Is Ice Or Heat Best For Chronic Pain?

September 14, 2022September 14, 2022 / Thomas Cohn, MD

We use ice and heat every day to make life a little better. Whether we’re cooling down a glass of water or heating up leftovers in the microwave, we regularly use ice and heat to manipulate the temperature of certain things. We can also use ice and heat on our bodies to make it function a little better! But which is better for chronic pain, ice or heat? We explore the answer to that question in today’s blog.

Icing Or Heating Chronic Pain

We can’t sit here and say that it’s always better to ice an area or always better to heat it if you’re suffering from chronic pain. Every person’s pain is different, and what works for one person may not work for another. So to say you should always do one or the other is disingenuous.

Instead, let’s take a closer look at what each technique does, and it may help you figure out what move is best. Heat helps to open up blood vessels and improve your circulation. Healthy blood can more easily flow to muscles and structures in your body, so if your chronic pain is being caused by a frequent muscle cramps or joint stiffness, heating the area may be the right move.

On the other hand, ice helps to constrict blood vessels. This limits the flow of fluid to and from an area, which can be helpful if you’re dealing with an inflammatory response. Icing will help to calm swelling and inflammation that can make movement uncomfortable. If this inflammation is contributing to nerve compression and chronic pain symptoms, icing may be the perfect solution.

Again, find what works for you, but here are a couple of methods that tend to be helpful based on the cause of your discomfort:

Lower Back Pain – Heat tends to be better than icing, but again this is highly dependent on the root issue.

Arthritis – Arthritis tends to see some mild symptom relief with either heat or ice.

Joint Overstress – If your joints are painful from a long day of physical activity, ice may be the best way to calm inflammation.

And finally, remember that how you apply ice and heat is important. Heating pads can work great, but so too can a warm bath or a hot shower. When it comes to using ice, be careful not to apply ice directly to the skin, as this can lead to cold burns or other injuries. Don’t apply an ice pack directly to the skin, instead wrap it in a towel or cloth before putting it on the affected area. Cold baths or showers can be another way to help calm inflammation instead of an ice pack.

You also want to limit your time with each technique. Don’t heat or ice an area for more than 15-30 minutes at a time. Over-applying ice can do more damage than sitting in a warm bath for an hour, but instead of sitting with heat applied for an hour, do so for 15 minutes then get up and stretch to help muscles get used to movement and activity when they are getting ample blood flow. Be sure to pursue active treatments alongside these ice and heating techniques for maximum benefit.

To learn more about whether ice or heat is right for you, or to talk to a pain specialist about your chronic pain issue, reach out to Dr. Cohn and his team today at (952) 738-4580.

Do This, Not That For Chronic Joint Pain

May 5, 2022 / Thomas Cohn, MD

If you have chronic pain or aches in your knees, hips or wrists, you’ve probably heard a bunch of advice on what you should and shouldn’t do to help alleviate this discomfort. While much of this advice is well-intended, it may not all be in your best interest. So what should you be doing, and what should you be avoiding if you hope to overcome chronic joint pain? We share some things you should and shouldn’t be doing to treat your recurrent joint pain.

How To Overcome Chronic Joint Pain

If you’re dealing with chronic joint pain, here’s a look at some of the things you’ll want to do to help treat it, and some activities you may want to avoid.

Do Activity, Don’t Just Rest – Don’t get us wrong, rest can be great in the short term for common joint aches and pains, but after a couple of days your joints will typically be better served if you target them with controlled activity. This will help develop muscles in the area, improve stability, increase flexibility and push healthy blood to structures that need it. If you never work to strengthen an area, tissue can atrophy and become weak. Your joints work better when you’re moving, so don’t shy away from activity.

Do Consult With A Specialist, Don’t Just Rely On Google – Google is a wonderful tool, but looking for medical information online can lead you to pursue some treatments that aren’t right for your specific issue. Instead of simply leaning on your search results for answers, get an individualized diagnosis from a specialist who can view your issues in person. You’ll get set up with a personalized treatment plan that is designed for you.

Do Active Treatments, Avoid Long-Term Passive Treatments – Your joint discomfort is unlikely to resolve by simply pursuing easy passive treatments, like opioids, resting and massage therapy. Those treatments can certainly serve complimentary roles as part of a comprehensive treatment plan, but you need to pursue active treatments like exercise, physical therapy, stretching and strengthening if you want your joints to have the best chance at functional improvements.

Do Focus On Your Total Wellness, Not Just Your Physical Health – While joint pain is a physical problem, long-term physical issues can have an effect on your emotional and psychological health. Don’t ignore the other ways your health and your mind are being affected by physical pain. If you aren’t sure how your physical pain could be affecting your mood or your mental health, it’s another reason to connect with a specialist. Care for your mind and body as you try to overcome a chronic joint issue.

Do Reevaluate Your Lifestyle, Don’t Keep Doing The Same Things – If lifestyle choices contributed to your joint pain, don’t keep following those choices and assume the problem will resolve. If you have poor posture habits, you smoke, you don’t eat a great diet or you are overweight, consider how these factors could be leading to problems for your joints. Again, if the connection isn’t clear, speak with a pain specialist like Dr. Cohn. Oftentimes simple lifestyle adjustments can go a long way in helping you overcome chronic joint pain.

For help overcoming your joint issue, or for other chronic pain problems, reach out to Dr. Cohn and his team today.

The Duality Of Chronic Pain Treatment

February 3, 2022 / Thomas Cohn, MD

For a number of health conditions, the focus is mostly or solely on the physical condition. For example, if you break your arm or sprain your ankle, treatment will be focused on providing a healthy environment for these physical injuries to heal. The physical injury gets the brunt of our attention because it is typically the catalyst for our discomfort. If we address the underlying problem, everything can get back to normal sooner.

However, that’s not typically the case with chronic pain. Chronic pain can certainly have a physical trigger, but oftentimes there is also a significant mental burden as well that needs to be managed in order to successfully treat the chronic pain condition. Only focusing on the physical cause of pain or the brain’s interpretation of pain oftentimes leaves the problem only partially treated. That’s why it’s so important to have a dual approach when treating most chronic pain conditions. Below, we talk more about the physical and mental approaches to treating chronic pain.

The Physical Approach To Chronic Pain

The physical approach to treating chronic pain is typically easier for patient to comprehend. If a pinched nerve is causing pain or joint degeneration is making movement painful, we can come up with some specific treatments for these physical issues. Rest, medications, physical therapy, exercise, weight loss and stretching techniques can all serve to help alleviate physical issues causing chronic pain. These therapies can help to:

Calm inflammation
Strengthen supportive structures
Stabilize an area that regularly handles stress
Shift structures back in alignment
Improve blood circulation
Promote healthy muscular and tissue function

Treating the underlying physical cause of pain is very important, but sometimes it’s only part of the problem. Other times chronic pain is caused or exacerbated by your brain’s interpretation of pain signals. As you might imagine, changing how your brain interprets pain isn’t easy, but it can be done with the help of a pain management specialist like Dr. Cohn.

The Mental Approach To Treating Chronic Pain

Learning how to use your brain to overcome your chronic pain condition can be tough, but programs like cognitive behavioral therapy and similar techniques help patients better understand and interpret the signals they are receiving. Now, you’re not going to be able to learn how to turn off pain receptors in your brain, but you will learn how to better cope with a painful flareup or how to mentally approach your chronic pain condition so that you string together more good days than bad.

A pain management specialist or cognitive behavioral therapist can help you:

Better understand your pain triggers and your underlying condition
Coping techniques when a flareup develops (deep breathing, yoga, relaxation, etc.)
The importance of healthy lifestyle choices in controlling physical pain (exercise, diet, sleep)
Identifying sources of stress that could exacerbate pain sensations

At the end of the day, for chronic pain conditions it is very important that you connect with a specialist who can help you overcome both the physical and mental challenges brought on by chronic pain. Treating one without the other can cause symptoms to linger. Let Dr. Cohn and his team help treat the totality of your pain so that you can regain control over your chronic pain condition. For more information or for help with your condition, give his office a call today at (952) 738-4580.

Looking At The History Of Pain Awareness Month

September 2, 2020 / Thomas Cohn, MD

September is here, and that means it is officially pain awareness month here in the United States. We’ve written about pain awareness month on the blog in the past, but today we wanted to take a closer look at how this campaign came to be and why it is so important for chronic pain sufferers, their families and their physicians.

A Brief History Of Pain Awareness Month

Pain awareness month was officially established in 2001 led by efforts from the American Chronic Pain Association. The fact that chronic pain has only been officially recognized for less than 20 years speaks to how dearly a campaign like this was needed. Many chronic pain patients suffer in silence because of the stigma of chronic pain or because of how they believe they may be perceived by others. By developing the campaign, the ACPA hoped to normalize chronic pain and help prevent these feelings of loneliness that can often accompany a chronic pain diagnosis.

Two years after the declaration of pain awareness month, the ACPA held a conference during September to further their agenda. The conference featured speakers and workshops on topics like:

Pain in the workplace
Pain and the family
When kids hurt
Women in pain/Men in pain

Media was invited to attend and further spread the work that chronic pain is something that millions of people deal with on a daily basis.

A few years later, pain kits were put together and distributed at the conference and online to help those in pain better manage their conditions. Toolkits were also provided for nurse and pharmacists, two groups who work closely with individuals in chronic pain. More than 150,000 kits were distributed by the end of 2006. By 2007, the ACPA felt that pain awareness month had officially been established, so they turned their sites on state-level changes across the US.

We’ve written about pain awareness month on the blog a few times in the past because we want to do our part to help bring attention to the problem of pain. Research for chronic pain conditions is grossly underfunded, and awareness campaigns like this can help drive funds towards new treatments and a renewed ability to understand the complexity of pain. Hopefully these campaigns are successful and we can continue to bring awareness and crucial funding to treat a variety of chronic pain conditions.

So if you are battling chronic pain or a chronic pain condition, know that you are not alone and that there are resources out there for you. We know firsthand how difficult chronic pain can be to treat, but you can get control of it if you’re willing to work with a doctor who will take the time to really listen to your concerns and uncover your root causes of pain. Dr. Cohn and his team have done that for so many people already, and he can do the same for you. For more information or to set up an appointment with his team, give them a call today at (952) 738-4580.

Pain Management – Out With The New, In With The Old?

October 2, 2017 / Thomas Cohn, MD

Comprehensive chronic pain programs (CPP) have a long history, and they used to be the mainstay of treating pain. Up until the mid 1990’s, they were present across the country and there were several hundred present in the United States. With the widespread adoption of the use of opioids and the ratcheting down of medical expenses by insurance companies, many of these programs were eventually forced out of existence.

These programs cost between $5,000 and $20,000 and sometimes involved 2-4 weeks or more of inpatient care. In retrospect, considering the cost of surgeries and medications, these programs were probably a cheap investment for high quality proven outcomes. Today there are very few of these programs left – less than 100 nationwide – and we are suffering from a crisis of pain management and opioid addiction. In Minnesota, there only several left in the state.

Comprehensive Chronic Pain Programs

The typical chronic pain program is a behavioral based approach to pain with an emphasis on weaning off of all opioids. Nonaddictive medications are fine, and surgical or interventional approaches to pain are usually not a part of the program. Most of the emphasis is on changing behavior as it relates to pain. There is guided physical therapy, often aquatics, dietary advice and significant amounts of group and some individual psychological intervention toward the effects of pain on mood and activity level. The goal is to increase activity and function and show a person that their pain levels are often minimally impacted.

These programs are most successful for those whom have withdrawn from life and interactions. A typical patient in one of these programs is depressed, isolated, sedentary and not working. They often are very focused on taking medications and feel their pain prevents them from doing anything. However, to be successful in such a program, they must want to change their lifestyle.

Unfortunately, if you have chronic pain and are maintaining function in life, these programs often have little to offer. For a person who is well adjusted, with multiple outside of the home interests, working full-time, trying to exercise, doing meditation and not taking opioids, these programs have minimal things to offer that would be worthwhile. Pain management for many complex chronic pain patients is often much more difficult. Further, there are very few physicians in general who specialize in pain, and even fewer who have the interest, knowledge and experience to deal with many of these people.

Finding a chronic pain program is often not too difficult, and asking your insurance company or physician will probably get you pointed in the right direction. Finding a good pain physician that will meet your needs can be extremely challenging. A good place to start is a Physical Medicine and Rehabilitation Physician that is board certified in pain. After that, look for recommendations and then visit with the doctor to see if they can meet your needs. Finding the right physician is often difficult, and unfortunately there are no easy answers when it comes to pain management.