When Battling Chronic Pain, Finding A Balance Is Key

December 8, 2020 / Thomas Cohn, MD

balance Balance is a key component in almost every aspect of our life. There are benefits to having a healthy work-life balance, and many of us grapple with the daily decision of whether money should be earmarked for needs or wants. But finding a healthy balance also plays a key role in helping patients fight back against their chronic pain condition. Below, we take a closer look at how finding a healthy balance in certain lifestyle factors can help you better manage your chronic pain condition.

Finding Your Daily Balance To Treat Chronic Pain

Now, we’re not here to say that all chronic pain conditions can easily be cured by making certain choices each day, but there is a lot of evidence that suggests improving your balance in these aspects can help to make chronic pain more manageable. So if you are struggling with a chronic condition, reflect on some of these factors and work to identify some imbalances that could be contributing to your chronic pain or inhibiting effective treatment of your condition.

Activity/Inactivity Balance – Developing a healthy relationship with activity and exercise is very important for helping to control your pain condition. Exercise triggers the release of endorphins in your brain that act as a natural pain reliever, and it can also help you work towards a healthy weight. Being inactive, gaining weight and losing muscle mass can lead to additional stress in areas of your body that are no longer best able to handle this stress, which can lead to inflammation and pain flare ups. We don’t expect you to become an ultra marathon runner because we know how pain can make it more difficult to exercise, but strive to get regular exercise 4-5 times a week. Whether that is in the form of a run, a walk or a routine in the weight room, it can help your body better manage your pain condition.

Food Choices – It’s also important that you find a healthy relationship with your daily food choices. Again, not every decision needs to be perfect, but each day you should strive to make more positive food choices than unhealthy choices. Aside from weight gain and the added stress that can put on your body, high fat and carbohydrate-dense foods can trigger inflammatory responses inside your body, again worsening chronic pain. Food choices are one of the more controllable aspects of your daily life, so strive for more positive food choices and you may notice less chronic pain.

Stress Balance – One of the reasons why we spoke about food choices being a more controllable factor is because this next factor can oftentimes feel uncontrollable. You can’t control whether your company has pending layoffs or your car got a flat tire, but you can try to identify certain stress triggers and either work to avoid them or teach yourself new coping mechanisms to prevent them from causing such large stress spikes. Some stress can bring out the best in us, but too much stress can heighten problems like chronic pain. Work with your pain specialist to identify sources of stress and develop healthy coping mechanisms.

Mindset: Yourself Vs. Others – There is a large psychological component to chronic pain that cannot be ignored, so it’s important to find a healthy balance in how you think about yourself and others. Being completely selfless will be exhausting and can make a pain condition worse, but being selfish and choosing a short term quick fix over a harder long-term solution will also lead to problems. You have to find a way to make time for yourself while also realizing that you can’t always act in your immediate best interests. Being able to step back, evaluate the totality of a situation and making the right choice will provide you peace of mind that can go a long way in helping control chronic pain symptoms.

If you can find a healthy balance with these factors, we’re confident that you’ll have a better chance of treating and controlling your chronic pain condition. For more information, or for help with your pain issue, reach out to Dr. Cohn’s office today.

To Prescribe Or Not To Prescribe

December 2, 2020 / Thomas Cohn, MD

“To be or not to be, that is the question,” is the famous line from the play Hamlet. For many doctors, especially pain management physicians, they battle with a similar question with every patient they encounter – “To prescribe or not to prescribe.”

Medication prescription and the written and unwritten rules that govern the practice have been a hot button issue of late, especially during the pandemic. In an effort to stay up to date on the latest news regarding chronic pain care, we often find stories blasting doctors for over-prescribing or doctors who find it necessary to validate their very real and very appropriate treatment plan that involves the prescription of opioids. Patients are also caught in the mix. Heck, I’ve had a colleague killed by a former patient because they would not prescribe opioids, which only makes it harder for patients with legitimate ailments and conditions that can effectively be managed by opioids to get their hands on the medications they so desperately need.

The debate over opioids has in some ways mirrored the most recent presidential election. Any reasonable person realizes that neither party is right 100 percent of the time, but many of the loudest Republicans and loudest Democrats only seek to champion their beliefs and refuse to listen to what the other side has to offer. We’ve seen the same situation play out with opioids, as it seems like we’re either hearing about opioid hysteria and mass over-prescribing or that no doctor should ever stand in the way of a patient who wants painkillers for their pain condition. And just like with politics, the answer tends to lie somewhere in the middle.

Prescribing Or Not Prescribing

There is no one-size-fits-all answer to whether or not a physician should always or never prescribe opioids, because every individual and every pain condition is unique. Even in patients who have similar characteristics and similar pain conditions, it’s irresponsible to say that they should always or never receive opioids as part of their care plan. An assessment needs to be made on an individual basis and it needs to be made on the totality of the situation.

There are so many different factors that need to be understood before a doctor makes a determination as to whether or not painkillers would be in the patient’s best interest. There are the obvious factors like age and diagnosis, but there are also the less-than-obvious factors like whether or not underlying anxiety or a mental health condition could be exacerbated by beginning a new opioid regimen. A physician will also dive into a patient’s medical and family history to look for signs of abuse or potential abuse. It’s not that the doctor doesn’t trust the patient with opioids, it’s that we want to make sure we’ve uncovered all potential hurdles to successful treatment. Navigating known potential obstacles is so much easier than trying to blindly push forward with a care plan.

And of course, a good pain physician will listen to the patient. We want to learn about your goals, your wishes and your concerns and factor those into our decision to prescribe opioids. During our decades of practicing medicine, we’ve certainly encountered the patient that clearly has ulterior motives for wanting a quick and fast prescription. But far more often than not, patients want opioids to play a role in a comprehensive treatment plan. They want painkillers so that their physical therapy exercises can be performed a little easier, or they believe opioids will help them live a more active lifestyle and combat their pain condition in other ways.

Painkillers can absolutely play an essential role in a pain care plan, but that doesn’t mean they should absolutely be prescribed for every patient. A totality of factors need to be analyzed in order to provide the best care for the patient, which is what all physicians should strive for. Doing right by the patient means taking the time to really understand their condition, their frustrations, their goals, their concerns and their opportunities. Sometimes that involves painkillers, sometimes it doesn’t. The sooner we realize that we need to come together to help find solutions for pain patients instead of condemning chronic pain sufferers and physicians, the better we all will be for it.

How To Prevent Chronic Pain During Thanksgiving

November 23, 2020 / Thomas Cohn, MD

Thanksgiving is right around the corner, and while it will likely look a little different this year because of the coronavirus, odds are millions of Americans will be celebrating the holiday in some fashion, and that can cause a chronic pain flareup. While you may be looking forward to the holiday, Thanksgiving can be both stressful and physically demanding for your body, and that can make a chronic pain condition much worse. Below, we share some tips for avoiding chronic pain flareups over the Thanksgiving holiday.

Thanksgiving and Chronic Pain

Here are some ways in which the Thanksgiving holiday can contribute to a chronic pain flareup, and what you can do to help keep pain at bay over the holiday.

1. Destress – Stress is one of the most common chronic pain triggers, and Thanksgiving can be a stressful time. When you consider the added stress that the coronavirus brings, it’s easy to see how it could be a stressful few days. We’re not saying you should skip every single family gathering and self-isolate if you don’t have symptoms, because isolation can have its own impact on your chronic pain, but you need to make smart decisions for your health and the health of others. Avoid large get-togethers where the virus could spread, and skip an event if you’re feeling symptoms. This can help give you peace of mind that you’re putting your health first, and that can help you destress. If you are having a couple people over, plan ahead and have everyone bring a dish to pass so you’re not overstressed trying to do all the cooking and cleaning. Work to destress your life during the Thanksgiving holiday.

2. Stay Active – Regardless of whether you’re staying home or attending a small function, make sure you are still exercising and keeping your body busy over the Thanksgiving break. Overeating and sitting on the couch for a few days won’t do any favors for your pain condition. Make it a point to get regular exercise and strengthen your body even as the weather gets colder and the days get shorter.

3. Diet – No, we’re not telling you that you need to diet throughout the Thanksgiving holiday, that would just be mean. However, we do want you to be mindful of your dietary choices over Thanksgiving. Carbohydrate-dense and sugary foods can lead to inflammation development and a chronic pain flare up, so make sure you are making some healthy choices at the dinner table. We don’t expect you to be perfect, but if you make some smart choices and strive for some regular exercise, you’ll be able to help control against a chronic pain flareup.

4. Move and Stretch – Finally, to help avoid back pain or muscle stiffness, it’s important that you stand up and move around when possible. If you’re flying home or taking a long road trip, find some time to get out of your seat and stretch to help take pressure off certain areas of your body that handle stress in a seated position. Even if you’re not traveling, don’t just plop down in front of the television for the Macy’s parade and a full day of football. Move around, go for a walk and stretch every so often to help prevent muscle stagnation and a chronic pain flareup.

If you need help with your pain condition before or after the Thanksgiving holiday, reach out to Dr. Cohn and his team today.

Medical Marijuana For Short-Term Chronic Pain Relief

November 17, 2020 / Thomas Cohn, MD

Medical marijuana is a topic we’ve written about on the blog numerous times in the past, and one point we’ve always hammered home is that we want more scientifically-backed research on the subject. As more research comes out, the more we expand our knowledge of the subject and can better treat our patients.

Recently, we read about a study that looked at the short-term benefits of medical marijuana use to control chronic pain symptoms. We share the results of that study in today’s blog.

Short Term Chronic Pain Relief With Medical Cannabis

The research was originally published in Volume 20, Issue 6 of Practical Pain Management, and it explored how medical marijuana could be used to help provide pain relief in patients with certain types of chronic pain. Patients for the study were at least 25 years of age, had experienced chronic pain for at least three months, and were willing to provide accurate reports about their chronic pain levels both before and during treatment. Treatment, in this instance, was taking medical cannabis after being informed of proper administration guidelines from a physician.

The most common chronic pain conditions that affected patients in this study were back pain, osteoarthritis, fibromyalgia and chronic headaches. Patients were asked to rank their pain at the beginning of the study and then again at 1-month, 3-month and 6-month intervals. Here’s what they found:

Patients in the study found that medical cannabis treatment was associated with significant improvements in pain symptoms and quality of life within one month of initiating treatment.
These effects were sustained at the three- and six-month intervals.
The only adverse effects patients reported were dry mouth, increased appetite and the sensation of feeling “high.”

After looking at the totality of the study, researchers stated that medical marijuana, when administered under the care and supervision of a healthcare professional, can be a safe and effective option for short-term pain relief for patients with varying types of chronic pain.

At our clinic, we always say that we want patients to find a solution to chronic pain that works for them. It won’t always be easy or passive, but we want you to find a solution that works for you. If medical marijuana or other treatments like the Daith piercing can help you find relief, we’re all for it. We’re also here to provide you with care or treatment recommendations if you want to pair your current treatments with a more professional approach. We’ll happily walk you though some of the more standard options like physical therapy or other lifestyle interventions, but we can also discuss alternative options and give you some more information so you can make the best decision for your health.

For more information about different ways to treat your chronic pain, or to set up a consultation with a specialist, reach out to Dr. Cohn’s office today.

Making Chronic Pain Less Scary

October 28, 2020 / Thomas Cohn, MD

Halloween is right around the corner, and we want to stay on theme with the spooky holiday by talking about ways to make your chronic pain condition less scary. So below, read up on some tips that can help you take more control over your chronic pain and prevent you from living in fear of your condition.

Making Pain Less Scary

One of the reasons why a chronic pain condition can be so frightening is because of our lack of control over the situation. Patients don’t know if today will be a good day or a bad day, and the anxiety with not having control over your pain condition can make physical symptoms worse. Below, we share some tips for regaining control over your chronic pain condition.

1. Stay Active – A pain condition can make it easier for a person to want to lie in bed and avoid participating in daily life, but that only serves to make your condition worse in the long run. Activity and exercise help to build muscle and release endorphins that act as a natural pain reliever. Being active also helps your mental mindset, which can go a long way in helping you calm fears or anxiety over your chronic pain condition. Force yourself to do some physical activity each day, even if it’s just walking around the block.

2. Get A Diagnosis – You might be hoping that chronic pain will just go away on its own, but that’s rarely the case. Passively treating the condition by looking for information online is limited in its ability to help you, and in many cases it can actually make a person more anxious over their pain due to over-diagnosing the issue. To get peace of mind over your condition, get a confirmed and individualized diagnosis from a pain management specialist.

3. Control What You Can Control – As we mentioned above, a lot of our fears over our condition stem from our inability to control the situation. And while you can’t control everything, you need to focus your attention and efforts on the things you can control, like your exercise levels, your diet and your willingness to actively treat your condition head-on each and every day. If you can say you’ve done all you can to help keep your condition at bay, then you shouldn’t lose sleep over your condition. You’re controlling what you can control, and sometimes that’s all you can do.

4. Improve Your Diet – Eating healthier won’t cause your back pain to vanish, but it does play a crucial role in being able to work towards less daily pain. A healthy diet will give you more energy to be active or to fight through the days when you just want to lay in bed. It can also help you keep off extra weight, which can sometimes exacerbate a pain condition. You don’t need to eat perfectly every meal, but keep your health in mind when meal planning.

5. Education – The more we learn about our pain condition, the less fear it holds over us. Never be afraid to turn to your pain specialist for answers to questions or concerns you might have. The internet can also be a helpful option if you make sure you’re finding information from reputable sources, but again, your care team will be able to provide the best advice for your specific situation, so lean on them for help along the way!

For more information, or for help with your chronic pain condition, reach out to Dr. Cohn’s office today.