Tips For Overcoming High Impact Chronic Pain

/ Thomas Cohn, MD

chronic pain More than 50 million Americans battle a chronic pain condition on a regular basis, but for a portion of these individuals, their pain is even more debilitating. According to research published in the Journal of Pain, roughly 11 million U.S. adults are dealing with what’s known as “High Impact Chronic Pain.” High Impact Chronic Pain, also referred to as HICP, is similar in nature to standard chronic pain in that it is categorized as pain that has lasted three months or longer. However, in patients with HICP, their pain is so significant that is also causes at least one major active restriction, like:

  • Being unable to work
  • Being unable to go to school
  • Being able to perform household chores

Because of the significant physical burden caused by HIPC, it’s also not uncommon for individuals to also be plagued by mental health issues like anxiety and depression. It can be a vicious cycle, with pain limiting physical and mental stimulation, which only makes it harder for a person to overcome their chronic pain issue. We don’t pretend like we have all the answers, but we do want to use today’s blog to give some advice on how you can work to overcome your high impact chronic pain condition.

Overcoming High Impact Chronic Pain

There is no step-by-step guide for overcoming high impact chronic pain, especially because pain conditions are so unique to the individual. With that said, there are a few things you can do that you may find helpful in providing mild, moderate or major relief for your pain condition. We recommend a combination of the following:

Professional Assistance – You shouldn’t try to manage your high impact pain condition by yourself. It’s already burdensome enough without also trying to figure out the best way to treat your unique pain condition. Instead, lean on a pain specialist with decades of experience treating all sorts of pain problems. Let us work alongside you to find solutions and make it easier for you to gradually work to overcome your pain issue so that you can get back to doing all the activities you love.

Be Active – We know that this is easier said than done, but activity is really important for your body if you’re dealing with a pain condition. Obviously you’ll want to tailor the activity to your current strengths and limitations, but physical activity will do wonders for your physical and mental health. Being active strengthens key areas inside your body, and it can be mentally rewarding to know that you are doing your part to help control your pain condition, which is key for your mental health.

Physical Therapy – If you want to pursue some physical activities and exercise under the guidance of a professional, consider syncing up with a physical therapist. Your physical therapist will develop a PT routine suited to your diagnosis and your goals, and they’ll gradually have you take on greater challenges as you work towards becoming the most functionally capable version of yourself. Many people like working with a PT because it allows them to get real-time feedback from a professional who will adjust their workout to their ever-changing needs.

Improve Your Diet And Sleep – You can’t eat and sleep your way back to full health, but your diet and your sleep quality can certainly prove beneficial or detrimental in your quest to overcome your pain condition. A poor diet can be pro-inflammatory, while a lack of quality sleep has been shown to increase pain sensitivity, which is not something you want if you’re dealing with high impact chronic pain. Conversely, a healthy diet ensures that your body gets the nutrients it needs for numerous essential functions, and quality sleep makes it easier for you to wake up feeling refreshed and ready to attack the day with activity.

Overcoming a chronic pain condition is never easy, and that’s especially true for patients with high impact chronic pain. With that said, if you strive to make a few small changes and you connect with a provider like Dr. Cohn, we’re confident that we can help you get your HIPC under control. For more information, or for help with a different pain issue, reach out to Dr. Cohn’s office today at (952) 738-4580.

1 in 4 Chronic Pain Patients Treating Their Condition With Medications Only

/ Thomas Cohn, MD

medicationsNew data from the National Institutes of Health found that more than 1 in 4 patients with a chronic pain condition were pursuing pharmacologic treatments as their only form of care. As we’ve said on this blog time and time again, chronic pain is a complex issue that needs to be treated with a combination of active and passive treatments.

Pharmacologic treatments are considered a passive treatment and involve things like over-the-counter medications, prescription nonopioids and opioids. Non-pharmacologic treatments tend to be more active in nature, like exercise, physical therapy and cognitive behavioral therapy. Dr. Cohn and his team follow the current recommendations of the Centers for Disease Control and Prevention, which suggest that chronic pain treatment oftentimes works best with a mix of nonpharacologic and pharmacologic therapies.

However, a recent NIH survey found that a fair amount of chronic pain patients are pursuing passive care as their only treatment option for their chronic pain condition. A survey of 7,422 patients with chronic pain uncovered that 26.6 percent of adults said pharmacologic therapy was their only form of chronic pain treatment.

Chronic Pain Treatment Findings

Additional findings from the survey include:

  • 60.2 percent of adults were pursuing both pharmacologic and nonpharmacologic therapies for their pain condition.
  • The most common pharmacologic treatments used were over-the-counter pain relievers (75.5%), prescription nonopioids (31.1%) and prescription opioids (13.5%).
  • The most common nonpharmacologic therapies used were exercise (55%), complementary therapies (36.7%), physical or occupation therapy (17.2%) and cognitive behavioral therapy (2.2%).
  • Older adults with more severe pain and those on public insurance were more likely to treat their pain with prescription opioids

The most concerning finding from the survey was that more than 1 in 4 patients are taking medications as their only form of chronic pain management. These medications treat the symptoms, and while they can calm inflammation or make movement more comfortable, they won’t serve to address the underlying issue that is causing inflammation or similar joint issues. You absolutely need to pair passive techniques like rest and medications with active techniques like exercise and physical therapy. These active treatments help you become stronger so that you can better handle stress, and they also work to stabilize structures that could be suffering from instability or mobility issues. Medications won’t solve your root problem, and while they can be a great compliment to a comprehensive treatment program, they are never a good stand alone option!

To connect with a provider who can develop a treatment plan suited to your specific needs, or to help create a treatment plan that incorporates the right balance of active and passive treatments, reach out to Dr. Cohn and his team today at (952) 738-4580.

How To Tackle The Physical, Mental And Emotional Sides Of Chronic Pain

/ Thomas Cohn, MD

chronic pain sidesThe physical pain of a chronic pain condition gets most of the attention, but a pain issue affects you in more than just a physical manner. There is also a significant mental and emotional side of chronic pain, and if you aren’t careful in how you treat the problem, you may find that the issue never fully resolves. In today’s blog, we take a look at some ways to tackle these three sides of a chronic pain problem.

Managing The Physical Side Of Chronic Pain

Let’s start by looking at the physical ways you can fight back against your chronic pain condition. These are some of the most common treatments that will be recommended  from your pain management specialist. Odds are they suggest a combination of some of the following techniques:

  • Daily exercise
  • Controlled stretching
  • Physical therapy
  • Posture improvements
  • Weight loss

All of these techniques serve to make you physically stronger or make it easier for your body to handle the stress that you are putting on it. Because chronic pain is oftentimes tied to a stability issue or problematic inflammation, working to improving your body’s functional performance through physical activity and exertion and be extremely beneficial.

Managing The Mental Side Of Chronic Pain

A chronic pain condition can also put a significant burden on your mental health, so it’s important that you don’t ignore your mental health while you’re pursuing some of the physical treatments listed above. Chronic pain can leave you feeling worried and anxious, so you’ll want to make sure that you are stimulating your brain and working to appropriately frame your chronic pain condition in your mind. For example, don’t just lay in bed all day and hope that pain goes away. Find ways to stimulate your brain and take your mind off chronic pain. Pursuing mentally stimulating activities can lead to the production of hormones that can help drown out pain signals.

It’s also important that you have the right mindset when it comes to your chronic pain condition. It can be easy to catastrophize your pain condition or always view things with a “glass half empty” perspective. You can’t always control your pain, but there are certain aspects you can control, and if you put your time and effort into the aspects of your condition that you can control (like diet, exercise, mental stimulation), you can take solace in knowing you are doing what you need to do to fight back against chronic pain. Try not to focus on the uncontrollable and reframe how you approach your care, and you’ll find that you have more peace over your condition, which can actually help you overcome your pain!

Managing The Emotional Side Of Chronic Pain

Finally, chronic pain can also be very emotionally draining. If you’ve had your pain condition for a while, odds are you’ve had to cancel plans to stop pursuing certain activities you love because of your pain, and that can really wear on a person’s emotions. Similar to the above point on how you need to pursue activities that are mentally stimulating and rewarding, you need to also throw yourself into activities that are emotionally rewarding. Have a friend over for dinner, go for a walk with your sister, call your friend who moved across the country, etc.

You can also find emotionally rewarding activities that don’t depend on other people. Force yourself to go see that new movie, volunteer to walk a dog at the adoption shelter every Friday, or simply curl up with a new book. Chronic pain can be isolating and emotionally draining, so you also want to make sure that you are finding ways to add a little joy to your life. When you’re happier and emotionally balanced, it will be much easier to manage the ups and downs of a pain condition.

If you need help with any of these aspects, or your want to create an individualized care plan for your pain issue, reach out to Dr. Cohn and his team today at (952) 738-4580.

Vitamin Treatment May Be The Key To Unlocking Chronic Pain

/ Thomas Cohn, MD

vitamin b3A type of Vitamin B3, called nicotinamide riboside, could hold the key to unlocking the problem of chronic pain in millions of Americans.

The vitamin works by targeting inflammation, which is oftentimes the source of pain in patients with chronic pain. Inflammation is your body’s natural response to injury, but in many patients with chronic pain, inflammation develops too easily or fails to resolve in an adequate manner, leading to frequent bouts of chronic pain. Inflammation onset and its ability to resolve is believed to be tied to mitochondria function. Your mitochondria help to power your cells and ensure the cell has the ability to perform a number of essential functions, like tissue repair and inflammation control.

To see if they could improve mitochondria function and in turn inflammation control, researchers triggered an inflammatory response in the hind paws of 15 mice. They then measured the amount of oxygen consumed by mitochondria in the sensory neurons of the mice, which is a helpful indicator of mitochondria function. A week after inflammation had resolved, researchers noticed that these mitochondria were consuming significantly more oxygen, suggesting that inflammation was inhibiting their normal function.

When comparing metabolites between mice in the test group and mice who had not experienced an inflammatory reaction in their hind paws, they found that mice in the test group had lower than expected levels of nicotinamide riboside in the mitochondria of their sensory neurons. Nicotinamide riboside helps mitochondria function properly.

Vitamin B3 And Chronic Pain

With all that new information, researchers conducted another test. This time, researchers gave half the mice a high dose of nicotinamide riboside. Next, they assessed the animals’ sensitivity to pain by measuring how quickly they moved their paws away from a heat source. They found that mice who did not receive the dose of vitamin B3 pulled their foot away from the heat source twice as quickly as those who had received the dosage, suggesting that nicotinamide riboside can help combat pain sensitivity, a common denominator in patients with chronic pain.

Researchers concluded by saying that they believe that nicotinamide riboside can help to calm pain sensitivity and restore crucial mitochondria function in mice dealing with an inflammatory response. Should these results translate to humans, it could be a major breakthrough in how inflammation-driven chronic pain is treated.

But before you rush out to grab some vitamin B3 supplements, know that this was early stage research conducted on mice, and we’re a long way away from proving its viability in humans. Still, it’s research like this that gives us hope that we may soon be able to find new and effective ways to treat the complex problem of chronic pain. In the meantime, if you’d like to work with a pain management specialist who will pursue some more clinically-proven techniques for treating your chronic pain issue, reach out to Dr. Cohn and his team today at (952) 738-4580.

When Your Pain Concerns Are Being Ignored By Your Doctor

/ Thomas Cohn, MD

doctor listeningAs we’ve talked about on the blog numerous times in the past, chronic pain can be an extremely frustrating condition, and that frustration only ratchets up another level when you feel like your needs are not being met by your pain care provider. The one person who should have your back during your battle with chronic pain is your doctor, so what should you do if you feel like you’re not being heard or your needs aren’t being met? We share some tips on what you should do in this situation.

When You’re Not Being Heard By Your Pain Specialist

If you feel like your concerns simply aren’t being met by your pain care provider, take a deep breath and follow some of this advice.

1. Let Your Doctor Know – First and foremost, you’ll want to have a conversation with your doctor. There’s a very good chance that you and your doctor have different expectations or goals for your pain care, and oftentimes you can get on the same page with a simple conversation. When communicating with your doctor, be specific. Give examples of situations where you felt like you weren’t being heard or your needs weren’t met. We want this communication to be conversational, meaning that you want to talk and you also want to listen to what the other side has to say. You’d be amazed at how often care problems can be resolved with a constructive conversation.

2. Self-Evaluate – It’s also important that you take time to reflect on yourself and your situation to make sure that your frustrations are valid and directed in the right place. As we mentioned above, chronic pain can be extremely frustrating, and it’s not uncommon for patients to take that frustration out on their provider, despite the fact that their doctor is doing everything in their power to help them manage their condition. We’re not saying that your concerns aren’t valid, but self-evaluation is important in all walks of life, and it would be a shame for misplaced frustration to cause a rift between you and your care provider.

3. Ask For An Explanation – One thing many providers are guilty of is not deeply explaining the “why” behind their treatment recommendations. Whether it’s because they assume the patient has a better understanding of their condition and treatment than they do, or they simply focus on the end result and not the method itself, it’s easy for doctors to overlook important aspects of your care. Perhaps you feel like your concerns aren’t being met because you don’t understand why they are recommending the treatment they are, so please ask for clarification. We’d be more than happy to explain exactly why we believe our recommended treatment course is right for your specific situation.

4. Don’t Dwell On One Specific Instance – If you’re working to overcome a chronic pain condition, odds are you’ve visited your provider on a number of occasions. Many of those visits probably went fine, but it can be easy to really focus on one negative experience. Try not to let one bad interaction sour your experience with your doctor. We all have bad days and are juggling personal and professionally responsibilities, and we’d all like a do-over from time to time. Try to grant your provider some grace, but if the behavior becomes a pattern, move on to the last tip.

5. Find A New Provider – Finally, if you’ve tried all of the above and still feel like your doctor isn’t the right provider for you, it’s time to look elsewhere for care. We know that switching providers can be a headache, but it will be worth it to connect with a professional who truly puts your needs first. We’d love to be that provider for you, so if you want to connect with a doctor who will make sure your concerns are always heard, reach out to Dr. Cohn and his team today at (952) 738-4580.