Combat Chronic Pain By Improving Your “Zest” For Life

February 10, 2021 / Thomas Cohn, MD

zest A new study focusing on the psychology of chronic pain recently revealed that intentionally training certain character strengths could possibly help patients reduce or overcome their chronic pain condition.

The desire to learn more about this possible connection was driven by the idea that chronic pain can suck the joy and satisfaction out of many of life’s pursuits. Researchers posited that if chronic pain can influence our quality of life and some of our daily character traits, the reverse may also be true, in that focusing on developing character traits that define us could in fact help a person gain more control over their chronic pain.

While that may sound a bit far fetched, when you break it down with some examples, the theory seems to hold some water. For example, someone who heavily relies on humor or a very honest person may be better able to deal with the totality of their chronic pain condition than someone without those personality traits because of the psychology that drives these character traits.

Which Character Traits Help With Chronic Pain Control?

To get a better understanding of which character traits may have more influence on a person’s ability to control their chronic pain condition, researchers asked 491 chronic pain patients to complete a survey about their pain severity, how it impacts their physical function and their self-efficacy (their ability to engage in normal daily activities despite pain). Additionally, patients were asked to complete a self-assessment of their character strengths, which included 24 different character strengths as defined by a previous study. Those 24 different character strengths were:

Creativity
Curiosity
Judgment
Love of learning
Perspective
Bravery
Perseverance
Honest
Zest
Love
Kindness
Social Intelligence
Teamwork
Fairness
Leadership
Forgiveness
Humility
Prudence
Self-regulation
Appreciation
Gratitude
Hope
Humor
Spirituality

Interestingly, some character traits were associated with greater pain self-efficacy in the face of higher pain severity and functional loss than others. The three best traits for chronic pain self-efficacy were:

Zest
Perseverance
Hope

While the three lowest were:

Appreciation
Creativity
Leadership

So, on that note, researchers pondered if working to improve one’s “zest” could in turn help them better manage their chronic pain condition. Zest, as the researchers write, “is characterized by a sense of vitality and ‘aliveness’ in their own individual lives, as well as having the ability to invigorate and energize the people around them.”

During a two-week intervention, 81 participants were asked to either work on cultivating their zest for life or another neutral condition and given instructions on how they could improve these characteristics. Both groups had similar pain levels at the beginning of the two weeks, and both groups reported less pain and functional improvement by the end of the study. However, only the patients in the zest group reported an increase in pain self-efficacy.

While the research is small and limited, it certainly is interesting. If you’re working to combat a chronic pain condition, follow the traditional methods but also work on improving your zest for life. It’s easier said than done, but by trying to become more enthusiastic for life and using your energy to the fullest degree, you may notice an improvement in your self-efficacy as it relates to your pain condition!

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

Exercise Your Way To A Better Memory

January 3, 2020 / Thomas Cohn, MD

If you’re trying to exercise more in the new year, you may need to remind yourself to make time to exercise in the first few weeks before it becomes a habit, but according to new research, exercise may also help you remember daily tasks later in life.

According to research out of Norway, experts say that exercise and being physically fit may help sharpen our memory and reduce our dementia risk, even if we don’t really start exercising until later in life. There have been numerous studies on the link between being physically fit and staving off dementia risk, but no study has tackled the topic of when the participant begins their exercise regimen. For this study, researchers focused on whether getting physically fit at midlife or retirement age was too late to see any improvements.

Researchers used medical records of more than 30,000 individuals and tracked how their health changed over a 10-year period. They grouped individuals into three separate groups:

Those who remained in the lowest 20 percent of aerobic fitness for the entire study.
Those who moved into or out of that bottom 20 percent at any point during the 10-year period.
Those who remained outside of the bottom 20 percent for the entire 10-year period.

Memory and Exercise Results

After analyzing medical records, nursing home data and specialized memory clinics to determine which participants developed dementia during a 20-year follow up, researchers came to some interesting conclusions. They found that people who were fit throughout the entire study were almost 50 percent less likely to develop dementia than the least-fit men and women. Possibly more of note, those men and women who entered middle age out of shape but gained fitness showed a similar substantial reduction in their subsequent risk for dementia.

Researchers said that the study didn’t examine which types of exercise were being performed by those who gained fitness, so it appears that any physical exercise that helps to remain fit could be beneficial for your memory, even later in life. Another study on the topic found that individuals saw similar gains when they participated in exercise that raised their heart rate and boosted fitness, so while walking may be an okay form of exercise, walking with some interval training may provide more benefits.

“I tell people to add in some hills when they go for a walk,” said Jennifer Heisz, an associate professor at McMaster University who oversaw the second study, “or pick up the pace between streetlamps.”

So if you want to increase your chance of having a strong memory later in life, find some daily exercises that boost your physical fitness! And for help with any aspect of fitness or your health, don’t hesitate to reach out to Dr. Cohn’s office today.

Should You Eat Before Or After Exercise?

December 23, 2019 / Thomas Cohn, MD

Should you fuel up before hitting the gym, or is it best to burn calories on an empty stomach? That’s the question researchers at the University of Bath in England sought to answer with their latest study.

For their research, the team decided to look at the fat burning capabilities of exercise based on when the participant last ate. They were wondering if when a person ate influenced how much muscle fat was burned during activity, because muscle fat can be a key contributor to the eventual onset of insulin resistance and diabetes. For their study, the team divided 30 overweight men into three groups.

A control group that lived their normal lives.
A group that consumed a vanilla-flavored shake two hours before cycling exercise.
A group that consumed a placebo shake two hours before cycling exercise.

Participants wore monitors and masks that tracked a number of different factors, including their heart rate and the amount of fat and sugar they burned. After exercise, the participants drank the shake they had not yet consumed (placebo for the vanilla shake group, and a vanilla shake for those who consumed a placebo before exercise).

The study lasted for six weeks, and researchers drew some interesting conclusions after looking at the data. As expected, the control group’s insulin sensitivity remained unchanged, while the men in both exercise groups improved their fitness and narrowed their waistlines, although few actually lost weight. Notably, participants who pedaled on an empty stomach burned about twice as much fat during each ride as the men who consumed their shake prior to exercise. All riders burned about the same number of calories while pedaling, but more of those calories came from fat when the men did not eat first. Riders that consumed the shake afterwards also had greater improvements in insulin sensitivity and had developed higher levels of certain proteins in their muscles that influence how well muscle cells respond to insulin and use blood sugar than the other groups.

“You can probably get more out of your workout without increasing its intensity or duration by exercising before breakfast,” said Javier Gonzalez, a professor of physiology and nutrition at the University of Bath, who oversaw the study.

So if you’re wondering when the best time to exercise is, it might be first thing in the morning after you wake up. That being said, any exercise is better than no exercise, so just get it in when it works for you!

How To Improve Your Sleep Quality

September 30, 2019 / Thomas Cohn, MD

sleep Everyone wants to sleep better. Problems with sleep are now pervasive in today’s society, and there are many culprits. Medical sleep experts are taking a deeper dive into the dynamics of sleep and are now starting to have a more comprehensive approach to issues. In the past, sleep problems were overly simple and only a few problems were considered. Sleep apnea was the main concern, then restless legs became another area. At sometime it became a matter of taking the correct sleep medication; the right pill was the answer, but we’re learning more about better techniques.

Poor sleep leads to multiple problems. The simple one is fatigue with difficulty functioning at an appropriate level. Compounding being tired is mood changes from anxiety to depression and even more severe psychiatric disorders. Sleep deprivation also leads to a large number of health problems including weight gain, hypertension, heart disease and possibly late neurological problems like dementia.

The New Science in Sleep

The new science in sleep is now paying closer attention to whether the person is trying to follow their normal circadian rhythm. Most people have normal sleep times and baseline cycles. Some people are morning people, while others like to stay up late and sleep in during the morning. These are natural cycles one is often born into, and trying to work against the natural tendencies often leads to additional sleep difficulties. Working within your natural cycle for sleep can diminish ongoing sleep problems. If you are a night owl, trying to be awake at the crack of dawn is likely just to cause problems.

Recognizing your own natural tendencies towards sleep can reduce anxiety and improve the quality. I am not a night owl at all, therefore when I chose a specialty in medicine I knew I wanted to be able to sleep at night. I knew I could not function well in the middle of the night so I needed a specialty where I could usually sleep at night. Throughout college I only pulled one all night routine. I almost always went to sleep before midnight and then awoke early to do whatever had to be done. My spouse is just the opposite and is up to all hours of the night routinely and hates mornings, and hates the cheerful me as I start exercising at the crack of dawn.

During the daytime our brains are processing new information and making new connections. At night the brain is doing its housekeeping, removing toxins and cementing into place the information acquired during the day. Nighttime also is the time the brain works on processing emotional connections. Time spent asleep is when the brain does all the background work to maintain health and is not interrupted by functions that are needed when alert and awake.

For healthy sleep and general ability to stay awake during the day, maintaining a regular circadian cycle is necessary. There are multiple things that one can do to improve your sleep. The first thing is to consider using a 10,000-lux light box in the morning to mimic sunlight for 30 minutes. This will help stimulate the brain to wake up and be less tired. At night, go to bed when you are tired. Do not lie around in bed waiting to fall asleep. Bedtime preparation is important. Stop working 1-2 hours before bed and avoid thinking about provocative topics prior to sleep. As part of the wind down, do something calming like reading or listening to music. Avoid looking at screens and social media. Lastly, avoid caffeine and stimulants late in the day as well as alcohol within two hours of sleep. Alcohol after the first hour of a sedative effect tends to make the brain alert after it is metabolized.

Having good sleep habits as well as working with your natural circadian rhythm improves the ability to successfully sleep and feel rested. It improves brain function and overall health in many ways. When sleep is a problem and the simple issues are addressed, then working with a medical sleep specialist is important to identify and address the causes of poor sleep.

How Regular Exercise Keeps Your Body Young

December 27, 2018 / Thomas Cohn, MD

New research published in the Journal of Applied Physiology revealed that regular exercise can have your muscles acting as if you are decades younger than your actual age.

According to researchers, older men and women who exercised regularly for decades had muscles that were indistinguishable in many ways from the muscles of healthy 25-year-olds. These older men and women also had much higher aerobic capacities than most individuals their age, making them biologically about 30 years younger than their chronological age, the study’s authors conclude.

Previous studies have found that older athletes have healthier muscles, brains and immune systems than individuals of the same age who are sedentary. However, those studies have concentrated on competitive athletes, not recreational exercisers. This study suggests that you don’t need to be a professional athlete to see many of the same benefits of regular exercise.

Exercise Study

For the study, researchers looked at the health of individuals who took up regular exercise during the fitness boom of the 1970’s. They were most interested in individuals who maintained that hobby through the next 40-50 years, with activities like running, cycling, jogging or swimming, even if they never competed in these activities.

28 men and women fit the bill, and they were compared to a second group of age-matched older individuals who had not exercised during adulthood, as well as compared to a third group of active young people in their 20s.

Each group was tested in a lab setting to measure their aerobic capacities, and tissue samples were also taken to look for the number of capillaries and levels of enzymes in muscles. The higher the numbers, the better the muscle health.

After looking at the findings, researchers were surprised to find that the muscles of the older exercisers resembled the muscles of the young group, and their aerobic capacities were about 40 percent higher than inactive individuals their age. They also concluded that the active older group had cardiovascular health similar to that of people about 30 years younger.

These findings are amazing, and they help us understand why regular exercise is so important. Exercise can literally roll back the clock and slow down the aging process, which can help prevent problems like pain or degeneration-related issues. So take care of your health while you’re young, and continue exercising as you get older. If you do this regularly, you can prove that age really is nothing more than a number, and we are in control of our health!