What Weather Makes Chronic Pain Worse?

May 20, 2020 / Thomas Cohn, MD

The weather can affect your mood, but can it also affect how pain is expressed and felt in your body? According to new research out of the United Kingdom, certain whether patterns may make your chronic pain condition worse. Below, we take a closer look at what the study uncovered, and we explain why certain weather patterns may lead to a chronic pain flareup.

Chronic Pain and The Weather

To better understand how weather systems affected individuals with pain, researchers from the University of Manchester conducted a 15-month study involving more than 13,000 people living with chronic pain. Patients were asked to record their pain intensity each day with the help of a smartphone app. GPS location data was also used to record the weather data for the individual’s location. Researchers ranked all tracked days, and the most painful days saw 23 percent of participants report an increase in pain, whereas only 10 percent said the same on the days ranked as the least painful days.

Researchers took the 45 highest ranking days for pain and averaged the weather conditions to determine the weather patterns that were present on the days when the most amount of people were in pain. The same was done for the 45 lowest ranking days. Here’s what they found:

On the most painful days, the jet stream was aimed right at the UK, with below-normal pressure over the UK.
On the most painful days, the humidity and precipitation rate were both above-normal.
On the least painful days, there was above-normal pressure over the UK.
On the least painful days, the humidity and precipitation rate were both below-normal, and winds were weaker.

Co-lead researchers Professor David Schultz, Department of Earth and Environmental Sciences at the University of Manchester, and Professor Will Dixon, had this to say about the study:

“Over 2400 years ago, Hippocrates wrote that different wind directions could bring better or worse health to individuals,” said Professor Dixon. “The belief by people living with long-term pain conditions, such as arthritis, that their pain is affected by the weather remains prevalent today, with about 75% of people with chronic pain believing this to be true. Yet, there is disagreement over what weather condition makes their pain worse.”

“Part of the reason for this lack of consensus is that previous researchers have treated the different measures of the weather such as pressure, temperature, humidity separately, which assumes that one could vary the temperature while holding all of the other weather measures fixed,” said Professor Schultz. “Of course, the real atmosphere does not behave like this, as all the variables are changing simultaneously. A simple analysis clearly won’t do to get at understanding how weather affects pain.”

The leading theory is that when low pressure systems arrives, the pressure against your joints drops as well, which can make swelling and inflammation worse. Our bodies then react to this inflammation, which can lead to an increase in pain sensations. It’s far from a concrete science, but this study seems to provide more proof that there is at least a correlation between certain weather conditions and an increase or decrease in chronic pain.

3 Things You Should Do Every Day If You Have Chronic Pain

May 14, 2020 / Thomas Cohn, MD

Navigating your daily life can be difficult if you’re stuck dealing with a chronic pain condition. Between the good days and the rough days, it’s hard to know what each morning is going to bring. However, no matter how hard each day is, it’s imperative that you do a couple of things each day to keep your body and mind moving in the right direction. In today’s blog, we share three things you should do every day if you’re stuck in a constant battle with chronic pain.

Do These Three Things Each Day If You Have Chronic Pain

Now, there’s no perfect recipe for treating chronic pain because it is so unique to the individual, but we’ve found that patients who strive to do these three things every day tend to have more good days than bad when it comes to managing their chronic pain condition.

Each day you should so something for your:

Body – In order to help get your pain under control, you need to take care of your body. Every day you should strive to do something that helps your physical health. Go for a run, or if that’s too difficult, go for a walk around the block. Try to get your blood pumping and strengthen some key muscle groups. A lot of chronic pain conditions respond well to weight loss and stress reduction from muscle improvement, both of which can occur by challenging your body on a physical basis. Make it a point to do something physical outside of your normal daily routine each and every day.

Mind – Chronic pain conditions are not just a physical manifestation. Many pain conditions also have psychological effects as well, and failing to care for your mind can inhibit you ability to achieve physical health improvement. Every day you should do something that challenges your mind and boosts your mental health. Do a crossword puzzle, relax with some meditation or just dive into a book. These activities will take your mind off your physical pain, but it can also help treat physical conditions because of how intertwined your mental and physical health can be. Do something recreational that truly engages your mind each day.

Soul – Finally, do something each day that is unequivocally, 100 percent and totally for you. Do an activity that you are passionate about each day. Take up a woodworking project, play hide and seek with your kids or just do something that makes you happy to be alive. Find what drives you and engage in your passions, and you’ll be amazed what this can do for decreasing and managing your chronic pain condition.

If you do these three things each day while also following your doctor’s recommendations, we’re confident you’ll find yourself in more control of your chronic pain condition. And if you have questions or want help with your personal pain problem, please reach out to Dr. Cohn and his experienced medical staff today.

Could This Experimental Treatment Help Cure Chronic Pain?

May 5, 2020 / Thomas Cohn, MD

University of Copenhagen

New research out of Denmark is showing promise for treating neuropathic pain. According to the team of researchers, they have been focusing on targeting hyper-sensitive nerves that contribute to chronic pain onset. They’ve done this by developing an experimental compound – a peptide called Tat-P4-(C5)2 – that has proved effective in treating similar pain in mice.

“We have developed a new way to treat chronic pain. It is a targeted treatment. That is, it does not affect the general neuronal signaling, but only affects the nerve changes that are caused by the disease,” says Kenneth Lindegaard Madsen, PhD, Associate Professor at the University of Copenhagen.

“We have been working on this for more than ten years. We have taken the process all the way from understanding the biology, inventing and designing the compound to describing how it works in animals, affects their behavior and removes the pain,” said Madsen.

How The Peptide Works

The image on this blog shows the Tat-P4-(C5)2 compound after it is injected into the spinal cord. The compound (purple) begins by penetrating the nerve cells of the spinal cord (yellow), but not the surrounding cells (cell nuclei can be seen in blue). The compound works by blocking neuropathic pain signals like the kind that are seen in patients dealing with diabetic neuropathy, CRPS or phantom limb pain. The team has been pleased with how successful the treatment has been in mice.

“The compound works very efficiently, and we do not see any side effects. We can administer this peptide and obtain complete pain relief in the mouse model we have used, without the lethargic effect that characterizes existing pain-relieving drugs,” said Madsen. “Now, our next step is to work towards testing the treatment on people. The goal, for us, is to develop a drug, therefore the plan is to establish a biotech company as soon as possible so we can focus on this.”

Aside from simply working to block pain signals from being interpreted by the brain, researchers believe a peptide-focused treatment may become the norm for a variety of pain conditions in the future because it can perform the same task as painkillers without the risk of addiction or dependence. Our bodies naturally build up a tolerance to traditional painkillers, and as dosage increases so too does the risk of dependence and overdose. But with peptide intervention, we can block pain signals without the need for potentially dangerous painkillers.

It’s far from a miracle cure, and even if it’s proven successful in a human trial it should be paired with other healthy habits like regular exercise and dietary improvements, but it certainly gives us hope for the future of pain care. We’ll keep our eyes on this research as it moves to the next stage of trial. In the meantime, if you need help with a chronic pain issue, let us help you. Contact Dr. Cohn’s office today for more information.

The Differences In Treating Acute Vs. Chronic Pain

April 28, 2020 / Thomas Cohn, MD

Everyone experiences pain differently, and depending on the type of pain you’re suffering from, it will generally be categorized into one of two groups – acute pain and chronic pain. Acute pain is the most common type of pain, and it is typically the result of trauma. For example, if you stub your toe on the kitchen table, you’ll be feeling acute pain in your toe. Conversely, chronic pain is a type of pain that is persistent or that lasts for longer than three months. Chronic pain can develop out of acute pain, or it can develop for another reason. For example, if that same stubbed toe led to nerve damage that never healed properly, you may suffer from chronic toe pain.

Although these two types of pain are often intertwined and related, they typically need to be treated in slightly different manners. Below, we take a closer look at some of the different ways acute and chronic pain are managed.

Treating Acute Pain

We treat both types of pain at our clinic, but acute pain tends to be treated more commonly in hospitals and emergency departments. Fractures, sprains, bruises and cuts are all common forms of acute pain that result from trauma or physical injury. Although treatment should be individualized to the patient, minor to mild acute pain is often treated with conservative options like:

Rest
Anti-inflammatory medications
Pain-relieving medications
Elevation
Compression
Hot or cold therapy
Casting

For more severe forms of acute pain, options like manual therapy, physical therapy or surgery may be recommended. Most providers will recommend that you try six weeks of conservative therapy before you pursue surgery, although certain acute injuries may require more immediate surgical intervention.

Treating Chronic Pain

Treating chronic pain is a little more difficult than acute pain, because it’s not always obvious what’s causing the pain. When you stub your toe, it’s easy to hone in on suspected problems. However, if you’ve been feeling mild discomfort in your spine for the last few months and it’s progressively gotten worse, there are a number of different issues that could be contributing to your pain. Because of this, the most important aspect to developing a successful chronic pain treatment plan is to determine the underlying cause of pain.

With the help of a physical exam, movement screens and imaging tests, a chronic pain specialist can help pinpoint exactly what’s going on in your body. From there, a treatment course is charted.

Many of the same treatment options for acute pain can be applied to chronic pain, but treatment tends to focus on more of the active treatments instead of passive options like rest and medications. While those aspects can play a key role in your recovery, chronic pain oftentimes responds better to treatments like:

Physical Therapy
Exercise
Stretching Techniques
Posture Awareness and Education
Weight Loss and Improve Diet

You’re also more likely to need to adjust your treatment strategy when trying to rid yourself of chronic pain, so take note of what’s working and what’s not working and discuss these options with your doctor. Don’t just keep trying certain treatments if they aren’t producing results, because odds are a few simple adjustments can greatly reduce your pain.

For more information about either type of pain, or for help with your pain, reach out to Dr. Cohn’s office today.

COVID-19 and Chronic Pain

April 20, 2020April 20, 2020 / Thomas Cohn, MD

Covid-19 has become a deadly pandemic across the world, and it is likely that almost no place on earth will go untouched. It is not a hoax, and for many the threat is very real. Projections suggest that somewhere around 60 percent or more of the population will become infected over the next several months, and 80 percent of these infections will be mild. However, if one has another significant medical problem, than they may be at risk for a complication and become seriously ill or require hospitalization. Those who have one of many medical problems that cause pain often have conditions like diabetes, cardiovascular disease, lung disease or are elderly and at a high risk for Covid-19, however pain itself does not increase risks of the virus. Currently, becoming ill with Covid-19 is like playing Russian Roulette, as there is between 1-4 percent chance if you get become sick it will kill you.

If you have a pain condition, in general one needs to continue working on safe management and try to avoid anything that would increase your risk for infection. First and most importantly, chronic pain does not kill you and is not an emergency problem. Chronic pain is a management problem and there are usually multiple options in treatment. Sometimes a temporary solution is safer than a more definitive option. Sometimes the best treatment may be unavailable due to medical restrictions on procedures like injections or surgery. Fortunately, usually an adequate and temporary plan can be implemented until a better solution is available. There also is a fair likelihood that your pain still may feel intense and that you wish control would be better, but it’s something we have to deal with amid the pandemic.

Managing Chronic Pain During The Pandemic

There are things that one can do to make the pain better. First, it is important to realize that pain is a cognitive/emotional experience and a response to sensory inputs to the brain. Pain is the perception of the sensory signals from various nerves. A soldier in the heat of battle often will not feel a serious injury while someone sitting at home with nothing to do will feel horrible sensations since the brain is not occupied by other thoughts. Therefore, the busier the mind is, the less it can think about distressing thoughts. Distract the brain and keep it busy with positive thoughts, work or even television.

The second thing that helps pain is keeping physically active and healthy. Most activities will not make chronic symptoms worse. Continue to exercise, as it is important to maintain a good stretching, strengthening and general conditioning program. Stretching keeps muscles from tightening up, feeling like bands and spasming. Strengthening keeps muscle able to have the power to perform activities. Aerobic conditioning allows muscle to have the endurance to perform activities, increases your own endorphins that reduce pain and overall helps to relax the body and mind. Activity fights off deterioration of the body.

The third thing to do is maintain an overall healthy lifestyle. Try to improve your diet such that you are not gaining weight and stressing the body. If possible, improve your diet, consider healthy choices like fruits, vegetables, diary and meats and learn to cook while staying away from highly-processed foods and excess carbohydrates. Keep your diet sustainable and something that you can afford and enjoy. If you are ambitious, try an inflammatory diet or a Mediterranean diet. On top of diet, sleeping an adequate amount is necessary. Turn off your electronic devices an hour before bed and relax the brain. Try clearing your thoughts with mindfulness, meditation or relaxation. There are many phone and computer applications that can help with relaxation. Sometimes, having professional psychological help is even beneficial. Good sleep and less stress help maintain or boost the immune system.

If you have pain, there are many ways to treat it. Now with the Covid-19 virus and the medical and social precautions being taken to prevent spread, some of the options for treatment are not available. The coronavirus may not be affecting you at the moment, but the risk of infections at this time and the possible risk of even death due to your actions is very real. One can be a spreader of the disease without symptoms, and medical workers have a very high incidence of the disease. Further, many medical procedures such as injections use up valuable protective equipment that really is needed for hospitals and senior living centers where there are not adequate supplies. At this time, pain can be treated for the short term with other options besides injections and elective surgery in most cases. If the procedure is not essential to prevent loss of life or limb, currently it can be postponed until the medical system is past the critical time of Covid-19 spread.