Tips For Staying Pain Free and Fit While Traveling

thanksgiving travelingWhile on vacation it is easy to lose all motivation to stay in shape. Extreme temptation is present to eat too much, to indulge with lots of fatty or sweet foods, and not to exercise. It is not fun to take the time to exercise versus sleeping or to say no to foods that the heart desires. However, staying a bit more fit is often easier than one may think, and making it a priority will serve you well. If you have chronic pain problems, keeping up with an exercise program will make travel go much smoother.

Exercising on the Go

If one stays at a hotel, most places have some exercise equipment available. Business travelers often exercise early in the morning, and if there are only a few pieces of equipment present, you may have to adjust your timing during the day if using it is important to you. Oftentimes no one else will be using workout equipment during the middle of the day and before dinner. I have often worked out with no one else around hours before dinner. The other benefit of exercising before dinner is that exercise tends to reduce your appetite.

Starting the day with exercise often helps get the body moving and decreases overall pain throughout the body. Many routines do not require any significant amount of equipment and can be done anywhere. The first thing is to spend 5-10 minutes with a good stretching routine. If you have low back pain, work at sitting on the ground and touching the toes, stand and touch the toes, and then do hip stretching by leaning forward with the pelvis. Tight muscles hurt, and although initially a stretch might slightly increase pain, as the muscles loosen, the pain often goes away.  

Strengthening does not require any amount of special equipment. Core strengthening can be done without any or with simple things like rubber tubing or bands. Basic core exercises to do include planks, leg lifts while lying or sitting, stomach crunches and supermans. Planks should be held for only 30-45 seconds and repeated one or two times. They can be done with leg and arm lifts and performed on the side to make them more difficult while working more muscles.

Using a balance board or balance cushion can add even more of a challenge, and these portable boards and can be found for $20-50. Rubber tubing can also be used for strengthening, and anchoring it in a door allows a number of exercises for the arms, trunk, lower back and legs. Affordable rubber tubing for exercise with a variety of resistances, handgrips and door anchors with a carrying sack can be found on Amazon. Just doing balance exercises requires no equipment and works the core muscles too.

Finding Time To Exercise During Holidays Or Vacation

Maintaining general conditioning may be one of the easiest tasks while on vacation. Start walking and do some sightseeing. Walk to a restaurant or take a walk in the morning or evening. Explore the area where you are on foot and spend 30 minutes to an hour just walking every day. Google maps will even give you walking directions an estimated time of when you’ll arrive. If more ambitious, go for a run, go swimming or in many cities there are now inexpensive bike sharing services that allow one to explore the area and get some exercise.

Lastly, while on vacation, eat sensibly. Try to keep to a similar diet while traveling as you do while at home.  A high protein meal plan with fresh fruits, salads and vegetables will keep you from overeating. Keep the simple carbohydrates down like the bakery goods, pasta, potatoes and desserts. Avoid stuffing yourself at meals, eating late at night, and drinking lots of alcohol. It is okay to splurge somewhat, but if you do not overeat you definitely will feel better.

Thoughts On Attending The Latest Pain Conference

conference meetingEvery physician is required to obtain continuing education credits. Depending on a when one was board certified, the types of boards one has, and what state you live in, the number of credits needed each year varies.

At least once a year, I try to attend some sort of conference in order to to add to my knowledge about how to treat pain. This year I have ventured into the new realm of the American Society of Regional Anesthesia (ASRA). Since pain care crosses the line into a number of different disciplines, one of the best ways to improve is to pick up knowledge outside your normal specialty.

Thoughts From The ASRA Meeting

For the last several days I have been at the annual pain meeting of the ASRA. It is a group of about 5,000 practitioners, which is actually one of the smaller major groups involved in pain management. Each group has a different focus, and finding a good balance is hard. So far I have enjoyed the meetings; it’s like being back in an intense school all day long. Best yet, most of the information has been very relevant to my regular practice. It also has included a lot of practical knowledge, and there hasn’t been too much esoteric academic information or stuff aimed at an someone just beginning to practice pain medicine. Many of the pain conferences are aimed at physicians who do not do any advanced procedures or only at physicians doing injections, and both extremes can be lacking balance for patient treatment.

One of the most important things a conference does is challenge your thinking. Hopefully questions are entering your mind about what can you improve upon and how to do better patient care. A conference like this is great. It is not focused on a single topic and there are many areas of my practice it could impact. General topics have ranged from very specific aspects of implantable pain technologies to the best ways to evaluate and treat very specific medical problems. One odd topic that has caught my interest is how to deal with changing government regulations to prevent burnout of physicians.

The hot topic at any of these conferences is now opioid use and abuse. However, at a pain conference it is not about a crisis of addiction, but a crisis of lack of treatments available to treat complex pain. The money is being spent on addiction management and not finding treatments that would manage the root cause of pain, and thus markedly reduce addiction.

The hardest thing at a conference (besides sometimes staying awake) is trying to sift through what is truly good information. After going to enough of these conferences, one begins to recognize those who are in it for self promotion. Every conference seems to have several people who promote the latest fad. If there is no money to be made with regards to a topic, the information is probably more science and less sales.

Learning new information is good. Missing seeing patients is tough, but the time gone is for the good of all patients in order to provide the best care. Benefits will be made on everything from what to do for patients to learning new things that may help tough patients. New treatments now will be tried for everything from CRPS to knee or elbow problems. The only sad part of going to these conferences is that often I see no other pain physicians from my location, but I’m certainly glad I went to this conference.

Timberwolves Star Speaks Out In Favor Of Medical Marijuana

medical marijuanaMedical marijuana has been a hot topic on this blog and in the national news. Minnesota currently allows individuals to apply for a medical marijuana license if they meet a certain number of health characteristics set forth by the state. We’ve made our position about medical marijuana known on several occasions, but we’ll refresh it here briefly if you didn’t check out those other blogs.

We believe the medical marijuana is certainly an avenue worth pursing, but we need to learn more about the compounds inside marijuana before rushing it to the market. It’s certainly shown some promise, but if we want it to be truly effective, we need a better scientific understanding of each individual compound in different strains of marijuana. We should consider putting more money into researching and learning about the medicinal properties of marijuana.

Now, a high profile athlete in Minnesota is speaking out in favor of medicinal marijuana. He may not be championing medical marijuana for chronic pain, but he has seen it work first hand.

Karl Anthony Towns Talks Medical Marijuana

Minnesota Timberwolves star Karl Anthony Towns recently spoke out in favor of removing marijuana from the listed of banned substances for NBA players, agreeing with a sentiment pushed by former NBA commissioner David Stern.

“I agree with David Stern with marijuana,” Towns told ESPN “You could use the [chemical] properties in it to make a lot of people better.”

NBA players deal with pain and discomfort on a regular basis throughout the season, and Towns believes marijuana could help some players deal with that discomfort.

“That’s something that Adam Silver has to do. That’s out of my control, but maybe legalizing marijuana. Not fully legal, where people are chimneys, but using [marijuana] as a beneficial factor as an athlete, as a person living daily.”

Towns has already seen how medical marijuana can be used to help certain individuals. His girlfriend’s nephew is autistic, and a medical dosage has helped the boy and the family with the condition.

“I’ve seen nothing but benefits for him,” Towns said. “And I’m very happy that he finds comfort. He finds that normalcy every day. Just like a father, a mother, a parent with a child, you’d do anything for your child.”

It sounds like Towns is in the same boat. He has seen the benefits of medicinal marijuana in his life, but he understands that simply legalizing it without researching the science behind the drug could lead to unintended consequences. We should be pouring more money into chronic pain research if we really are committed to helping people manage their pain.

Minnesota Getting $16.6 Million To Fight Opioid Epidemic

opioids chronic pain minnesotaMinnesota is set to receive $16.6 million in federal grants that will be given to foundations and organizations committed to fighting the opioid epidemic.

More than 30 different agencies will receive grants from the federal fund, and the goal is to reach and help more than 110,000 Minnesotans who are seeking treatment for opioid dependency. Most of the money will go to existing programs to launch new efforts or expand current efforts in combating the opioid crisis.

“These grants are designed to build on what we are doing,” said Minnesota Human Services Commissioner Emily Piper.

The Opioid Problem In Minnesota

According to health data, there were nearly 2,500 opioid-related overdoses last year, and 376 of those overdoses were fatal. There were more than 3.5 million prescriptions written for opioid painkillers in Minnesota in 2016.

The federal grant will go to a number of specific places and programs, including:

  • More widespread availability of naloxone, a key substance in helping save people who have overdosed on painkillers.
  • Expanding medication-assisted treatment.
  • Increasing aid and resources on American Indian reservations.
  • Adding opioid-specific care providers throughout the state.
  • Establishing a program to help unborn and newborn babies of mothers with opioid dependencies.

There has also been a push for more regulation at the national level from Minnesota lawmakers. A presidential opioid crisis commission recommended that President Trump support two bills proposal by Minnesota Senator Amy Klobuchar. The first would require more monitoring of drug prescriptions and the second would attempt to reduce the number of opioids that are being illegally distributed through the US mail system.

Combating Sleep Problems Associated With Chronic Pain

sleep pain chronicSleep for individuals with chronic pain is often a major struggle. Unfortunately, just like the cause of pain itself, it is a difficult and multifaceted problem with different issues contributing to sleep struggles. Pain and discomfort at night are the leading complaints, but often it is more complicated and usually not a simple issue to solve.

Underlying medical problems may also be contributing to sleep disturbances, and not addressing these may prevent adequate solutions. Addressing sleep problems often requires intervention from multiple specialists.

The Importance Of Sleep Hygiene

Sleep problems can range from simple to complex problems. Starting with the simple issues is always important. First is trying to discover what are the difficulties with sleep and what habits and patterns for sleep occur with a person. Sleep hygiene is one of the leading areas of problems. One of the most common problems is the consumption of caffeine or similar stimulants during the day. Most people are sensitive to caffeine, and it is found in many drinks, especially various sodas and teas. Drinking these after the lunch hour for many can affect sleep. The use of alcoholic beverages can also interrupt sleep, initially it may make one tired, but as it wears off, the body awakens and one may be running to the bathroom.

Sleep hygiene also includes the habits one has in the bedroom. Currently, the most common problem is screen time including computers, tablets, television and phones prior to sleep. Watching a screen tends to activate the brain and wake a person up, and the color spectrum produced with lots of blue light is also awakening. Turning off the all the screens one hour before bedtime is advised. The bedroom should be reserved for sleep. Doing work in bed and spending time in bed not sleeping gives the brain the wrong signals to stay awake. Lastly, most people sleep better in a cool room, being to warm leads to restlessness.

Your Mattress and Sleep

The most common question that is asked to me is should I get a new bed and what bed should I get? Anyone who has shopped for a bed knows this is an expansive proposition. Before buying a new bed, try to get everything right in the bedroom first, from the room temperature to the sleep hygiene. If the bed is old, first try a mattress topper with 3-4 inches of quality memory foam. A good topper is far cheaper then a full mattress and may be perfect solution. A new bed is only needed if your mattress is ancient and beyond salvage.  

Since beds can be extremely expensive, start with determining your budget and then look at your options from memory foam mattresses to adjustable air bladder types like the Sleep Number bed. The mail order memory foam mattresses are often extremely affordable, comfortable and are reported to be a good quality. Everyone has a different preference for a bed, but if it is rock hard, it will not provide uniform body support and probably cause more pain. A bed that is too soft will probably also be uncomfortable and not provide adequate support to the body. The first recommendation would be try a memory foam type mattress for a new bed. If your budget is less constrained, the ability to change a bed’s hardness and support with an air bladder type bed is wonderful. Adjustable bed frames that can raise the head or feet is a further luxury.

The last issue with chronic pain and sleep is once you have optimized the sleep environment, what else can be done? The first concern is to see if there another medical concern preventing sleep. A sleep specialist often best evaluates these issues, and those who are neurologists often have the broadest understanding of all the issues. They can address problems from restless legs, sleep apnea to interrupted sleep by pain. They can be extremely helpful in determining the best medication routine for improving sleep. If a safe simple solution is not working, a sleep specialist is extremely important in determining the path forward.