Diversification Key To Effective Chronic Pain Management

February 22, 2024 / Thomas Cohn, MD

They 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.

Why Posture Problems And Chronic Pain Are Often Linked

February 15, 2024 / Thomas Cohn, MD

Chronic pain conditions can be caused and exacerbated by a variety of factors, but one common culprit that is often overlooked is a person’s posture. If you have bad seated or standing posture, it changes how stress is dispersed on your whole body. It can put additional pressure on certain areas like your lower back or neck, speeding up natural degeneration and contributing to chronic pain in these areas.

And while the problem of poor posture is obvious from a provider side, it’s oftentimes overlooked by patients. A recent study by Orlando Health found that only 47 percent of survey respondents were concerned about poor posture and its impact on their health. This is especially concerning when you consider just how frequently the average person puts their spine in an less than ideal position.

Depending on which survey you’re looking at, you’ll find that the average American spends anywhere from 2-4 hours a day on their cell phone, and much of this time involves craning their head and neck forward to look at a smartphone in their lap. If they work a desk job, it only gets worse, as they likely aren’t in a perfect spinal alignment for the 8+ hours they spend at the office. That means that for some people, their spine is in a less than ideal position for more than half of the day.

How Poor Posture Triggers Chronic Pain

Poor posture can trigger chronic pain in a variety of ways. We already touched on one above, which is that poor posture changes how stress is dispersed in your body. When your neck and back have to handle additional stress because you are out of a healthy alignment, discs can wear down faster and irritate nearby nerves. Nerve pain is a common underlying cause for a number of chronic pain sufferers, and it can oftentimes be traced back to poor posture.

Bad posture habits can also contribute to chronic discomfort in the form of frequent headaches. When you’re out of alignment, the muscles and soft tissues in your neck have to work harder to support your head. These muscles are constantly tensed trying to support this additional stress, and this muscle tension can trigger migraines or the aptly named tension headache. Chronic headache sufferers may notice a major improvement in symptoms by improving their diet and their posture habits.

Poor posture also means that inflammation is more likely to develop in certain areas of your body. An inflammatory response is your body’s natural reaction to stress and trauma, so inflammation can develop if certain areas are constantly being overstressed because your spine is out of alignment. Inflamed tissues can irritate nearby nerves and structures, making movement painful and triggering a chronic pain flareup.

We live in a world where it is easy to fall into bad posture habits. Laptops, smartphones and other electronic devices have us constantly looking down or in a hunched seated position, and if we’re not careful, we can end up overloading different areas of our spine. Over time, this contributes to tissue degeneration, muscle tension and inflammation, all of which can serve to make chronic pain problems worse. We’re not saying that improving your posture will address all of your chronic pain issues overnight, but bad posture can oftentimes stifle your progress and cause chronic pain to linger. If you improve your posture, adjust your diet and get more regular exercise, we’re confident that you will be providing your body with the right environment to overcome your pain condition.

To learn more about the connection between your posture and chronic pain conditions, or to talk to a specialist about a pain issue you’re experiencing, reach out to Dr. Cohn and his team today at (952) 738-4580.

Could Non-Invasive Brain Procedure Help Solve Chronic Pain?

February 8, 2024 / Thomas Cohn, MD

Researchers out of Virginia Tech are exploring the possibility of using targeted soundwaves to put an end to chronic pain sensations.

According to the research published in the journal PAIN on Feb. 5, researchers believe that low-intensity soundwaves aimed at a place deep in the brain called the insula could positively impact the perception of pain as well as some of the bodily effects of chronic pain, like heart rate variability.

““This is a proof-of-principle study,” said study lead author Wynn Legon, an assistant professor at the Fralin Biolmedical Research Institute at Virginia Tech. “Can we get the focused ultrasound energy to that part of the brain and does it do anything? Does it change the body’s reaction to a painful stimulus to reduce your perception of pain?”

Harnessing Ultrasound Technology

Ultrasound technology is commonly associated with the ability to view a baby inside a mother’s womb, but it has plenty of other helpful medical uses. High intensity ultrasound can ablate tissues, while low intensity soundwaves can alter electrical activity within a nerve. The latter was the idea behind Legon’s latest study.

For the study involving 23 patients, researchers applied heat to the back of their hands to induce discomfort. At the same time, a wearable headpiece delivered focused ultrasound waves to a specific spot in their brain that was guided by magnetic resonance imaging. Participants were asked to rate their pain perception during each application from zero to nine. At the same time, researchers monitored a person’s heart and heart rate variability, which can help to interpret the body’s reaction to painful stimulus.

When the soundwaves were administered, participants reported an average reduction in pain of three-fourths of a point.

“That might seem like a small amount, but once you get to a full point, it verges on being clinically meaningful,” said Legon. “It could make a significant difference in quality of life, or being able to manage chronic pain with over-the-counter medicines instead of prescription opioids.”

The study also found that the ultrasound application reduced the measured physical responses to the stress of pain – heart rate and heart rate variability.

“Your heart is not a metronome. The time between your heart beats is irregular, and that’s a good thing,” Legon said. “Increasing the body’s ability to deal with and respond to pain may be an important means of reducing disease burden.”

Although the research is in its infancy, it presents a new angle for tackling the issue of chronic pain. Hopefully future studies will find similar results, as a non-invasive and non-addictive treatment is the ideal answer to the problem of chronic pain.

For now, if you’re looking for a more traditional way to overcome your chronic pain condition, sync up with Dr. Cohn and his team. For more information, or for help with a specific chronic pain issue, reach out to Dr. Cohn’s office today at (952) 738-4580.

Chronic Pain’s Impact On Your Heart

January 18, 2024 / Thomas Cohn, MD

It should come as no surprise that a chronic pain condition can have repercussions for other areas of your body, but it can also cause problems for a very vital part of your body – your heart. In today’s blog, we take a closer look at how an unmanaged pain condition can make life more difficult for your heart.

Chronic Pain And Your Heart

When you’re dealing with pain signals, the area of your brain called the amygdala is more active. When your amygdala is active, it triggers something known as the hypothalamic-pituitary-adrenocortical axis (HPA axis for short). Your HPA axis releases a number of hormones throughout your body, like adrenaline, cortisol and noradenraline. Your body knows how to respond to the presence of these hormones, but problems develop when your body is exposed to an unrelenting release of these hormones as a result of your chronic pain. Essentially, chronic pain causes your amygdala and HPA axis to go into overdrive, leading to excess hormone production which can be harmful to certain bodily systems, inducing your heart. Research has found that hyperamygdalar activity has been linked to an increased risk or arterial (heart) inflammation.

There is also an established connection between pain and your heart rate. Research has found that heart rate variability can occur as a response to painful stimuli, and over time an extended period of time, this can increase your risk of heart arrhythmia. Working to calm your pain condition can also help to normalize your heart rate and take stress off the vital organ.

Chronic pain has also been linked to issues with blood pressure, which too impacts your heart health. Acute pain has been linked to a short-term increase in blood pressure, but chronic pain sensations can affect your body’s ability to regulate its blood pressure. Chronic pain can impair your cardiovascular and analgesia systems, which can increase your risk of long-term elevated blood pressure, which only stresses your heart further.

Finally, chronic pain has been connected to an increased risk of a myocardial infarction, or heart attack. Not only are you at a greater risk of heart attack if you have an elevated heart rate and blood pressure, but certain medications used to mange your chronic pain may too increase your risk of a heart attack. One study followed 17,614 people who were using pain relievers for at least three months to treat their chronic pain condition. When compared to a control group, researchers found that the patients taking long-term pain relievers were 20 percent more likely to suffer a heart attack (and 30 percent more likely to suffer a stroke).

And while we’re still learning more about the connection between chronic pain and your heart health, it’s clear that unmanaged chronic pain can have a significant impact on your overall heart health. Fortunately, treating the underlying chronic pain condition can also help to improve your heart health, which is just another reason why you shouldn’t just succumb to a life with chronic pain.

If you want to take care of your heart health, strive to take more control over your chronic pain condition this year. For professional help achieving this, reach out to Dr. Cohn and his team today at (952) 738-4580.

Chronic Pain Incredibly Common Among TBI Survivors

January 4, 2024 / Thomas Cohn, MD

New research shows that upwards of 60 percent of people living with a traumatic brain injury are affected by a chronic pain condition.

The study found that chronic pain affects a large portion of TBI survivors, even up to 30 years after their initial head injury. The research was published in The Journal of Head Trauma Rehabilitation, and it involved over 3,800 respondents who had previously been hospitalized with a moderate to severe TBI. Most respondents were white (77%) and male (75%), with an average recovery time since injury of five years (between 1-30 years).

For the study, researchers surveyed participants about their head injury and other current health issues they are facing, like chronic pain, which was defined as “persistent or recurring pain that lasts longer than three months, including headaches or pain anywhere in the body, which occurs more than half of the days over a three-month period.”

Study Results

After looking at the data, researchers uncovered some concerning statistics about the connection between TBIs and chronic pain onset. They found:

46 percent said they were currently living with a chronic pain condition.
14 percent said they previously dealt with a chronic pain condition.
40 percent reported no chronic pain symptoms now or since their TBI.
32.5 percent of participants with a current chronic pain condition reported constant pain.
Compared to those with no chronic pain, patients with a current chronic pain condition had severely worse scores on three outcomes measured in the survey – the Functional Independence Measure, the Disability Rating Scale and the Glasgow Outscore Scale.

Another concerning finding from the survey was that medications were the most common form of chronic pain treatment. Medications were used by more than 91 percent of patients with a current chronic pain condition and by 90 percent of patients with a past chronic pain condition. As we’ve always said, it’s not that medications aren’t an effective part of a comprehensive treatment plan, but they cannot be your main or only form of treatment. You need to pursue active interventions, like exercise, diet, weight loss, cognitive behavioral therapy or relaxation/deep breathing techniques in order to get the most out of any medication regimen.

The study stopped short of explaining the specific connection between head trauma and chronic pain onset, but it stands to reason that damage in the brain can affect nerve relays throughout our body. Nerve damage can cause our pain signals to be fired when no painful stimuli is felt, or it can cause your brain to interpret a normal sensation as a painful one. It should come as no surprise that patients with a moderate to severe head injury ended up having some neural connection issues even long after the trauma. It speaks to the importance of working to overcome the totality of the TBI so that symptoms don’t manifest later down the road.

If you’re struggling with chronic pain and believe it may be tied to a previous head injury, reach out to a pain specialist in your area like Dr. Cohn. We can work to pinpoint the source of your chronic pain issue and get you set up on the road to recovery. It’s never too late to take the first step towards less chronic pain. For more information, or for help with a different pain issue, reach out to Dr. Cohn and his team today at (952) 738-4580.