1 in 4 Chronic Pain Patients Treating Their Condition With Medications Only

November 22, 2023 / Thomas Cohn, MD

New data from the National Institutes of Health found that more than 1 in 4 patients with a chronic pain condition were pursuing pharmacologic treatments as their only form of care. As we’ve said on this blog time and time again, chronic pain is a complex issue that needs to be treated with a combination of active and passive treatments.

Pharmacologic treatments are considered a passive treatment and involve things like over-the-counter medications, prescription nonopioids and opioids. Non-pharmacologic treatments tend to be more active in nature, like exercise, physical therapy and cognitive behavioral therapy. Dr. Cohn and his team follow the current recommendations of the Centers for Disease Control and Prevention, which suggest that chronic pain treatment oftentimes works best with a mix of nonpharacologic and pharmacologic therapies.

However, a recent NIH survey found that a fair amount of chronic pain patients are pursuing passive care as their only treatment option for their chronic pain condition. A survey of 7,422 patients with chronic pain uncovered that 26.6 percent of adults said pharmacologic therapy was their only form of chronic pain treatment.

Chronic Pain Treatment Findings

Additional findings from the survey include:

60.2 percent of adults were pursuing both pharmacologic and nonpharmacologic therapies for their pain condition.

The most common pharmacologic treatments used were over-the-counter pain relievers (75.5%), prescription nonopioids (31.1%) and prescription opioids (13.5%).

The most common nonpharmacologic therapies used were exercise (55%), complementary therapies (36.7%), physical or occupation therapy (17.2%) and cognitive behavioral therapy (2.2%).

Older adults with more severe pain and those on public insurance were more likely to treat their pain with prescription opioids

The most concerning finding from the survey was that more than 1 in 4 patients are taking medications as their only form of chronic pain management. These medications treat the symptoms, and while they can calm inflammation or make movement more comfortable, they won’t serve to address the underlying issue that is causing inflammation or similar joint issues. You absolutely need to pair passive techniques like rest and medications with active techniques like exercise and physical therapy. These active treatments help you become stronger so that you can better handle stress, and they also work to stabilize structures that could be suffering from instability or mobility issues. Medications won’t solve your root problem, and while they can be a great compliment to a comprehensive treatment program, they are never a good stand alone option!

To connect with a provider who can develop a treatment plan suited to your specific needs, or to help create a treatment plan that incorporates the right balance of active and passive treatments, reach out to Dr. Cohn and his team today at (952) 738-4580.

How To Tackle The Physical, Mental And Emotional Sides Of Chronic Pain

November 17, 2023 / Thomas Cohn, MD

The physical pain of a chronic pain condition gets most of the attention, but a pain issue affects you in more than just a physical manner. There is also a significant mental and emotional side of chronic pain, and if you aren’t careful in how you treat the problem, you may find that the issue never fully resolves. In today’s blog, we take a look at some ways to tackle these three sides of a chronic pain problem.

Managing The Physical Side Of Chronic Pain

Let’s start by looking at the physical ways you can fight back against your chronic pain condition. These are some of the most common treatments that will be recommended from your pain management specialist. Odds are they suggest a combination of some of the following techniques:

Daily exercise
Controlled stretching
Physical therapy
Posture improvements
Weight loss

All of these techniques serve to make you physically stronger or make it easier for your body to handle the stress that you are putting on it. Because chronic pain is oftentimes tied to a stability issue or problematic inflammation, working to improving your body’s functional performance through physical activity and exertion and be extremely beneficial.

Managing The Mental Side Of Chronic Pain

A chronic pain condition can also put a significant burden on your mental health, so it’s important that you don’t ignore your mental health while you’re pursuing some of the physical treatments listed above. Chronic pain can leave you feeling worried and anxious, so you’ll want to make sure that you are stimulating your brain and working to appropriately frame your chronic pain condition in your mind. For example, don’t just lay in bed all day and hope that pain goes away. Find ways to stimulate your brain and take your mind off chronic pain. Pursuing mentally stimulating activities can lead to the production of hormones that can help drown out pain signals.

It’s also important that you have the right mindset when it comes to your chronic pain condition. It can be easy to catastrophize your pain condition or always view things with a “glass half empty” perspective. You can’t always control your pain, but there are certain aspects you can control, and if you put your time and effort into the aspects of your condition that you can control (like diet, exercise, mental stimulation), you can take solace in knowing you are doing what you need to do to fight back against chronic pain. Try not to focus on the uncontrollable and reframe how you approach your care, and you’ll find that you have more peace over your condition, which can actually help you overcome your pain!

Managing The Emotional Side Of Chronic Pain

Finally, chronic pain can also be very emotionally draining. If you’ve had your pain condition for a while, odds are you’ve had to cancel plans to stop pursuing certain activities you love because of your pain, and that can really wear on a person’s emotions. Similar to the above point on how you need to pursue activities that are mentally stimulating and rewarding, you need to also throw yourself into activities that are emotionally rewarding. Have a friend over for dinner, go for a walk with your sister, call your friend who moved across the country, etc.

You can also find emotionally rewarding activities that don’t depend on other people. Force yourself to go see that new movie, volunteer to walk a dog at the adoption shelter every Friday, or simply curl up with a new book. Chronic pain can be isolating and emotionally draining, so you also want to make sure that you are finding ways to add a little joy to your life. When you’re happier and emotionally balanced, it will be much easier to manage the ups and downs of a pain condition.

If you need help with any of these aspects, or your want to create an individualized care plan for your pain issue, reach out to Dr. Cohn and his team today at (952) 738-4580.

Vitamin Treatment May Be The Key To Unlocking Chronic Pain

November 9, 2023 / Thomas Cohn, MD

A type of Vitamin B3, called nicotinamide riboside, could hold the key to unlocking the problem of chronic pain in millions of Americans.

The vitamin works by targeting inflammation, which is oftentimes the source of pain in patients with chronic pain. Inflammation is your body’s natural response to injury, but in many patients with chronic pain, inflammation develops too easily or fails to resolve in an adequate manner, leading to frequent bouts of chronic pain. Inflammation onset and its ability to resolve is believed to be tied to mitochondria function. Your mitochondria help to power your cells and ensure the cell has the ability to perform a number of essential functions, like tissue repair and inflammation control.

To see if they could improve mitochondria function and in turn inflammation control, researchers triggered an inflammatory response in the hind paws of 15 mice. They then measured the amount of oxygen consumed by mitochondria in the sensory neurons of the mice, which is a helpful indicator of mitochondria function. A week after inflammation had resolved, researchers noticed that these mitochondria were consuming significantly more oxygen, suggesting that inflammation was inhibiting their normal function.

When comparing metabolites between mice in the test group and mice who had not experienced an inflammatory reaction in their hind paws, they found that mice in the test group had lower than expected levels of nicotinamide riboside in the mitochondria of their sensory neurons. Nicotinamide riboside helps mitochondria function properly.

Vitamin B3 And Chronic Pain

With all that new information, researchers conducted another test. This time, researchers gave half the mice a high dose of nicotinamide riboside. Next, they assessed the animals’ sensitivity to pain by measuring how quickly they moved their paws away from a heat source. They found that mice who did not receive the dose of vitamin B3 pulled their foot away from the heat source twice as quickly as those who had received the dosage, suggesting that nicotinamide riboside can help combat pain sensitivity, a common denominator in patients with chronic pain.

Researchers concluded by saying that they believe that nicotinamide riboside can help to calm pain sensitivity and restore crucial mitochondria function in mice dealing with an inflammatory response. Should these results translate to humans, it could be a major breakthrough in how inflammation-driven chronic pain is treated.

But before you rush out to grab some vitamin B3 supplements, know that this was early stage research conducted on mice, and we’re a long way away from proving its viability in humans. Still, it’s research like this that gives us hope that we may soon be able to find new and effective ways to treat the complex problem of chronic pain. In the meantime, if you’d like to work with a pain management specialist who will pursue some more clinically-proven techniques for treating your chronic pain issue, reach out to Dr. Cohn and his team today at (952) 738-4580.

Preventing Common Causes Of Fibromyalgia Flareups

October 19, 2023 / Thomas Cohn, MD

Anyone who suffers from fibromyalgia knows just how disruptive a flareup can be. One minute you’re enjoying your day, the next you’re dealing with pain and fatigue. And while fibromyalgia can be a tricky condition to completely cure, you can significantly reduce the number of flareups you experience if you are aware of some of the most common fibromyalgia triggers.

Below, we take a look at some of the ways you can prevent fibromylagia flareups by addressing some of the most common triggers.

Common Fibromylagia Triggers And Prevention Tips

Here’s a look at some of the most common fibromylagia triggers, and some advice for keeping these triggers at bay.

Sleep Deprivation – Failing to get adequate healthy sleep can seriously increase your risk of a fibromyalgia flareup. Poor sleep has been clinically proven to increase our sensitivity to pain, make a person more susceptible to a flareup. Obviously the issue can be cyclical in nature, with poor sleep leading to fibro flareups, and flareups making it hard to attain restful sleep. Our best advice is to make your bedroom a dark and quiet environment free from light and technological distractions, and strive to go to bed and wake up around the same time in order to make it easier for your body to develop a healthy circadian rhythm.

Routine Irregularity – If your daily routine is regularly upended, it’s easier to become stressed, and stress is a major trigger for fibromyalgia. We’re not saying that you need to do the exact same things every single day to avoid stress triggers, but try to create a healthy sleep and meal schedule. Wake up, eat your meals and go to bed around the same time each day to help your body get in a healthy routine.

Poor Dietary Choices – Unhealthy food choices are oftentimes pro-inflammatory, and inflammation onset can trigger a fibromyalgia flareup. Try to get the bulk of your calories from fruits, vegetables, lean proteins and whole grains. Limit the fatty and sugary foods, as they can lead to reactions inside your body that cause a fibromyalgia flareup.

Stress – Stress is likely the most common cause of a fibromyalgia flareup, and that makes sense because we all experience stress each and every day. We deal with work pressure, social stressors and family drama, and all of that stress and anxiety can lead to muscle tension and a fibromyalgia flareup. Work to eliminate sources of stress from your life, and find healthy outlets to manage it when it manifests. Many people find that exercise, yoga, meditation or reading can help them find some inner balance and reduce feelings of stress.

Illness – People with fibromyalgia tend to have it worse when they get sick, because sickness triggers an inflammatory response within the body, and this inflammation can contribute to a fibromyalgia attack. There’s no way to completely avoid getting sick, but make it a point to develop some healthy habits. Eat a nutritious diet, wash your hands regularly and get your flu shot every year!

If you’re finding it difficult to mange your fibromyalgia flareups, don’t be afraid to lean on a professional for assistance. Dr. Cohn has helped countless patients reduce or eliminate their fibromyalgia flareups by giving them the individualized attention they need to cultivate a treatment program tailored to their individual needs. For more information, or to enlist his help, give his office a call today at (952) 738-4580.

Chronic Pain The Main Reason For Medical Marijuana In Minnesota

October 12, 2023 / Thomas Cohn, MD

Recreational marijuana became legal in Minnesota on August 1, but many patients with chronic pain were legally seeking out marijuana well before this year. That’s because Minnesota is one of many states that allows for the production, purchase and use of medicinal marijuana.

Medicinal marijuana has been recommended as a way to relieve symptoms in patients with a variety of conditions. From easing the symptoms of terminal cancer to providing relief for much less serious issues, medicinal marijuana is currently being pursued by tens of thousands of Minnesotans for their health condition. Recently, we learned that the most common reason why a person sought out medicinal marijuana in Minnesota was due to chronic pain.

“By far, chronic pain is what drives our program,” said David Rak, research manager for the Minnesota Department of Health’s Office of Medical Cannabis.

Medicinal Marijuana For Chronic Pain

According to Rak, nearly 60 percent of patients in Minnesota’s medicinal marijuana program cite chronic pain as their reason for enrollment. Currently, 24,270 of the program’s 41,183 participants are seeking treatment for chronic pain.

Researchers are still working to understand exactly why medical marijuana can help relieve symptoms in patients with chronic pain. However, because chronic pain is so unique to the individual, and because there are so many different types of marijuana, it’s not easy to pinpoint why some patients experience relief why others do not. Some researchers believe medicinal marijuana works by triggering the release of certain natural chemicals in the brain that can provide pain relief, while others suggest that medicinal marijuana can help to reduce inflammation and associated discomfort.

Others swear by the benefits of medicinal marijuana for another reason. As we’ve talked about on the blog in the past, healthy sleep is critical for working to overcome a pain condition, and many patients find that medicinal marijuana helps them fall asleep faster and achieve a more restful sleep.

“Sleep is really an important factor, actually,” said Rak. “If you’re sleeping better and you wake up rested, you’re more ready to start the day. You feel stronger.”

Others love that it has helped them transition away from potentially dangerous opioids. A study by the Department of Health found that 38 percent of patients with intractable pain who had been using marijuana for five months were able to reduce the amount of opioids they were taking as a result of their marijuana use. That same study also found that 42 percent reported a significant reduction in pain intensity after using medicinal marijuana.

So if you have chronic pain, should you consider enrolling in the state’s medical marijuana program, or should you just buy recreational weed and see if it offers the same benefits? For starters, you’ll want to talk with your pain management specialist before beginning either regimen. Odds are they will have some recommendations and additional treatments they’ll propose in conjunction with the medical marijuana program, like exercise or physical therapy.

If you do decide to move forward with marijuana, it’s probably best to go through the state’s medicinal marijuana program. Being enrolled allows your doctor to work with a dispensary pharmacist and decide on a type that will work well for your symptoms and not interfere with any other medications you’re taking. Medicinal marijuana products are also highly regulated and tested to ensure they have a specific amount of THC and CBD, something you may not get if you buy elsewhere. The program used to carry a $200 enrollment fee, but now it is free, although you’ll have to have your chronic pain condition certified by a professional like Dr. Cohn.

For more information about whether or not chronic pain could be a viable complimentary treatment for your chronic pain condition, reach out to Dr. Cohn and his team today at (952) 738-4580.