Could Cutting Sugar Curb Chronic Pain?

October 29, 2015 / Thomas Cohn, MD

Everyone knows that there’s a correlation between sugar intake and complications from diabetes, but excess sugar intake could also exacerbate symptoms caused by chronic pain.

For starters, there’s a known link between excess sugar and obesity, and extra weight can put added stress on your joints. If you’re dealing with chronic pain caused by inflammation, this extra stress can make movement extremely painful. But there’s more:

“While weight gain and teeth decay may be the most obvious consequences of excessive sugar consumption, there are many other ‘hidden’ effects of consuming too much of the sweet stuff,” according to Dana Dovey in a recent Medical Daily article.

Dovey said excess sugar can cause heart failure and heart disease, kidney disease, high blood pressure, erectile dysfunction and fatty liver disease. But she also details how extra sugar can make chronic pain worse.

The Brain and the Joints

Let’s start with the brain. According to a recent article published in Neuroscience, excess sugar levels can reduce a chemical called “brain-derived neurotropic factor.” When this occurs, normal cognitive tasks like learning, memory, reading and sleep all become more difficult, and we’ve already explained how inadequate sleep can make chronic pain even worse.

Chronic pain also negatively affects the joints. According to a study published in 2002, elevated levels of processed sugar can lead to excess inflammation in your joints. Inflammation is the main source of pain for most chronic pain sufferers. Arthritis is caused by chronic inflammation, which is why many arthritis sufferers are told by their doctors to limit their sugar intake.

You don’t need to quit sugar cold turkey, but be cognizant of how much sugar you’re putting in your body, and try to slowly curb it. Start with something simple, like sugary drinks. If you have a soda with lunch every day, try to cut down to one soda every other day, or swap out your sugary cereal for something healthier. Wean yourself away from sugar, and you’ll have a clearer mind and less pain in your joints.

DARPA’s Role in Solving Chronic Pain

October 26, 2015 / Thomas Cohn, MD

The Defense Advanced Research Program Agency, known as DARPA, has a new project. DARPA is the agency that first fostered the development of the driverless car and a number of robots for both civilian and military purposes. It is the research wing of the military and it works on developing new technologies that may benefit the military as well as everyone else.

The latest project is the Electrical Prescriptions (ElectRx) program. It is designed to discover the science and technology that will stimulate the peripheral nervous system to detect and fight disease. The goal is to establish a better understanding of the nervous system and how it functions in health and disease.

The government has not spent significant money on pain in the past. Now DARPA is going to push major funding into the research area of understanding the nervous system, how it is injured, and what causes chronic disease. Then they plan to research how to use science and technology to modulate the nervous system. There are going to be seven research teams working over the course of four years to move the needle to improve our understanding of what goes wrong in injury and disease and to develop new technologies in treatment.

DARPA’s Plan

According to program manager Doug Weber, DARPA hopes to create fundamental changes in how we manage diseases and injuries.

“Through the combination of a growing understanding of how the nervous system regulates many aspects of our health and advancing technology to measure and stimulate nerve signals, I believe we’re poised to make fundamental changes to the way we diagnose and treat disease,” said Weber.

To that end, seven teams of researchers have been selected to research and demonstrate a way to modulate the nerves artificially so a healthy signal flow can be maintained for self-healing.

DARPA hopes to implement therapeutic stimuli when unhealthy activity in the nervous system occurs as an alternative to traditional treatments for chronic pain, inflammatory diseases, and PTSD among many possible conditions. The influx of a significant funding and research into the understanding of the nervous system in health and injury hopefully will lead to new and better treatments of pain. This appears to be a very positive step forward for the field of pain, however it will be several years before we know the results.

Desk Workers Have High Rates of Lower Back Pain

October 20, 2015 / Thomas Cohn, MD

A three-month study that examined back problems of sedentary and active workers found that desk workers were more likely to end up in the doctor’s office with back pain.

The study examined employment data from 1,300 people who said they deal with spine-related pain. Researchers said that desk workers outnumbered field workers by a rate of 4 to 1. Additionally, one in four participants with a desk job had more than one spine-related problem, like neck and back pain, or shoulder pain and finger numbness.

“Our data shows that half the patients with sedentary jobs had lower back pain,” said Dr. Garima Anandani of Qi Spine, the clinic that conducted the survey.

Growing Epidemic

According to the World Health Organization’s Global Burden of Diseases study, which was conducted in 2010, lower back pain caused by a person’s job is a growing problem. Lower back pain was the leading cause of absenteeism from work in 2010.

“People sit on chairs for 10 to 12 hours,” said Dr. Anandani. “Moreover, they tilt their heads to cradle a phone while typing. These factors affect the biomechanics of the body.”

Dr. Anandani said the best way to combat back pain during your time at the office is to focus on your posture. Some tips to keep in mind while working your desk job include:

Stand up for five minute every 30 minutes
Keep your back straight, don’t hunch over your computer
Consider a stand up desk
Keep your head positioned over your spine, not out in front of you
Consider a headset for phone calls, so your neck isn’t torqued to the side when you’re on a call
Exercise each day when you get home from the office.

If pain persists and exercise and anti-inflammatory medications aren’t working, consider visiting a back specialist. They’ll be able to diagnose the underlying problem and help chart a course of recovery.

Mental Health and Chronic Pain

October 12, 2015August 25, 2016 / Thomas Cohn, MD

New research published in the Journal of Pain suggests that 1 in 4 teenagers diagnosed with a mental health issue also suffer from chronic pain.

We’ve discussed the correlation between changes in your brain and the onset of chronic pain on the blog before, but the recent study shines more light on the link. For their study, researchers at the University of Basel analyzed data from nearly 6,500 teens between the ages of 13 and 18. They uncovered that more than 25 percent of teens with a mental disorder also experienced chronic pain.

Other findings from the study show:

20 percent of teens suffer from a mental disorder, and 25 percent of them have chronic pain.

Mental disorders developed prior to the onset of chronic pain.

All types of chronic pain were associated with mental disorders.

“All types of pain were related to mental disorders,” researchers wrote. “The most substantial temporal associations were those with onset of mental disorders preceding onset of chronic pain, including those between affective disorders and headaches and any chronic pain; between anxiety disorders and chronic back/neck pain, headaches, and any chronic pain; between behavior disorders and headaches and any chronic pain; and between any mental disorder and chronic back/neck pain, headaches, and any chronic pain.”

Breaking It All Down

Researchers say the results indicate that anxiety and behavioral disorders may indicate that a teen is at a heightened risk for chronic headaches or back and neck pain. It also means that some forms of chronic pain may be preventable if we increase treatment options for mental health issues.

“Future studies should focus on identifying the underlying biological and psychological mechanisms with a view to developing interdisciplinary approaches to prevention and treatment,” said lead researcher Dr. Marion Tegethoff.

I too would be interested in further studies on the subject, but I know that exercise has been proven to be beneficial for both people suffering from depression and for those with chronic pain. So while we wait for more information on how we can combat chronic pain through mental health services, go for a 30-minute jog or go for a long walk with a friend!

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.