Chronic Pain and Your Credit Score – An Interesting Link

chronic pain creditChronic pain has many obvious drawbacks, but it also has many hidden consequences. We know that chronic pain can be costly to treat, but new research suggests that it can have a severe impact on your buying power or your ability to secure credit.

According to a new study published in the National Pain Report, a survey of 840 chronic pain sufferers found that a whopping 63 percent were unable to secure credit. As you might have guessed, this has far-reaching consequences for pain sufferers.

Chronic Pain and Your Credit

Researchers said that there were a number of different reasons why chronic pain sufferers had difficulty securing credit. Some of the most common challenges individuals with chronic pain run into credit-wise include:

  • Difficulty obtaining credit because chronic pain makes it hard or impossible for them to maintain employment.
  • High interest on credit cards or loans that they are able to secure.
  • Difficulty getting a cell phone contract.
  • Inability to get approved for a home loan or apartment rental.
  • Inability to secure utilities, like electricity, propane or gas.
  • Difficulty getting automobile or life insurance, and when they do, rates are often very high.

“The inability to secure credit brings a long list of challenges, particularly for those who also suffer with medical conditions, like pain,” said Jim Shanahan, President and CEO of Prepaidian, Inc, a company who specializes in Prepaid debit cards that are intended to provide buying power for people who are unable to secure credit. “You may be unable to get a checking account, or pay exorbitant fees on those accounts, in addition to trying to manage medical bills.”

How To Improve Your Credit While Dealing With Chronic Pain

Improving your credit score while you deal with chronic pain isn’t always easy, but there are things you can do to improve it bit by bit. For example, always try to make your payments on time, even if it’s just the minimum amount. Paying on time helps to improve your credit score. Secondly, don’t be in a rush to close your accounts. Closing accounts, even ones you don’t use, negatively impacts your credit score because it limits your buying power. If you absolutely have to close out an account, see if you can increase your line of credit on a different account. Even if you don’t plan to spend that much, your credit score improves when you have more potential buying power at your disposal.

Secondly, try to settle up past due accounts. Odds are if you’re willing to pay at least a portion of the bill, the credit card company will be willing to erase the debt, because getting some money is better than getting nothing. You can call in and see if they’ll waive late fees or some interest charges, because it never hurts to ask, and if waiving a fee gets the credit card company their money, oftentimes they’ll be willing to compromise. It never hurts to ask.

Lastly, if medical bills from chronic pain are stacking up, try to get on a payment plan with your health center or insurance company. Making regular payments and working towards a zero balance will do wonders for your credit score. Explain your situation, and people may be more willing to help.

5 Tips For Exercising With Chronic Pain

exercise painExercise can help prevent and manage chronic pain, but chronic pain can also make it difficult to exercise on a regular basis. However, if you keep some tips in mind, you may find it easier to get through your exercise routine even if you are plagued by chronic pain.

Today, we share five tips that can make exercise easier even if you are battling a chronic pain condition.

Chronic Pain and Exercise

Here are five tips for making your exercise routine a little more bearable when you’re dealing with chronic pain.

1. Avoid The Wrong Activities – Try to get your exercise in by being mindful of where pain exists and which activities overstress these areas. You want to strengthen certain areas while avoiding overstressing painful areas. For example, if you have chronic low back pain, exercise activities like cycling or canoeing may put excess stress on your lumbar spine. Don’t partake in activities that will make the problem worse.

2. Find Your Pace – Yoga classes or group exercise routines can help make exercising more fun, but not if you’re struggling to keep up. Go at your own pace and do not worry what other people are doing. If you’re dead set on working out with a group or another person, find someone who closely matches your ability and who will be willing to scale things back or stop altogether if pain makes exercise too difficult.

3. Aqua Therapy – We’ve pushed the benefits of aqua therapy in the past, and we think it’s a great option for chronic pain sufferers because the water’s natural buoyancy helps to take stress and pressure off our joints. Also, the water provides natural resistance, which makes it easier to strengthen different structures that you might not be able to as easily on land.

4. Balanced Routine – While we want you to find what works for you, it’s also important that you find some balance in your workout routine. You need to focus on your cardiovascular health, aerobic conditioning and strength training in order to best keep chronic pain at bay.

5. Accept That Not Every Day Is Going To Be Great – This happens with everybody, so don’t get discouraged if you just don’t seem to “have it” on any given day. As long as you are up and trying to improve your physical health, that day is a win. It’s not going to be easy, and it’s not always going to go smoothly, but if you’re making a conscious effort to exercise 4-5 times a week, your body will thank you for it.

For more tips on how to exercise with chronic pain, or to talk to a doctor about your chronic pain condition, reach out to Dr. Cohn today.

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

chronic pain programComprehensive 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.

JAMA’s Approach To Chronic Pain Is Misguided

chronic pain opioidsEvery week, the prestigious Journal of the American Medical Association (JAMA) publishes short articles that address important topics in medicine. Last week one of the articles was on taking care of chronic pain patients in primary care medical practices.

In the era of opioid abuse, one would think educating primary care physicians on pain would be beneficial. This article unfortunately was a catastrophe. The information on addiction was wrong and the treatment of pain was overly simplistic.

Understanding Opioid Addiction

Opioid addiction is a significant issue today. Yearly over 30,000 people die due to opioid-related incidents. This is nearly as many people as those who die in automobile accidents. However, addiction is an illness in itself, and of all the people who use opioids, only a small percentage of about 5-7 percent at most ever become addicted. Addiction to opioids is no different then other addictions and requires psychological intervention and medical detoxification.

Chronic pain is a very complex disease, and has many causes. There often is not a single problem involved and finding solutions to improve the issues present takes a deep medical understanding of many different fields. One must be able to identify and understand all the medical problems contributing to pain. Having a solid knowledge of rheumatology, internal medicine, orthopedics, neurology, and musculoskeletal medicine are just a few of the skills needed in pain medicine. In reality, it does not matter how people progress to a chronic pain condition, what matters is that 1/3 of the adult population has problems with chronic pain.

The article in JAMA recommends that primary care physicians need to see the pain patients frequently, with shared decision making, compassionate care, promoting shared decision making, and use an interdisciplinary approach. They should work with motivational interviewing, and have physical therapists and psychologists in the office to work with them and the patients.

This article was written by physicians from the University of Michigan, and pardon my language, is crap. From experience, these physicians are in academics and they are tremendously sheltered from the pressures of most practice situations. Most primary care physicians have 15 minutes at the most to see a patient and they do not have any other support like psychologists in their practice or physical therapy. At the University of Michigan, pain patients are also referred out to the Physical Medicine physicians. The advice in this article is of extremely low use.

What We Should Be Doing

Primary care physicians need far more practical advice on management of chronic pain. First off, chronic pain is not a single medical condition but most commonly it is the response to multiple medical problems. The role of primary care medicine is, more importantly, to identify that there is a problem and help quarterback and guide a patient to the correct treating physicians. With limited time for each visit, send the patient to experts in pain management such as a physical medicine physician who actually has the appropriate training and resources to treat complex problems.

Secondly, avoid the quick fix by trying to hand out medication, especially opioids and many of the other drugs on the market since developing a comprehensive management strategy is necessary. Again this type of management is not really primary care and working with a specialist is more productive. Once a specialist has developed a successful treatment approach, be willing to take over and maintain the program. Third, realize pain is extremely complex, often with no cure, and the goal of treatment is to improve function and make the symptoms more manageable. The best advice for primary care physicians is to learn who are the knowledgeable and successful pain management experts in your area and use their expertise to help manage these complex patients.  

Pain Catastrophizing and Chronic Pain Care

Pain CatastrophizingWhen it comes to managing chronic pain, it’s imperative to take as much care of your mental health as it is your physical health. Ignoring your mental health can lead to more negative attitudes towards your pain, which can lead to even more problems according to a new study.

A new report out of the Stanford University School of Medicine suggests that individuals who negatively fixate on their symptoms have been found to report greater pain intensity and are more likely to be prescribed opioids. Interestingly, the association was much higher in females than it was in men.

“When it comes to opioid prescriptions, pain catastrophizing has a greater effect on the likelihood for having a prescription in women than it does in men,” said medical student and lead researcher Yasamin Sharifzadeh.

Pain Catastrophizing

According to researchers, “pain catastrophizing” is defined as the cascade of negative thoughts and emotions in response to actual or anticipated pain. When you begin to let these negative thoughts continue to build and take hold over your pain, it can actually amplify the pain process and lead to greater pain and increased disability. Previous studies have shown that pain catastrophizing has been linked to increased pain sensations, but this is the first study to find a correlation between it and an increased likelihood of being prescribed opioids.

For their research, Sharifzadeh and her team analyzed clinical data from more than 1,800 patients with chronic pain. After analyzing the data and parsing out the results between genders, researchers came to an interesting conclusion.

“In men, it is pain intensity that dictates whether or not they are prescribed opioids,” Sharifzadeh said. “However, in women, there is a more nuanced issue where relatively low levels of both pain catastrophizing and pain intensity are associated with opioid prescription. Pain catastrophizing and pain intensity are working together in determining if a woman has an opioid prescription.”

This is especially problematic when you consider that women are more likely to suffer from chronic pain, be prescribed pain relievers and given higher doses for longer periods than men, according to the Centers for Disease Control and Prevention. However, by recognizing this correlation, doctors can help to mitigate this risk.

“If physicians are aware of these gender-specific differences, they can tailor their treatment,” Sharifzadeh said. “When treating chronic pain patients — especially women — they should analyze pain in its psychological aspect as well as its physical aspect.”

If you feel like your mental health is fighting a losing battle with chronic pain, reach out to your doctor. Contact Dr. Cohn today.