chronic pain treatments

Diversification Key To Effective Chronic Pain Management

/ Thomas Cohn, MD

chronic painThey say that you should be wary about putting all your eggs in one basket, and oftentimes that sentiment holds true when it comes to managing chronic pain. It’s wonderful that you are taking proactive steps to fight back against chronic pain, but rarely will you find that pursuing only one treatment method is the most effective. We almost always recommend a combination of treatments to our patients because we’ve found that common treatments are oftentimes complimentary of one another. In today’s blog, we explain why treatment diversification oftentimes yields the best results.

Pursuing Multiple Chronic Pain Treatments

Working to treat your chronic pain on multiple fronts oftentimes helps you win more small battles on a regular basis. One active treatment is great, but multiple treatments can build on one another, fueling even better results.

Let’s give an example of how multiple chronic pain treatments can build on one another. We typically say that exercise or physical therapy is one of the best treatments for chronic pain. Physical activity strengthens supportive structures and reduces the overall impact of stress on your body. When your body can better handle the stress you put on it, it’s less likely to succumb to a chronic pain flare up. Exercise also has a number of related benefits for our health, like improving circulation and regulating our gut health. If you’re only going to pursue one treatment for chronic pain, usually exercise or physical therapy is the best option.

However, you can enhance the benefits of your exercise program by pursuing some complementary treatment techniques. Here’s a look at some additional techniques and how they can make exercise more effective.

Sleep – Improving your sleep quality can help your muscles recover from the physical stress of the day and ensure your body can effectively remove waste products that are produced as a byproduct of exercise.

Diet – A healthy diet can give your body the nutrients it needs to fuel exercise and bodily functions like bone production or cell replication. Exercise can improve your circulation, and improved circulation makes it easier for your blood to deliver the nutrients from your diet to the areas that need it most.

Ice/Heat – The use of ice packs or heating pads can help to regulate the movement of fluid in your body as they have a physical impact on the size of your blood vessels. Effective icing or heating can help you manage inflammation that can occur as a result of physical activity, helping you recover faster so that you can pursue physical activity again in the neat future.

Anti-Inflammatory Medications – Similarly, anti-inflammatory medications and pain relievers can help quell discomfort that may be preventing you from exercising or prolonging your recovery period after exercise.

Hydration – Staying hydrated makes it easier for your muscles to work properly during exercise. Dehydrated muscles are more likely to cramp or spasm, so staying hydrated can help to prevent some potential physical issues during exercise.

As you can see, a number of additional chronic pain treatments can serve to make other treatments more effective, so don’t pigeonhole yourself when it comes to chronic pain management. If you want help developing the right complementary treatment plan for your needs, reach out to Dr. Cohn and his team today at (952) 738-4580.

More Patients Seeking Chronic Pain Treatments Without Opioids

/ Thomas Cohn, MD

long term opiodsA growing number of US adults with chronic pain are pursuing a combination of non-drug and non-opioid approaches to control and treat their condition, which is an encouraging sign.

As we’ve talked about on the blog in the past, pain medications can play an important role in a comprehensive chronic pain treatment program, but oftentimes other active treatments provide more benefits and do not pose the same risks as potentially-addictive pain opioids. A recent poll found that 55 percent of adults with chronic pain used pain management techniques that did not involve any opioids at all over the surveyed three-month period. 11 percent of respondents used both opioids and non-opioid techniques, and only four percent said they only used opioids for chronic pain management. However, 30 percent of patients with chronic pain said they did not pursue any pain management techniques over the three-month period.

Other Chronic Pain Findings

Here’s a closer look at some of the findings from the survey:

  • Complementary therapies were the most commonly used non-opioid pain management technique (35% of adults), followed by physical, occupational or rehabilitative therapies (19%).
  • 5% of patients pursued self-management programs, 4% underwent cognitive behavioral therapy, and 2% sought out peer support groups.
  • 39 percent of adults said they pursued non-opioid chronic pain treatments that weren’t expressly mentioned by the survey.
  • Participants using complementary and psychological or psychotherapeutic interventions were more likely to be younger women with more education.
  • Prescription opioid use for chronic pain management was more common among older adults between the ages of 45 and 64 years compared to those aged 18 to 44 years (19% vs 8%).
  • Prescription opioid use was also more common among women than men (17% vs. 13%), in adults with health insurance compared to those without (16% vs. 6%) and in those with a high school education than those with more than a high school education (17% vs. 14%)
  • Prescription opioid use was less common among people making more than $100,000 than those making less than $35,000 (9% vs. 20%)

Researchers concluded that the findings were a step in the right direction for curbing the national opioid crisis, and it shows that more patients are working to pursue alternative and active chronic pain treatments instead of over relying on opioids that oftentimes simply mask symptoms instead of treating the underlying issue.

It’s great that so many people are working to take a vested interest in their health and really pursue different treatments instead of just taking pain medications. Opioids can make movements less painful and make it easier for patients to pursue certain active treatments, but there are numerous studies that have found some risks associated with long-term opioid use. The results are encouraging, but nearly one in three people with chronic pain aren’t seeking any type of treatment for their pain, and that number is still far too large. If you know someone with chronic pain, encourage them to connect with a specialist, because oftentimes symptoms can be reduced or even eliminated!

For more information, or for help with your chronic pain issue, reach out to Dr. Cohn and his team today.

Researchers Study THC Microdosing For Chronic Pain

/ Thomas Cohn, MD

microdosing THCIf you’ve been following our blog for a while now, you probably know that we’re interested in how cannabis or medical marijuana can be used to help with some chronic pain conditions. Recently, we came across a new study published in the European Journal of Pain that explored how microdosing THC could be used to treat chronic pain. Below, we take a closer look at the findings of that study.

Microdosing For Chronic Pain

Microdosing is the term used to describe the act of taking a subtherapeutic dosage of a drug. More recently, the term has become synonymous with regularly taking small doses of psychedelic drugs like LSD. Some artists and authors say microdosing on these agents can unlock the creativity inside of them, but the study out of Europe wanted to see if microdosing other types of drugs could prove to be a successful treatment option for some health conditions. Considering that cannabis has already been used to treat some types of chronic pain, researchers were interested to see if a THC microdose could offer similar benefits.

The randomized, double-blind study separated 27 patients into three different groups. There were:

  • One inhaled microdose of 500 micrograms (0.5mg) of THC
  • One inhaled microdose of 1,000 micrograms (1.0mg) of THC
  • A placebo group

Participants with neuropathic chronic pain were given the doses on three separate test days and asked about their pain scores throughout the study. Researchers found that both microdose groups experienced some short-term reductions in chronic pain.

“Both doses, but not the placebo, demonstrated a significant reduction in pain intensity compared with baseline and remained stable for 150-minutes,” the researchers wrote in the published study. “The 1-mg dose showed a significant pain decrease compared to the placebo.”

Other findings from the study include:

  • No signs of cognitive impairment in either active dose group.
  • Reports of a psychoactive “high” sensation were significantly higher in the 1-mg group compared to the 0.5-mg group.
  • The 1-mg dose used in the trial is about about 5-10x less than what many consider to be the low-end of a psychoactive dose of THC.

“We can concluded from the study results that low doses of cannabis may provide desirable effects while avoiding cognitive debilitations, significantly contributing to daily functioning, quality of life, and safety of the patient,” says Elon Eisenberg, lead research on the project, from the Technion-Israel Institute of Technology. “The doses given in this study, being so low, mandate very high precision in the treatment modality.”

However, the study did have some limitations. The study was conducted and funded primarily by Syqe Medical, which produces the single microdose inhalers used in the trial, but the study was independently peer-reviewed and published. Also, the trial only involved 27 people, so we’ll need more research on a much larger scale before considering this an option for the right chronic pain patient. That being said, it’s certainly an avenue we’ll be keeping an eye on in the coming months and years!

Shared Reading Helpful For Chronic Pain Patients

/ Thomas Cohn, MD

Shared Reading Chronic PainNew research suggests that shared reading may help ease discomfort and provide cognitive benefits for individuals battling chronic pain.

Shared reading, as the researchers defined, was the act of of gathering with others and reading short stories, poetry or other literature out loud. Researchers said by reading literature that triggers memories of experiences throughout life, like happy childhood memories or relationships, patients can experience benefits similar to or that outweigh the effectiveness of cognitive behavioral therapy for chronic pain.

Shared Reading And Chronic Pain

There are hundreds of different treatment options for chronic pain, because chronic pain is unique to the individual. Some people experience pulsing pain in their lower back, others battle waves and waves of headaches, while others have nerve damage that sends pain signals to the brain when their is no painful stimulus present. What works for one person will not always work for another, and unfortunately that’s the problem that many pain sufferers are running in to. In turn, they are looking into alternative options, one of which is shared reading.

For their study, researchers compared the benefits of shared reading to cognitive behavioral therapy, which is a technique that aims to change the way people think and behave in order to better manage physical and mental issues related to chronic pain. To do this, patients with severe chronic pain were asked to participate in either five weeks of CBT or 22 weeks of shared reading. At the conclusion of the five weeks of CBT, individuals in that group joined the shared reading group for the remainder of the 22 weeks. The shared reading sessions incorporated literature that was designed to prompt memories of family, relationship, work experiences or other happy memories throughout their lifetime. Participants were required to report their pain severity and emotions before and after each session, and they were asked to record their pain and emotions twice a day in a personal journal.

Study Results

At the end of the study, researchers wrote:

  • While CBT helped to manage a person’s emotions, shared reading appeared to help patients address the painful emotions that might be contributing to chronic pain.
  • Pain severity and mood improved for up to two days after shared reading sessions.

“Our study indicated that shared reading could potentially be an alternative to CBT in bringing into conscious awareness areas of emotional pain otherwise passively suffered by chronic pain patients,” researchers wrote. “The encouragement of greater confrontation and tolerance of emotional difficulty that sharing reading provides makes it valuable as a longer-term follow-up or adjunct to CBT’s concentration on short-term management of emotion.”

Researchers want to conduct future studies with larger sample sizes, but it’s an interesting approach to treating chronic pain. We’ll certainly keep tabs on shared reading as a potential treatment option.

What Virtual Reality Can Teach Us About Chronic Pain

/ Thomas Cohn, MD

Virtual reality may be the next innovation in the gaming world, but it also may offer real world benefits for chronic pain sufferers.

According to research published in Psychological Science, virtual reality is being used to see how physical and physiological factors impact chronic pain. Researchers say that misrepresenting physical positions through virtual reality can change how someone experiences pain. For example, researchers would outfit patients with a virtual reality device that appeared to show their neck torqued in a position of discomfort to determine how a perceived position impacts brain signals.

Virtual Reality

“Our findings show that the brain does not need danger messages coming from the tissues of the body in order to generate pain in that body part — sensible and reliable cues that predict impending pain are enough to produce the experience of pain,” said researcher G. Moseley of the University of South Australia. “These results suggest a new approach to developing treatments for pain that are based on separating the non-danger messages from the danger messages associated with a movement.”

The Virtual Study

To see how virtual movements impacted chronic pain perception in your brain, researchers recruited 24 chronic pain sufferers whose pain stemmed from several different conditions, including poor posture, tension, repeated strain, trauma and scoliosis. Participants were equipped with a virtual reality head-mounted display and were positioned to prevent excessive torso movement.

Once the headsets were in place, researchers asked participants to rotate their head until they experienced pain. What the participants didn’t know is that their virtual reality devices either:

  • Projected an over-rotated representation of the person’s neck.
  • Projected an under-rotated representation of the person’s neck.

After looking at the data, researchers uncovered that the feedback display had a significant impact on when the participant reported pain. Researchers found:

  • When head rotation was understated, participants rotated their heads about 6 percent farther than normal before reporting pain.
  • When head rotation was overstated, pain-free range of motion was reduced by an average of 7 percent.
  • Intensity of pain did not differ across the various representations.

“We were surprised at how robust and predictable this pattern of results was,” said Moseley. “If cues signaling danger amplify or indeed trigger pain, then these cues present a novel target for therapy.”