Pain “Catastrophizing” Can Make Chronic Pain Worse

August 26, 2020 / Thomas Cohn, MD

Chronic pain can be a cyclical battle that can be tough to break out of. Pain can leave you feeling discouraged, and this discouragement can have real world implications for your chronic pain treatment. In other words, unless you really focus on beating your chronic pain, it’s only going to get tougher to treat.

Don’t Let Pain Control Your Life

This sentiment was given credibility based on a recent study led by researchers at Penn State. For their study, researchers took a closer look at how people felt about their chronic pain condition and cross-referenced it with whether or not the were physically active later on in the day. In the study that focused on patients with knee osteoarthritis, researchers found that patients who “catastrophized” their pain (classified as feeling an exaggerated sense of helplessness or hopelessness) were less likely to be physically active later in the day. Moreover, this contributed to a domino effect of sedentary behavior followed by even more pain catastrophizing.

So while the results show that it can be hard to break free from chronic pain, it also shines a light on how we can best help patients with chronic pain conditions.

“Reducing daily pain catastrophizing may help older patients to be more active and less sedentary on a daily basis,” said Ruixue Zhaoyang, assistant research professor. “This could help improve their chronic pain condition, physical function, and overall health, and reduce the possibility of hospitalization, institutionalization, and healthcare costs in the long term.”

Nobody looks favorably on their chronic pain condition, but at the same time, if you’re constantly focusing on how the condition is negatively impacting your life, it can lead to pain catastrophizing. Researchers say patients who think that their pain is “terrible and never going away,” or those who say they “can’t stand their pain anymore” may be catastrophizing their condition and subliminally decreasing their likelihood of pursuing active treatment solutions, like exercise and physical therapy.

So if you are struggling with your chronic pain condition, really take a hard look at how you’re viewing your pain condition in your head. Are you constantly negative about your pain, and do you shy away from activity when you’re frustrated by your pain. If so, you’re not alone, and you should know that solutions are right around the corner. We can help change the way you think about your pain condition so you’re more likely to follow through on proven active treatments to help with your condition. For more information, or to learn more about how we can help treat the physical and mental aspects of chronic pain, reach out to Dr. Cohn and his team today.

Dr. Cohn Featured In Minnesota MD News!

July 31, 2018 / Thomas Cohn, MD

Chronic pain is a huge problem in Minnesota and throughout the United States, and more people are becoming aware of the issue and trying to help spread awareness. One group that is attempting to help keep people informed and find solutions to chronic pain is Minnesota MD News!

Recently, Sheri Levisay sat down with Dr. Cohn and other members of the CDI Pain Care team to get a better understanding of how we’re working to treat chronic pain and find permanent solutions for every patient.

We’ve pasted a snippet of the feature story below, but for the full story, head on over to Minnesota.MDNews.com. Thank you to Sheri and her team for helping to put a spotlight on pain conditions that affect millions of Americans each and every day!

Few conditions affect more Americans than chronic pain. The American Academy of Pain Medicine estimates 100 million adults suffer from chronic pain, at an annual direct and indirect cost of up to $635 billion. A 2015 National Institutes of Health analysis found 25.3 million people with chronic pain suffered daily for at least three months, and 40 million described their pain as severe.

Compounding the problem is overreliance on opioids. Annual opioid prescriptions in the United States exceed 200 million, according to the CDC, and 165,000 Americans died from overdoses related to opioid pain medication from 1999 to 2014.

As leaders in health care and government search for solutions, patients with pain are left wondering whether their only alternatives are painkillers and surgery.

At CDI Pain Care, Thomas G. Cohn, MD, board-certified in physical medicine and rehabilitation as well as pain medicine, has an answer to that dilemma which reflects his 25 years of experience in the field: conservative pain management.

CDI Pain Care’s comprehensive approach starts with…continued here.

A Doctor Who Understands Your Pain

September 5, 2017 / Thomas Cohn, MD

I have been known to preach a little about the work it takes to control pain. It is not about taking a pill or just going to therapy and it will all be better. I often offer advice and I rarely cut people a lot of slack. I also do not like opioid medications, but that is for obvious reasons related to effectiveness and addiction. But most people wonder if I actually understand pain. The answer is yes, I deal with my own issues daily, but my patients are not paying to listen to me complain. The reality is I had to learn what works for me to manage my issues.

My Pain Story

My story started in medical school. Keeping in shape was important just to have the energy to spend countless hours in class and studying. At one point, a housemate convinced me to try weightlifting. The second time I tried I had the weights in the wrong position, lost my balance, and took out my back. I probably herniated a disc in my lower back, but there were no scans available then. I did therapy and over months it became manageable most of the time, not slowing me down if I was generally careful and not doing stupid things.

In my mid forties, 20 years later, my back started to become more noticeable. I had regular low back pain, and it started to frequently radiate down the leg. I gave up on running since that set it off, and just tried to keep in reasonable shape. This worked until I was in my late forties, and then finally I had a MRI scan that showed a significant slippage at the bottom of the spine, a disc that was pretty much shot and a lot of narrowing where the nerves exit the spine. The radiologist that read the scan had only one question for me, and that when was I thinking about having surgery. Surgery had not crossed my mind since my issue was pain. I decided to follow the advice I had given others; If there was no weakness and no loss of bowel or bladder control, surgery was not the answer.

Conservative management was my goal. I had a couple of lumbar epidurals that brought down the worst pain and I did a few physical therapy sessions and they gave me a ton of exercises. The exercises were repetitive, and they seemed to be focused on the same muscles, doing all of them took about 40 minutes and they were boring. As the pain improved, I gave up on the program. Within 18 months the pain was again bad and I had another epidural, but I thought I needed to condense the exercise program. I narrowed it down to a set of core exercises that were all different parts of my core muscles, and I added a stretching regimen. Core work was about 10-20 minutes depending on what I did, and stretching was only about 5-10 minutes at the most.

My kids were hockey players, and my daughter had scoliosis and had exercises and a balance board. When I tried the balance stuff, I was terrible and it proved to me I needed to work more on core. I also felt since I was getting old, general strengthening would be a good thing to add to my workouts to reduce muscle loss. Lastly, I needed to also throw in general aerobic conditioning to maintain cardiac health.

Finding What Works For Me

The workout for the last few years has been pretty consistent. I start every day pretty early to get it done. After I climb out of bed, I stretch for a couple of minutes, and my dog gets a belly rub while I loosen up my back. After that comes core work that includes planks on a balance board, sit-ups, leg lifts and upper body/core with rubber tubing. I use a universal gym machine for additional strengthening and a roman chair device for abdominal work and pull-ups. Cardiac/aerobic workouts rotate between an elliptical, bike and rowing machine doing intervals. The rowing machine is the most recent addition. It supposedly works 85 percent of all your muscles, and it really seems to loosen things up and get the body moving well without stressing things out. During the summer I get outdoors and bicycle. Since I have a big dog, she gets twice a day walks daily year around.

As with everyone, as we get older, we all start to gain weight. I like to eat, and often enjoy snacking on junk food. Eventually my wife convinced me that I needed to change my habits. I had to stop eating as much carbohydrates, eat more vegetables and protein, and get rid of sugary drinks and snacks. I am no where near the weight I was in college, but I think I probably have more upper body muscle and some extra gut, but I have lost a few pounds.

For most people with back pain, sleep is a huge problem. Like many, I never feel well rested. I used to be a stomach sleeper, but with my back, extension is the worst position and that is absolutely out. Side or back sleeping is feasible. Multiple pillows are my best friends keeping my knees bent while on the back, between the legs while on the side, and adjusted under my neck to keep that in a neutral position. A good memory foam pad adds to the comfort level to help relieve pressure points. I am not a deep sleeper, and after four hours stiffness often wakes me up. Instead of fighting it, I get up and stretch for just a few seconds, and then go back to bed and I can sleep for several more hours. For me, sleeping over 7.5 hours just hurts my back, so I get moving after that amount of time. To fall asleep, I do not do work right before bed, I do some reading and try to clear my mind of anything serious.

Like everyone else who has back pain, I have to take care of my back. It is not easy to do, but it is a priority to stay healthy. It would probably help me if I could figure out how to get more sleep at night since some experts say this is good for general health. Maybe I should try to meditate, but this would also take time, and I am not yet into that either. I may spend to much time exercising, but a large part of it is walking my dog, and someone has to do it. Eating a more healthy diet has reduced my weight slightly. To lose more weight, another major change and reduction in calorie intake would be necessary and no fun. Life is a matter of balancing multiple options. If you have pain, one of the best treatment options is a comprehensive exercise program. There will never be a magic solution for pain, it will always require lifestyle choices.

Dr. Cohn Out of Office Until July 7

June 23, 2014June 23, 2014 / Thomas Cohn, MD

I wanted to take a moment to let my readers and patients know that I’ll be out of the office from June 21 through July 6. I will be going on vacation for a portion of that time, and I’ll be unable to be contacted for most of that duration. I will begin seeing patients again at the CDI Sartell office on July 7th.

If you have immediate needs during that time please contact Dr. Robert Long or his assistant Julie Marden by calling 952-738-4456. If you want to set up an appointment with me when I get back, call the main office number at 320-251-0609.

After Hours Calls

If you want to set up an appointment after the office has closed for the day, you’ll need to follow the after hours procedure. We always have a doctor on call in case something arises. Dr. Long and Dr. Kim will be the on call physicians in my absence. They are wonderful doctors and are more than capable of providing you with the care you need.

I have written some blog posts to be shared while I am on vacation, so there will continue to be new stories on the blog as well as activity on my social media profiles. So while you will continue to see activity, remember that I will be unable to personally answer any questions that may be submitted through Facebook or on a blog post. I’ll answer your questions when I get back, and if it’s a serious concern please call CDI. They’ll make sure you get the care you deserve.

Thanks,

Dr. Thomas Cohn.

P.S. I meant for this post to appear on Friday, but we are currently in the process of switching to a self-hosted server. This created a visibility issue for this post on Friday. I apologize for any inconvenience.