The Updated Guidelines For Treating Children With Chronic Pain

February 18, 2021 / Thomas Cohn, MD

We often visualize chronic pain as a condition that only affects older individuals who have suffered a traumatic injury or whose bodies have been exposed to decades of stress and degeneration. While those groups do make up the majority of the people we treat for chronic pain, they are far from the only groups we help.

Another group that accounts for millions of cases of chronic pain throughout the United States is children. These cases can be much more complex, because oftentimes it’s not normal wear and tear that has caused their chronic condition. It can be caused by a number of other factors, like significant injury, genetic and growth plate defects, or a combination of psycho-social issues.

To continue to help provide the best care to children with chronic pain, the World Health Organization recently updated their 10 best practices for treating children with chronic pain. We take a look at the new recommendations and offer our insights in today’s blog.

10 Best Practices For Treating Chronic Pain In Children

According to the World Health Organization, here are the 10 best ways that chronic pain physicians can manage and treat the condition in children:

Children with chronic pain and their families and caregivers must be cared for from a biopsychosocial perspective; pain should not be treated simply as a biomedical problem.
The biopsychosocial model of pain recognizes pain as a complex multidimensional experience that is the result of interaction among biological, psychological and social factors. Pain management thus requires a multimodal, interdisciplinary and integrated approach.
A comprehensive biopsychosocial assessment is essential to inform pain management and planning. As a component of this assessment, healthcare providers should use age-, context- and culturally appropriate tools to screen for, and monitor, pain intensity and its impact on the quality of life of the child and family.
Children with chronic pain must have a thorough evaluation of any underlying conditions and access to appropriate treatment for those conditions, in addition to appropriate interventions for the management of pain.
Children presenting with chronic pain should be assessed by healthcare providers who are skilled and experienced in the evaluation, diagnosis and management of chronic pain.
Management, whether with physical therapies, psychological or pharmacological interventions, or combinations thereof, should be tailored to the child’s health; underlying condition; developmental age; physical, language and cognitive abilities; and social and emotional needs.
Care of children with chronic pain should be child- and family-centered. That is, the child’s care should focus on family values, cultural preferences and resources available.8. Families and caregivers must receive timely and accurate information. Shared decision-making and clear communication are essential to good clinical care. Communication with patients should correspond to their cognitive, development, and language abilities.
The child and their family and caregivers should be treated in a comprehensive and integrated manner: all aspects of the child’s development and well-being must be attended to, including their cognitive, emotional and physical health. Moreover, the child’s educational, cultural and social needs and goals must be addressed as part of the care management plan.
In children with chronic pain, an interdisciplinary, multi-modal approach should be adopted which is tailored to the needs and desires of the child, family and caregivers, and to available resources. The biopsychosocial model of pain supports the use of multiple modalities to address the management of chronic pain.

To sum up these recommendations, a pain management specialist who is familiar with chronic pain in children needs to be able to assess the physical and social constructs that go into the expression of a pain condition. From there, the specialist needs to be able to effectively communicate with both the child and their families and provide solutions and ideas tailored to each, taking into account their age, education level, values, cultural needs and access to certain types of care. Pain management needs to be an ever-changing collaboration between the patient, the physician, their family and their care team.

Needless to say, treating chronic pain conditions in children is a tall task, and one that you need to trust to just the right physician. You need a physician who is going to put in the time and the effort needed to help treat the underlying cause, not just alleviate the symptoms. It’s hard work, but it’s arguably the most rewarding work in our field when you can help put an end to a child’s pain. Dr. Cohn has extensive experience doing this for children with a range of chronic pain conditions, and he’d like to help your child find a solution to their pain.

For more information, or for assistance in treating your child’s pain condition, reach out to Dr. Cohn’s office today.

How Artificial Intelligence Could Replace The Pain Scale

February 4, 2021 / Thomas Cohn, MD

For anyone who has suffered from chronic pain or has been treated for a pain-related condition, you may remember being asked to rank your pain on a scale of 1-10. While this 10-point pain scale has become the standard for many pain management specialists across the US, it’s far from a perfect model.

Because unlike a blood pressure cuff that can give an objective result like 120 over 80, the 10-point pain scale is subjective in nature. What may feel like a 4 to one patient may be a 7 for another. For this reason, it’s often tough for pain specialists to gauge a person’s pain level and how to best help treat them.

However, artificial intelligence may soon be able to assist in how we quantify the subjective measure of pain. According to scientists at IBM and Boston Scientific, artificial intelligence may be able to capture pain sensation readings and allow them to be interpreted with a more objective model.

Artificial Intelligence And Chronic Pain

For their experiment, researchers used activity monitoring devices in order to capture and analyze biometric data that can correspond to the perception of pain. Researchers used biomarkers collected in clinical studies involving patients undergoing spinal cord stimulation. This included things like movement data, sleep data, heart rate levels and even voice recordings. Then artificial intelligence was employed to sift through all the results in hopes of identifying patterns that may allow a doctor to “read” a patient’s pain levels through data instead of using the 1-10 pain scale.

“We want to use all the tools of predictive analytics and get to the point where we can predict where people’s pain is going to be in the future, with enough time to give doctors the chance to intervene,” said Jeff Rogers, senior manager for digital health at IBM Research.

The research is still in its infancy, but scientists are encouraged by early results. However, it’s going to take tens of millions of data points in order to come up with anything close to resembling the readable pain scale they hope for. If all continues to go as hoped, researchers believe it could lead to the development of medical devices that can not only accurately forecast a person’s pain, but also spot the early signs of a flare up so patients can take steps to stay ahead of their pain. It’s a lofty goal, but it could be a gamechanger for millions of Americans who battle chronic pain on a daily basis. We’ll keep tabs on its progress over the coming months and years and provide any updates as they are released.

The Three Components To Successfully Conquering Chronic Pain

January 26, 2021 / Thomas Cohn, MD

Conquering chronic pain is a daily battle, and it’s not something that is always easy to handle. In fact, if you don’t have the right support systems or partners by your side, it can be very difficult to overcome a chronic pain condition. In our experience, we’ve found that people who have three specific components during their chronic pain treatment have a higher likelihood of success. In today’s blog, we take a closer look at the three components to successfully conquering a chronic pain condition.

Three Pillars To Conquering Chronic Pain

The triangle is the strongest shape in nature, so if you view these three key components as parts of a triangle, it can help you visual how they can help make up the foundation for chronic pain treatment. Here are the three key components for successfully conquering chronic pain.

Yourself – Successfully managing a chronic pain condition begins with yourself. Not only do you need to want to get better, you have to actively work towards achieving it. Wanting it without taking tangible steps to reach this goal isn’t going to be effective. There’s no magic pill you can take to solve your chronic pain, it’s going to take active modalities like exercise, physical therapy and stretching techniques. Understanding this, and taking ownership of your role in managing your chronic pain condition will help you move the needle in the right direction each day. Educate yourself, commit to treatment and lean on others when you find yourself struggling in order to do your part to overcome chronic pain.

Your Doctor – Finding a pain management specialist who understands your condition, who really listens to your concerns and who won’t stop until they’ve helped solve your pain is another key component to chronic pain management. There are plenty of doctors who will prescribe pain medications and help treat the symptoms of your condition, but those won’t help you on a long-term basis. You need to find a doctor who works hard to diagnose the root problem and develop a treatment plan suited to your individual needs. They also need to be willing to reevaluate the patient and update their treatment recommendations as things change, because chronic pain is a complex issue that can change over time. If you’re not satisfied with your professional pain care, reach out to Dr. Cohn’s office and see what it’s like to work with a pain specialist who is committed to seeing the problem through.

Your Support System – Finally, it’s important to have a support system in place when things get difficult. This could be in the form of family, friends or an online support group. Some people enjoy confiding in those who are close to them, while others feel like they don’t want to be a burden and don’t want to lay their problems on people who can’t relate. Find what works for you and really work to find a support system that can help you when things aren’t going great. You’ll have bad days, but having a good support system in place can make it easier to bounce back and string together more good days than bad. If you need help developing a support system, talk to your pain specialist about online or in-person support groups, or open up to family members. And don’t be afraid to be a support system for others in your life who are going through their own issues, be it divorce, a health issue or some other problem. Lean on others, and be a rock for others who need support, and you’ll find it easier to manage your chronic pain condition.

For more information or for help with your chronic pain condition, reach out to Dr. Cohn’s office today.

The Long Term Consequences Of Untreated Chronic Pain

January 18, 2021 / Thomas Cohn, MD

Chronic pain is something we’d rather not think about or deal with, but constantly trying to ignore your pain can lead to some unintended long term consequences. Left untreated, a chronic pain condition can lead to a decreased quality of life in a number of different ways. In today’s blog, we take a closer look at some of the potential long term consequences of untreated chronic pain.

Why You Need To Treat Your Chronic Pain

Here’s a look at five potential consequences of trying to power through a chronic pain condition without intervention.

1. More Pain – The most obvious potential pitfall of ignoring your pain condition is that you may be welcoming more widespread or intense pain. Sometimes your lifestyle has made your chronic pain condition worse, so if you keep doing the same things, it can lead to worsening pain. If your posture or work habits have led to chronic pain onset, and you don’t do anything to address it, odds are pain and dysfunction will only get worse.

2. Poor Sleep Quality – Chronic pain can affect our ability to get restful sleep, and if you don’t work to rectify the problem, you can string together weeks, months or years of less-than-ideal sleep. Over time this poor sleep quality can have plenty of physical consequences for your health. It can increase pain perception, contribute to a more sedentary lifestyle and increase your risk of future cognitive decline. Don’t string together long stretches of poor sleep quality because you didn’t treat your chronic pain condition.

3. Harder To Treat – While oftentimes not as serious as cancer, chronic pain conditions function much like a cancer diagnosis in that intervention techniques tend to have a higher rate of success when the condition is caught early and treatment begins sooner. The more damage caused by untreated chronic pain, the harder it is to successfully and fully treat the issue.

4. Poorer Cardiovascular Health – Studies have also shown that untreated chronic pain can actually have negative effects on your heart health. More specifically, chronic pain can decrease activity levels and increase stress, both of which can lead to a rise in your blood pressure. Over time, an elevated blood pressure level can leave you at risk for complications related to the condition, like coronary heart disease and even heart failure.

5. Decreased Quality of Life – All the above factors can play a role in the onset of the final factor, which is a decreased overall quality of life. Chronic pain affects our life in a myriad of ways, and added together they can all serve to make life a little less enjoyable. This gradual decline will only continue unless you take tangible steps to take control over your chronic pain condition, and Dr. Cohn and his team can help you do just that. For more information or for help with your chronic pain condition, reach out to his clinic today.

Withdrawal Symptoms Common In Chronic Pain Patients Using Medical Marijuana

January 13, 2021 / Thomas Cohn, MD

As we’ve said on the blog in the past, we’re a proponent of helping patients find a treatment plan that works to help prevent or control their unique chronic pain condition. For many individuals, medical marijuana plays a key role in their treatment, but it’s far from a perfect solution. As we’ve also said on the blog in the past, we want more studies to be conducted on medical cannabis so that we can begin to unwrap this complex component. A recent study did just that, and they found a potentially concerning side effect associated with its use for chronic pain patients.

According to a new study, more than half of all patients who used medical marijuana to help treat a chronic pain condition experienced withdrawal symptoms during even short consumption breaks. There have been documented studies that suggest among recreational users, with about 40 percent experiencing some sort of withdrawal symptoms when not using, but this study took a closer look at these effects on medical marijuana users. Withdrawal symptoms aren’t expressly projected as a user’s yearning for their next dosage, rather, these symptoms can manifest in a number of different ways that affect a person’s health. For example, withdrawal symptoms can affect a person’s sleep, mood, mental state, energy and appetite, and these issues are manifesting in roughly half of medical marijuana users.

Withdrawal Symptoms And Chronic Pain

For this study, researchers polled more than 520 individuals using medical marijuana to treat non-cancer-related chronic pain issues. They were asked if they experienced any of the symptoms after not using for a significant time: Craving for cannabis, anxiety, sleep difficulties, decreased appetite, restlessness, depressed mood, aggression, irritability, nausea, sweating, headache, stomach pain, strange dreams, increased anger and shakiness.

At baseline, 41 percent of people were classified in the mild withdrawal symptom group, 34 percent were in the moderate group, and 25 percent were in the severe group. Additionally, 13 percent of participants saw their withdrawal symptoms rise to the next level by the end of the first year of treatment, and eight percent transitioned upwards by the end of two years.

Interestingly, regardless of the group they were in, sleep problems were the most common symptom. And as we’ve said on the blog, inadequate sleep can have significant effects on your chronic pain condition. Poor sleep quality can worsen pain symptoms, so while some of these withdrawal symptoms may not seem all that bad, they can actually be making your pain condition worse.

At the end of the day, while they are two different treatment paths, a medical marijuana program needs to be implemented much like an opioid regimen for pain. A comprehensive patient profile needs to be developed, the patient needs access to educational material to ensure they understand the potential risks associated with the treatment, and regular checks need to be conducted along the way to ensure everything stays on track. If withdrawal symptoms or other issues are present, specific interventions need to be developed, because it’s unlikely that the problems will go away on their own. In fact, they oftentimes get worse.

So while medical marijuana can be a great addition to a chronic pain treatment plan, we doctors and patients need to be aware of the potential pitfalls to successful treatment so that they can be avoided and managed. If you’re dealing with a chronic pain condition and want help with treatment, reach out to Dr. Cohn and his experienced medical team for more information.