Millions Battling Chronic Pain And Concurrent Mental Health Condition

October 5, 2023 / Thomas Cohn, MD

New research from the University of Arizona Health Sciences and published in the journal PAIN found that nearly five million Americans experienced the co-occurrence of chronic pain and a mental health condition like anxiety or depression, leading to functional limitations in their daily life.

As we’ve mentioned on the blog in the past, it’s not uncommon for chronic pain and a mental health condition to develop alongside one another because chronic pain can have a significant effect on your physical, mental and emotional health. If you are forced to miss social events, your career aspirations are limited or you simply find it hard to pull yourself out of bed in the morning because of physical pain, your mental health will also take a hit. For some, that manifests in the form of anxiety or depression.

In a review of data from 31,997 people who participated in the National Health Interview Survey, researchers found that that roughly 38.1 million Americans are dealing with a chronic pain condition, 9.6 million are dealing with a diagnosed mental health condition, and 4.9 million are dealing with co-occurring chronic pain and a mental health condition. Additionally, adults with chronic pain were roughly five times more likely to report anxiety or depression compared to adults without chronic pain.

“The study’s findings highlight an underappreciated population and health care need – the interdependency between mental health and chronic pain,” said the paper’s lead author Jennifer S. De La Rosa, PhD, director of strategy for the University of Arizona Health Sciences Comprehensive Pain and Addiction Center, which funded the study. ”This work is so exciting because it offers the opportunity to use team-based interdisciplinary approaches to medicine, leveraging what is known across disciplines to meet the needs of these individuals.”

Chronic Pain And Mental Health Conditions

Other important findings from the study include:

Nearly 70 percent of people with co-occurring symptoms reported limitations at work.
More than 55 percent of people with co-occurring symptoms reported difficulty taking part in social events
Nearly 44 percent of people with co-occurring symptoms said they had difficulty running errands alone
Among all U.S. adults living with unremitted anxiety or depression, the majority (55.6%) are people who also have chronic pain.

This study only further emphasizes the idea that you can’t simply focus on treating the physical aspects of a chronic pain condition. Pain weighs heavy on your mind, and if you’re only focused on the physical pain, you may find that your mental health is suffering.

Even if you don’t believe your mental health has been affected by a chronic pain, you need to be aware that you’re at a higher risk of certain mental health disorders. You need to trust your care to a provider who will give you the comprehensive care you need to tackle all aspects of your chronic pain condition. Dr. Cohn and his team have done that for years for other patients, and we’d be more than happy to put our experience to work for you. For more information, or for help with a different chronic issue, reach out to Dr. Cohn and his team today at (952) 738-4580.

Chronic Pain More Common Than Diabetes And Depression

May 19, 2023 / Thomas Cohn, MD

New data from the National Institutes of Health found that new cases of chronic pain are being reported at higher rates than diabetes, depression and high blood pressure.

The research, based on data from an annual survey form the Centers for Disease Control and Prevention, surveyed adults on how often they experienced pain in the previous three months. In the survey, chronic pain was defined as having pain on most days or every day over that three-month period. The results were then compared to the responses of more than 10,000 respondents in 2019 and 2020. Researchers then worked to determine the rate of new cases that developed over that period using a metric called person-years, which took into account the number of people in the study and the amount of time between survey responses.

An analysis of the data found that new chronic pain cases were developing at an alarming rate. Researchers found that there 52 new cases of chronic pain per 1,000 person-years, which outpaced the rate of new cases of high blood pressure (45 new cases per 1,000 person-years). The chronic pain rate was also far higher than the new case rate of depression and diabetes. The team also noted that of those without any pain in 2019, 6.3 percent reported new chronic pain in 2020.

“What we’re finding is, to nobody’s surprise, we have an astounding problem of pre-existing chronic pain in this country and a huge amount of people who are developing chronic pain as each year goes by,” said Dr. Sean Mackey, chief of pain medicine at Stanford University School of Medicine, who wasn’t involved in the research.

Concerning Data On Chronic Pain

High blood pressure is still more prevalent, but chronic pain is closing the gap as new cases outpace hypertension. Data shows that around 48 percent of adults had high blood pressure between 2017 and 2020, while 21 percent of the more than 10,000 surveyed adults reported chronic pain. That outpaces the 19 percent of U.S. adults with depression, and the rates of diabetes, heart disease and asthma, which all sit under 10 percent.

So while high blood pressure may still be a greater threat to the nation as a whole, the findings on chronic pain should be eye opening on a national level. It is great to see that this study is getting attention from large outlets like The New York Times, USA Today and NBC News, but covering the issue is only part of the puzzle. We also need to commit a lot more funding to treatment-focused studies. Understanding that chronic pain is a problem is helpful, but now that the national burden is under the spotlight, we need to put resources towards improving our understanding of how to best treat this highly individualized condition.

Another silver lining to take away from this study is the knowledge that if you are suffering from chronic pain, you certainly aren’t alone. More new cases are being diagnosed than many other serious conditions, and while that’s not great news in and of itself, it does mean that it should be easier to connect with others and with doctors who are familiar with your plight.

If you have questions about chronic pain or a condition that you’re battling, let us be a resource. Reach out to Dr. Cohn and his team today at (952) 738-4580.

How To Handle The Holidays, Chronic Pain And Depression

December 9, 2021 / Thomas Cohn, MD

The holiday season is upon us, and while some people look forward to this time of year, others dread having to navigate the holidays if they are dealing with chronic pain and depression. As we’ve talked about on the blog in the past, there is a strong link between chronic pain and an increased risk of mental health conditions like depression and anxiety, and both chronic pain and your mental health can get worse during the holiday season for a host of reasons.

Maybe family issues take the spotlight this time of year, you’re dealing with the financial stress that the holidays can bring, or you’re worried that seasonal affective disorder brought on by the colder and darker days could further complicate your mental health. These are all real threats to your mental health that countless people deal with during the holidays. And while it may not make you feel a lot better that others are going through something similar, there are ways to combat chronic pain and depression during the holidays. We share those tips in today’s blog.

Managing Your Mental And Physical Health During The Holidays

Everyone is dealing with their own issues, so there’s no one-size-fits-all playbook for overcoming issues that can be intensified during the holidays. Some of these tips may be helpful to you, while others may not. What’s important is that you keep on trying until you find a healthy outlet that works for you.

Learn To Say No – One of the best things you can do during the busy holiday season is learn to say no. Don’t spread yourself too thin by trying to please others all the time. Set some healthy boundaries and say no when things aren’t right for your physical or mental health. While that may sound easier said than done, really try to start setting health boundaries and saying no for the betterment of your health.

Exercise – Numerous studies have found an association between exercise and improved mental and physical health. Now, that’s not to say that going for a run will cure your depression or fix your ailing back, but it’s a step in the right direction. Exercise and activity strengthens our body and releases dopamine in our brain, which acts as a natural mood enhancer. Find ways to get moving every day because activity and exercise can help improve your physical and mental health.

Manage Your Expectations – It’s also important to have realistic expectations and goals. If you have unreasonable expectations, you’ll constantly be missing your target, and that can be self-defeating. You don’t need to try to lose 30 pounds in a month or run a half marathon next month. Instead, start with small, easily attainable goals and build on those. Something simple like “Do three things for your mental or physical health today,” and then write down what three things you did at the end of the day. Work on setting attainable goals and expectations so that you set yourself up for success.

De-stress Your Way – The holidays can be extremely stressful, and that can be hard on your mental and physical well-being. Now more than ever, it’s important that you find ways to help yourself de-stress. Take your dog for a walk, run on the treadmill, head to your room and read for 30 minutes, call a friend and talk about anything other than what’s stressing you. Find what works for you, and when you feel stress developing, alleviate it with healthy habits.

Reach Out To A Pain Management Specialist – Finally, if you’re still finding it difficult to manage physical or mental health issues this holiday season, please reach out to a professional. Not only is our team well-versed in helping treat physical chronic pain issues, but we have decades of knowledge of the mental side of pain and stress. If you don’t take care of the mental aspects of pain, anxiety and depression, the physical side will never truly resolve, and vice versa. Let us help find individual solutions for whatever is bothering you.

We hope you have a wonderful holiday season, but we know that won’t come easy for many people. Just know that we’re here for you if you need us. For more information, contact Dr. Cohn and his team today at (952) 738-4580.

Can Antidepressants Relieve Pain?

February 17, 2014June 24, 2014 / Thomas Cohn, MD

Pain and depression are closely linked in the brain, and medications used in depression can be helpful in the controlling pain. Some antidepressants directly impact pain, while others only affect depression.

Antidepressants are most helpful in treating pain caused by damage to nerves or by an overactive nervous system (aka neuropathic pain). Specifically, antidepressant medications can help treat the following painful conditions:

Acute injury and surgical pain may be helped, but is still being studied.

Types of Antidepressants

There are two types of antidepressant medications that are used to control neuropathic pain:

Tri-cyclic antidepressants (TCAs), such as amitriptyline, Nortriptyline, and desipramine
Serotonin/noradrenaline reuptake inhibitors (SNRIs) such as Cymbalta and Savella

Antidepressants such as Zoloft, Prozac, Celexa, and Effexor have no affect on pain. These medications decrease nerve transmission and nerve sensitivity. The TCAs have many side affects including dry mouth, low blood pressure, sedation, and urinary problems. The newer SNRIs have very few side affects. Cymbalta is very effective in a number of neuropathic pain situations including diabetes, radiculopathy, and fibromyalgia, while Savella only is known to work in fibromyalgia.

Pain & Depression are Closely Linked

The nerve fibers that transmit pain sensation travel through the brain in the same regions that process emotional signals. These regions actually interact with each other. Stimulating depression centers can increase the perception of pain. When depression is not controlled, and a patient does have pain, rarely will the pain be controlled no matter what the treatment. Therefore, treating depression is often essential in effectively treating pain. Many people do not want to admit that they might be depressed, and thus not treating the depression does affect the pain level perceived.

Pain and depression in the brain are closely linked. Neuropathic pain is often treated with a variety of medications, many of which are antidepressants. Pain itself can change a person’s function and activity level, and cause depression. Treating the concomitant depression that pain may cause does help manage the severity of pain in many patients. Some medications treat both pain and depression, others may only treat depression, treating both together is often very effective in controlling pain.

The Link Between Anxiety, Depression, and Pain

December 31, 2013May 24, 2017 / Thomas Cohn, MD

According the International Association for the Study of Pain, pain is defined as:

“an unpleasant sensory and emotional experience associated with actual or potential tissue damage, or described in terms of such damage.”

This is one of the best descriptions of what pain is and is used worldwide to explain the experience of pain.

Pain and Emotion

Pain is an emotional experience. Emotions such as happiness, sadness, and anxiety are generated in the brain. Thus, pain and anxiety are intimately linked in the brain in terms of the locations that generate these perceptions. As noted in the definition, pain has unpleasant emotional components, which most people perceive as anxiety.

The link between pain and anxiety is, in reality, more than just theoretical. Sensation that is interpreted as pain is processed in several areas of the brain. Some of the main regions of pain sensation are in very close proximity to the regions that process emotions of anxiety and depression. When there is prolonged activity in the areas that process pain sensation, the areas nearby that process depression can be activated. The areas then can spontaneously interact, pain sensations can be interpreted as anxious emotions, and anxiety can be misinterpreted as pain.

Anxiety and Chronic Pain

Those who have chronic pain often become depressed and anxious. The two sensations become intermingled, and often the pain is greatly amplified by the depression. Treating the emotional consequences of pain is often as important as treating the physical causes of pain. If the depression and anxiety are not controlled, the pain is not controlled. Once the depression and anxiety are controlled, insight into pain can occur and pain often becomes manageable. There may be a physical cause to the pain, but if the emotional components are not controlled, then the pain is not controlled.

Comprehensive Treatment

Since pain, anxiety, and depression are intimately linked in the brain, comprehensive pain care involves treatment that is aimed at all aspects. A comprehensive pain program looks at both physical control of pain and emotional control of the consequences of pain. These programs link psychological approaches to pain, with physical methods. A pain psychologist is often involved in patient treatment. Medications for chronic pain that affect both physical signals of pain and emotional components then become understandable in their effectiveness.

Pain is a complex medical issue. It has both physical and emotional components. The physical side is the tissue damage and perception of signals. The emotional side is the anxiety and depression that is linked to the chronic pain signals. Treating chronic pain, due to its emotional components has long involved a multidisciplinary approach that includes psychological management.