Five Things Untreated Chronic Pain Can Do To A Person

September 2, 2022 / Thomas Cohn, MD

Chronic pain certainly isn’t fun to live with, but some people think that if they can grit their teeth and bear it, that’s the worst they’ll have to deal with. Unfortunately, chronic pain can impact us in other ways that aren’t so obvious, and it can lead to a number of other problems if the pain condition isn’t carefully treated. In today’s blog, we explore some of the ways that untreated chronic pain can affect a person.

How Untreated Chronic Pain Can Affect A Person

There are countless ways that untreated chronic pain can affect a person, but here’s a look at five major issues that can develop if you don’t confront your condition head on:

1. Depression – Chronic pain and depression have been closely linked. Pain can have a significant impact on the brain, and if it goes on long enough, it can actually lead to depression and depressive symptoms. It can also be hard to recognize depression when you’re simultaneously dealing with an unresolved pain condition. These two conditions can be cyclical in nature, and it can be hard to break free from the cycle.

2. Anxiety – Untreated chronic pain can also leave you feeling more anxious. If you’re constantly worried about whether you’ll have a flareup or if chronic pain is going to force you to cancel plans, you can begin to develop anxiety. Eventually, even though anxiety is rooted in your chronic pain condition, it can spill over into all aspects of your life and compound the problem. Fortunately, targeting the chronic pain condition oftentimes helps to resolve these feelings of anxiousness.

3. Heightened Pain Perception – Some people think that ignoring chronic pain sensations can help them build a greater pain tolerance, but oftentimes you’re actually training your brain to do the opposite. If your brain is constantly interpreting pain signals, and you’re not doing anything to help calm these signals, your brain can become hyper-aware of these nerve sensations and either become oversensitive to pain signals or start misinterpreting nerve relays as pain signals. You may actually become more sensitive to pain signals by trying to ignore them.

4. Stress – You may also find yourself more easily stressed when living with untreated chronic pain. Every activity becomes more stressful when you’re attempting to do it while in pain. Work becomes more stressful. Family life becomes more stressful. Even activities that are supposed to be enjoyable become more stressful when pain is present.

5. Irritable – Finally, you may not notice it, but your friends and family members may have noticed that you seem to have become more irritable as a result of your untreated chronic pain condition. Again, pain can have a severe impact on our mental health, and we may not even realize it’s happening. If you notice that you’re becoming quicker to anger or you’re more irritable, know that it’s not just because you’re getting older, it’s because you’re dealing with untreated chronic pain.

The good news is that by treating chronic pain, you can work to address all of the issues listed above. If you want to take the first step in overcoming your chronic pain condition and any side effects it’s causing, reach out to Dr. Cohn and his team today at (952) 738-4580.

Don’t Feel Guilty About Your Chronic Pain Condition

August 23, 2022 / Thomas Cohn, MD

guilty Roughly 1 in 5 people deal with chronic pain on a regular basis, and a significant amount of them feel guilty about their diagnosis. There is absolutely no reason you should feel guilty about your chronic pain condition, but the fact of the matter is that we talk about overcoming the stigma or guilt associated with a chronic pain condition with patients all the time.

So many people feel guilty about fighting a daily battle with chronic pain, but why do they feel this way, and what can we do to overcome these feelings? We try to answer those questions in today’s blog.

Why Do We Feel Guilty About Chronic Pain?

A recent study published in the British Journal of Health Psychology decided to take a closer look at the subject of guilt among chronic pain patients. You can take a closer look at the full study here, but we’ll jump to some of the takeaways. First, the team identified three main reasons why chronic pain patients felt guilty about their battle with chronic pain. They are:

1. Others assume that a patient’s pain condition is not legitimate – Oftentimes even after an official diagnosis, patients in the study faced questions about the legitimacy of their condition.

2. Others assuming that the patient is not managing their condition well – Some people felt like they were letting their doctor or their family down if they were not making progress in treatment.

3. Assumptions regarding how one’s actions affect others in terms of the person’s inability work or fulfill social roles – In other words, patients felt like others may view them as less of a co-worker or parent because their pain can sometimes affect their ability to perform certain duties within these roles.

When you look at those three reasons, we spot an interesting trend. Chronic pain patients are feeling guilty about how they come off to other people, like their friends, family, caregivers and doctors. How they feel they are being perceived by others is what’s driving these feelings, and that’s unfair.

So what can we do about feeling guilty about chronic pain? While it’s easier said than done, stop focusing on what other people think. The best way to do that is to focus on yourself. If you know that you are doing every thing you can to treat your chronic pain condition, than the opinions of others should feel less important. You know that you are trying your best, so those comments and suggestions shouldn’t get under your skin. And if they do, you can simply let them know everything that you are trying to get the condition under control.

Again, we know that it’s easier said than done to say “Don’t let what other people think bother you,” but if you’re truly giving it your best effort, it should be easier to shake off any feelings of guilt because you know that you’re doing all you can. You can only control your actions, so if you’re doing what you can, the thoughts and opinions of others shouldn’t hold much water. Trust yourself, commit to your rehab, and know that you should be feeling pride about your work ethic, not shame over other people’s misconceptions.

As always, if you have questions or concerns about managing your chronic pain condition, reach out to Dr. Cohn. He’ll treat you with respect and explain how to manage some of the psychological effects of chronic pain. For more information, give our team a call today at (952) 738-4580.

Music Can Help Ease Chronic Pain, So Long As We Can Pick The Song

August 17, 2022 / Thomas Cohn, MD

As we’ve talked about on the blog in the past, previous studies have found that the arts can help certain patients better manage their chronic pain condition. Recently, a group of researchers took things one step further when the tested how music could impact someone’s perception of pain. They found that music can help to drown out pain signals, especially when the listener believed they had control over what song they were listening to.

Music And Pain Management

To improve our understanding of how pain levels can being affected by music, researchers asked 286 adults experiencing real-world chronic pain to rate their pain both before and after listening to a music track. The music was specially designed in two different versions with varying complexities, and participants were randomly assigned to hear either the low- or high-complexity versions. Some participants were also randomly selected to be given the impression that they had control over the music qualities in the song, although the same version was played regardless of their selection.

After tracking reported pain levels before and after listening to the musical track, researchers found that participants who felt that they had control over the music experienced greater relief in the intensity of their pain compared to participants who were not given such an impression. Moreover, participants who stated that they actively engage with music in their everyday life experienced even greater pain-relief benefits from having a perceived sense of control over the song they heard. No connection between music complexity and pain relief was found.

The findings suggest that the ability to control what we listen to – or at least the appearance of such control – is important for optimizing music’s pain-reveling potential.

“Now we know that the act of choosing music is an important part of the wellbeing benefits that we see from music listening,” the study authors concluded. “It’s likely that people listen more closely, or more carefully when they choose the music themselves.”

So while it’s unlikely that your pain specialist will prescribe a healthy dose of time with your iPod at your next appointment, there does seem to be some merit to helping to drown out pain sensations by connecting with music of your choice. Consider pairing other active pain management treatments like physical therapy or exercise with some of your favorite songs, and you may notice an even bigger reduction in your pain perception.

And as always, if you want help with a new or ongoing pain problem, reach out to Dr. Cohn and his team today at (952) 738-4580.

Law Change Helps Patients Fighting Chronic Pain In Minnesota

August 8, 2022 / Thomas Cohn, MD

A number of new laws went into effect on August 1, but one law in particular could be a godsend for certain chronic pain patients in Minnesota. The law clarifies and updates how doctors can prescribe medications to patients battling chronic pain, which will make it easier for some patients battling complex pain problems to receive the medications they so desperately need.

The new law came after some concerns developed in the wake of the 2016 CDC Guideline for Prescribing Opioids for Chronic Pain. Those guidelines really attempted to reduce opioid addiction and overdose deaths by placing limits and restrictions on the types of medication that patients with chronic pain could receive. However, as we’ve talked about on the blog in the past, chronic pain is highly individualized, so attempting to paint all pain patients with a broad brush stroke and subject them all to the same restrictions was bound to cause problems for some patients.

The 2016 guidelines featured specific numeric thresholds for opioid prescribing, which were later adopted widely and used in regulations and state laws to police opioid prescribing. But these restrictions also had an unintended effect – patients who could no longer get the crucial medication they needed to help with their pain would sometimes turn to the streets for painkillers.

“Many have turned to the streets out of desperation,” said Laura Johnson, a chronic pain patient who spoke to the Minnesota Senate during a spring hearing. “Many more have ended their lives.”

Both the American Medical Association and the Minnesota Medical Association backed up Johnson’s testimony, sending letters in support of a proposed change.

The New Guidelines

The updated guidelines essentially allow doctors more freedom to continue prescribing opioids past the previous threshold so long as they are doing so with a clear purpose and accurate documentation. The revised statute provides new or updated definitions for treating problems like intractable pain, palliative care and other rare conditions. Here’s what they say:

No physician, advanced practice registered nurse, or physician assistant shall be subject to disciplinary action by the Board of Medical Practice or Board of Nursing for appropriately prescribing or administering a controlled substance in Schedules II to V of section 152.02 in the course of treatment of a patient for intractable pain, provided the physician, advanced practice registered nurse, or physician assistant keeps accurate records of the purpose, use, prescription, and disposal of controlled substances, writes accurate prescriptions, and prescribes medications in conformance with chapter 147 or 148 or in accordance with the current standard of care.

No physician, advanced practice registered nurse, or physician assistant, acting in good faith and based on the needs of the patient, shall be subject to disenrollment or termination by the commissioner of health solely for prescribing a dosage that equates to an upward deviation from morphine milligram equivalent dosage recommendations or thresholds specified in state or federal opioid prescribing guidelines or policies, including but not limited to the Guideline for Prescribing Opioids for Chronic Pain issued by the Centers for Disease Control and Prevention and Minnesota Opioid Prescribing Guidelines.

Prescribers are prohibited from tapering a patient’s medication dosage solely to meet a predetermined dosage recommendation or threshold if the patient is stable; is experiencing no serious harm from the level of medication prescribed, and is in compliance with treatment plan and patient-provider agreement.

No pharmacist, health plan company or pharmacy benefit manager shall refuse to fill a prescription for an opiate issued by a licensed practitioner authorized to prescribe opiates solely based on the prescription exceeding a predetermined morphine milligram equivalent dosage recommendation or threshold.

Prescribers and patients are required to enter into an agreement that includes the patient’s and prescriber’s expectations, responsibilities, and rights according to the best practices and current standard of care with agreement to be signed by the patient and the prescriber, and a copy of the agreement included with the patient’s medical record and a copy to the patient, to be reviewed at least annually and when there are any changes to treatment plan.

Absent clear evidence of drug diversion, nonadherence with the agreement must not be used as the sole reason to stop a patient’s treatment with scheduled drugs.

These updated guidelines should ensure that patients and providers who are doing everything in their power to correctly address a chronic pain issue won’t run into problems with access to medications that they need. Hopefully we see these intended results in the near future. And if you need help with a pain issue in the greater Twin Cities area, reach out to Dr. Cohn and his team today at (953) 738-4580.

In Pain, Stigmatized and Unsupported – What It’s Like To Have Chronic Pain in 2022

August 4, 2022 / Thomas Cohn, MD

As technology advances and we get a better understanding of the underlying causes of chronic pain, you’d think we’d be able to put up a better fight against the debilitating condition. However, a recent survey from the U.S. Pain Foundation uncovered the true landscape of what it’s like to have chronic pain in 2022. Needless to say, we have a lot of work to do in addressing the problem.

The Current Chronic Pain Landscape

For their survey, the U.S. Pain Foundation interviewed 2,275 patients with chronic pain, 72 caregivers and 31 health care professionals to better understand the health care crisis that is chronic pain. The results revealed that for many people, pain is significant, and they don’t know where to turn for support. Here’s a look at a number of the findings from the survey.

On a scale of 1-10, more than half of respondents (52%) rated their average pain level a 7 or higher.
99% said that their chronic pain condition restricted their ability to engage in routine activities.
Only 18% were employed full-time.
79% said they felt stigmatized because of their pain, and 63% said they felt stigmatized by their provider.
1 in 4 patients said they rarely or never had their feelings validated or listened to by their provider.
79% of respondents currently take prescription medications, and 77% felt that it was the most helpful treatment for their pain.
49% of respondents said cost of services was their leading barrier to treatment.
41% of people with pain said they felt their insurance coverage decisions were driven by cost, not what was in their best interest medically.

There’s a lot to sift through in this report, but it provides a pretty rough outlook on chronic pain in 2022. A couple of the biggest takeaways that we want to touch on are in regards to:

Pain – Chronic pain is a condition that affects millions of Americans, but it seems unlikely that people realize just how painful these conditions can be. With more than half of people rating their pain at a 7 or higher, it’s clear that pain isn’t just bothersome or uncomfortable, it’s downright painful. We need to work on lessening pain scores.

Stigma – Fighting the stigma of chronic pain has been one of our top priorities. We pride ourselves in giving each patient the full time and attention they deserve to really understand their pain and how it’s affecting them. By doing this, we believe we’re better able to match patients to active treatments like physical therapy, exercise, breathing techniques or mindfulness training to help overcome their individual issue.

Treatment – As we’e said countless times on the blog in the past, medications can absolutely play a pivotal role in helping you overcome a chronic pain condition, but they shouldn’t be a standalone option. While the report did mention that multidisciplinary approaches were common, it’s a bit concerning to see that 77% felt that it was the best treatment for their pain. It’s possibly the best treatment for their symptoms, but it’s unlikely to be the best treatment for their underlying issue. Hopefully patients are taking advantage of the symptom relief provided by medications to pursue other endeavors like exercise or physical therapy to also attack the root issue of their pain disorder.

If you want someone who won’t make you feel stigmatized and will be a resource for you on your road to recovery from chronic pain, reach out to Dr. Cohn and his team today at (952) 738-4580.