address the discomfort, there may be more going on than meets the eye, and you may benefit from a consultation with a pain management and headache specialist like Dr. Cohn. For more information or to set up an appointment, call his office today at (952) 738-4580.

How Is Chronic Pain Diagnosed?

March 18, 2021 / Thomas Cohn, MD

If you head to the doctor with the suspicion that you broke your arm, it’s pretty easy to test your hypothesis with an imaging test. An X-ray will tell you all you need to know about your arm, and it will pave the way for a treatment plan. However, not all medical conditions can be so easily diagnosed with the assistance of an imaging test. Others, like chronic pain, often require a variety of different diagnostic efforts to come up with an accurate conclusion. In today’s blog, we take a closer look at the different methods used to diagnose chronic pain.

Diagnosing Chronic Pain

Every chronic pain situation is different, so there is no one-size-fits-all method for diagnosing the problem. Instead, a combination of methods are used and studied in connection with one another to form a diagnosis. Here’s a look at some of those diagnostic methods:

Imaging Tests – Imaging tests may not be as effective for chronic pain as they are for broken bones, but we can still learn a lot from them. They may not be able to always tell us what’s wrong, but they can help doctors rule out potential problems. A physician can use an imaging test to rule out fractures or disc herniation, and sometimes more detailed images can help determine if an inflammatory chronic pain condition is the likely culprit.

Patient Discussion – Talking with the patient is also a very helpful form of developing a diagnosis. We’ll want to know where pain resides, what makes it worse, what makes it better and what types of symptoms you’re experiencing. Be as detailed as possible, because all of this helps a physician make a comprehensive diagnosis.

Functional Testing – Sometimes your doctor will ask you to perform a few movement exercises to see if it triggers a flare up or brings relief. Seeing your body in motion and how it responds to action can tell a physician a great deal about the muscles and soft tissues in your body. Trust that they know what they’re doing when they ask you to perform a few stretches or exercises.

Psychological Exams – As we’ve discussed on the blog in the past, oftentimes there is a significant psychological component to physical pain. Your doctor isn’t trying to determine if you’re crazy by diving into your mental health, they are trying to understand the full scope of the condition and how psychological-based interventions could provide physical pain relief. Questionnaires or neurological exams are common for complex chronic pain conditions.

Bloodwork – Testing a blood sample is another way to determine what’s going on in your body. A blood test can look for the presence of an infection, overproduction of certain blood cells or other biomarkers tat could help pinpoint what’s causing discomfort in your body.

Used together with one another, a good pain management specialist can connect the findings collected through the above techniques and come up with an accurate diagnosis for your individual condition. To see this plan put into action, reach out to Dr. Cohn’s office today.

Why The Pandemic Is Making Chronic Pain Worse For Most Patients

March 3, 2021 / Thomas Cohn, MD

There is little doubt that the pandemic has been hard on everyone. We’ve had to readjust to a new normal and find new ways to juggle our personal and professional lives. Everyone has been hit hard, but new research shows that it has been especially difficult for chronic pain patients. For many of them, their chronic pain condition has gotten worse during the pandemic.

Chronic Pain Worsening During The Pandemic

According to a new study, the majority of chronic pain patients have seen their chronic pain condition worsen throughout the course of the pandemic. For the study, researchers surveyed 502 chronic pain patients, with 88 percent of the group being females between 30 and 59 years old. More than 87 percent of patients had pain in more than one location, and the most common locations of pain were in the lower back, neck and abdomen. Participants were asked to complete online surveys about their condition and the pandemic to get an understanding of how their pain had changed since lockdowns began (This study took place in Spain, but the results likely mirror chronic pain here in the US).

According to the data, 70 percent of respondents said their chronic pain condition worsened in terms of severity, frequency of episodes or in how it interfered with their daily activities throughout the pandemic. Researchers also looked into why chronic pain frequency was on the rise during the pandemic. They surveyed respondents and came up with some of the most common stressors that could have a negative effect on a person’s chronic pain expression. Those factors include:

Job insecurity
Worries about the future
The number of people living in the same dwelling
Having someone close to them who died of COVID-19
Fear of becoming infected and its relation to their chronic pain condition

Additionally, the study found that some new pain triggers emerged from the pandemic. Prior to COVID-19, the most common new pain triggers were stress and weather changes. Now, patients cite an increase in triggers like sleep problems, negative thoughts, sadness, insufficient physical activity and fear of the contagion.

Finally, the study also shed light on how people are coping with chronic pain, and it’s not encouraging.

“The study has shown that since the state of emergency began, more than half of the patients have used rest to manage their pain, and a similar percentage have increased the consumption of medication. Both could have counterproductive effects,” explained Rubén Nieto, professor and researcher at the lab that conducted the study.

The pandemic has worsened chronic pain conditions for countless patients across the world, but it’s important that you don’t let the state of the world draw you into bad pain management habits. Now more than ever, it’s important that you get regular exercise, eat a healthy diet and pursue other active treatment methods instead of over-relying on passive techniques like rest and medication. This can be accomplished more easily with a pain physician by your side, so please don’t hesitate if you need assistance along the way. For more information or for help with your chronic pain condition, reach out to Dr. Cohn’s office today.