Why Social Distancing May Be Harder On Patients With Chronic Pain

April 15, 2020April 15, 2020 / Thomas Cohn, MD

Chronic pain is the number one cause of long-term disability here in the United States, and a chronic condition can be physically, emotionally and psychologically draining. And as you’ve probably noticed over the past few weeks, social distancing can also be physically, emotionally and psychologically draining. When these two events happen concurrently, the effects can be intensified, leaving chronic pain patients more susceptible to fall out from their condition or the current state of society.

Because of this, patients with chronic pain need to be even more diligent about how they handle their physical and mental health during this time of social distancing. Below, we share some tips to prevent your chronic condition or social distancing from causing problems as we work towards normalcy.

Chronic Pain and Social Distancing

Although patients with chronic pain may be more used to social distancing than the average person because their chronic condition may cause them to skip activities that they would have participated in, that doesn’t mean it gets any easier to pass on doing the activities that you love. To prevent your chronic pain or the quarantine from getting the best of you, consider the following tips.

Stay Connected – Make it a point to connect with others, even if you can’t see them face to face. Set up a Zoom meeting with some family members, or have a virtual happy hour over Facetime with friends or coworkers. Make sure you are not social isolating. Connecting with others, even if it’s over the phone or computer, can do wonders for your mental health, and that can help provide physical benefits as well.

Do Your Exercises – Don’t just use social isolation as a time to sit on the couch and eat whatever you want. Make sure you are still getting regular exercise and doing your physical therapy exercises, as these will help tremendously with your pain condition. Being sedentary will typically only make things worse since you’re not actively working to strengthen injured areas, so don’t use social distancing as an excuse to be inactive.

Mind, Body, You – Every day, make sure you’re doing at least one thing that benefits your mind, body and yourself, as this will help keep your physical, mental and emotional health in check. For example, do some exercise to care for your body, do some yoga or meditation to help your mind relax, and do something you personally love to do, like read a book or watch an episode of your favorite television series. Ignoring one of these aspects can make it harder to overcome a chronic condition.

Get Healthy Sleep – Sleep can be harder to come by if your routine is a little disjointed because of social distancing or your chronic condition, but getting restful sleep is imperative to your mental and physical health. A lack of sleep can intensify pain signals and affect your whole day, so really commit to going to bed and getting up around the same time to help your body get into a rhythm.

Connect With A Physician – If you’re having physical, mental or emotional issues during this time, contact a healthcare provider or your pain care specialist. This is uncharted territory for all of us, but we’ll get through this together. Let us help you with whatever you’re going through. We’re offering new ways to help our patients through these tough times, so contact our office to see what we can do for you if you’re struggling with any aspect of your chronic pain condition.

Managing Chronic Pain During The COVID-19 Outbreak

April 3, 2020 / Thomas Cohn, MD

Managing chronic pain can be challenging, but for many people this sentiment holds true now more than ever. We’re living in uncertain times as we continue to try to contain the spread of COVID-19, also known as the novel coronavirus. This virus is challenging for the entire world, but as we learn more about it, it’s clear that it is especially problematic for certain groups of people and those with underlying health conditions. Unfortunately, there is a lot of crossover between the groups who are susceptible to significant complications from the virus and those who live with chronic pain on a daily basis.

This is not meant to be an overly grim outlook on our current situation, but we should proceed with caution as we navigate the next few weeks and months. There is good news though, because we’re learning more about the virus every day and how to best care for those who contract the condition. However, we want to help explain how chronic pain patients should try to proceed these next few months to both stay safe and manage their chronic condition.

Chronic Pain and Coronavirus

For starters, patients with chronic pain need to be especially cognizant about the social distancing order, especially if your chronic condition affects your immune system or your respiratory system. Those with immunodeficiancies and lung problems can really have an issue overcoming the virus, and many of those who have succumbed to the virus have these types of underlying health conditions.

So with your social distancing in mind, follow these tips to help control your chronic pain and reduce your risk of contracting the coronavirus.

1. Exercise – You still need to find ways to exercise even if you can no longer go to the gym. Get creative about how you exercise and strengthen key muscle groups. Going for a run or a walk is still fine in most parts of the US so long as you try to stay further than six feet from others you encounter. Otherwise, dust off the treadmill or look up some online yoga exercises that you can perform in the comfort of your home. Just because you’re self-isolating doesn’t mean you get to be lazy, because that will make it harder to control your chronic pain.

2. Mental Health – Social distancing does not mean that you need to isolate yourself. Talk with family members regularly or set up recurring conference calls with friends. Finding some ways to take your mind off your pain or the state of the world will do wonders for your mental health, and that’s important for your physical health as well. Find healthy outlets for your mind.

3. Learn – Now is a great time to take up a new hobby or invest in a new skill. If you’re working from home, you may find some extra time on your hands if you’re no longer commuting for your job or your hours have been cut. Don’t just use this time to watch Netflix and lay on the couch. Your body will feel more engaged by new activities and will take your mind off your pain, which is good for your health. Come out of this quarantine with one new skill your proud of, and it may even help your pain condition.

4. Connect Virtually – If you’re having questions about your condition or how to best manage an issue, see if you can connect with your physician for a virtual visit. Some clinics are still open, but many physicians and physical therapy departments are offering telemedicine options to help see patients more easily. There are still ways to connect with your physician, even in the wake of a pandemic.

Keep these four tips in mind, and really invest in your physical and mental health these next few weeks and months. It may seem challenging, but you may be able to come out of this with a better grip on your chronic condition than you had before. For help with any of this, reach out to our office today.

Could Deep Brain Stimulation Help Treat Chronic Pain?

February 4, 2020 / Thomas Cohn, MD

Nearly one in three adults in the US suffers from some form of chronic pain, and despite everyone’s best efforts, it’s not always easy to treat. We’re always looking for new ways to best help our patients decrease and eliminate their chronic pain, and one new treatment that is being closely monitored and tested is deep brain stimulation.

Deep brain stimulation (DBS) may sound like some futuristic medical experiment, but it’s already being used to treat some cognitive impairments. It has been successful in helping limit symptoms in conditions like Parkinson’s disease, dystonia and tremors, and now doctors are wondering if it could be useful in managing some types of chronic pain.

DBS works by implanting electrodes deep into a person’s brain in the areas that help control movement. A stimulator is also implanted in the chest, and the stimulator can help drown out problematic brain signals. The only issue is that it’s not a perfect science, and you’d like it to be perfect when you’re implanting a device in a person’s head. The electrical current relayed through the stimulators is constant, meaning it can’t adjust to what’s going on in the brain, it simply operates as a way to drown out problematic signals.

Because of this, some patients have experienced changes in personality or problems speaking, and like many treatments, the brain can get used to the stimulation and find ways to drown out the signal that is supposed to be drowning out the problematic signals. So while it’s not a perfect system, medical experts are always trying to improve it, and now they are researching whether it could be a viable option for chronic pain patients.

Deep Brain Stimulation For Chronic Pain

Researchers at the UCSF Weill Institute for Neurosciences recently received a $7.56 million, five-year grant to see if DBS could be used as a treatment for some forms of chronic pain. However, their goal is to develop the technology so that the current can be harnessed and used based on signals from the brain in real-time, instead of as a constant current.

Researchers likened the system to a space heater and a thermostat. The space heater provides constant heat, whereas a thermostat can turn the heating system on and off based on the current temperature and a desired setting. Right now DBS is a space heater, but researchers say they hope to use the grant to help develop a more thermostat-style model.

“We are trying to build a model to serve as a thermostat to control electronic stimulation to provide pain relief,” said Dr. Prasad Shirvalker, assistant professor of Anesthesiology at UC San Francisco. “We’re at the front edge of trying to open up new indications for DBS.”

Hopefully researchers can figure out how to control DBS in the most complex system in our body so that chronic pain patients can have another avenue to pursue relief. We’ll keep tabs on this research as it progresses.

FDA Warns Against Pain Curing Claims Of CBD Industry

January 29, 2020 / Thomas Cohn, MD

cbd oil When it comes to selling healthcare products, companies often try to walk a fine line between marketing their product and making false claims about the true ability of their product. Oftentimes there are a lot of semantics at play and the Food and Drug Administration rarely intervenes over product claims unless they feel that the consumer is being grossly misled about a product. It appears they recently felt that way over claims made in the CBD industry.

We’ve talked about cannabidiol on the blog in the past, and like CBD, medical marijuana or other relatively new products on the healthcare market, our stance has been pretty similar. We want patients to find a solution that works for them, we want further scientific research to better understand these products, and we want patients to pair passive treatment options with active treatments like exercise and physical therapy. Until we can point to the science behind a product, we’re leery to suggest it as a solution other than to say, if it works for you and isn’t compromising your health, go for it.

CBD For Pain, Cancer and More

That’s not exactly the same sentiment felt by Rooted Apothecary LLC, a company based in Naples, Florida, that has been pushing CBD products on its customers. They are legally selling CBD products, but the FDA and the Federal Trade Commission believes the claims they are making about the effectiveness of the products are misleading and even illegal.

Some of the claims made by the company about their CBD products include such unsubstantiated claims as it can be effective for teething pain and earaches in infants, or that “CBD was effective in killing human breast cancer cells.” They also made claims that CBD has been effective in treating Parkinson’s disease, Alzheimer’s disease and can safely be used in conjunction with opioids. Not only are these claims unsubstantiated by science, but they can put the consumer’s health at risk.

“Cannabis and cannabis-derived compounds are subject to the same laws and
requirements as FDA-regulated products that contain any other substance,” said
Acting FDA Commissioner Ned Sharpless, MD, in a press release. “We’ve sent
numerous warning letters that focus on matters of significant public health
concern to CBD companies, and these actions should send a message to the
broader market about complying with FDA requirements. As we examine
potential regulatory pathways for the lawful marketing of cannabis products,
protecting and promoting public health through sound, science-based decision-
making remains our top priority.”

Whether it’s CBD or another health and wellness product, we recommend that you do your own research and consult with your physician if you have any questions, especially if you’re already trying certain treatments for your pain. If something sounds too good to be true, it probably is. CBD is far from snake oil, but it’s not a magic pill either. Do your research, trust your gut and consult a professional for any questions you have.

Can You Sleep Your Way To Less Chronic Pain?

January 15, 2020 / Thomas Cohn, MD

As we’ve talked about on the blog in the past, there is a clear link between sleep health and pain sensitivity, and we’re going to further explore the interconnections of these two things in today’s blog. A recent study published in the Journal of Science built on our knowledge of this connection, which leads to the question, can we sleep ourselves out of the cycle of chronic pain?

For their study, researchers took a closer look at a person’s brain and the pathways through which pain is perceived. This is the area that processes pain stimuli. In other words, it tells us where the pain sensation we’re feeling is coming from. This pain signal then moves to the insula, a part of the brain that integrates incoming signals and forms our perception of pain. Finally, that signal is sent to the nucleus accumbens, an area that plays a significant role in decision-making, reward and pain evaluation.

During their research, the team found that the activity of the nucleus accumbens in sleep deprived patients differed from those who regularly receive adequate amounts of sleep. The nucleus accumbens helps to dull incoming pain signals, but this process doesn’t occur as frequently or as greatly in patients who are sleep deprived.

Takeaways

The findings are in line with a previous study that found that burn victims increased their opioid consumption after just one night of interrupted sleep, which also reinforces the idea that sleep quality and our perception of pain is linked. But what does that mean for the average patient with chronic pain? It means you should focus on getting a healthy amount of quality sleep while also pairing that restful period with physical activity during the day. You’re not going to get rid of your chronic pain by laying in bed all day, but you’re also due for trouble if you get six hours of interrupted sleep each night.

Check out this old blog post on ways to improve your sleep quality, but we’ll provide some quick tips here. Get in the habit of going to bed at roughly the same time each night, make the room cool and as dark as possible, and avoid reading, watching Netflix or scrolling through your phone while in bed. Make the bedroom a place for sleeping and your body will begin to get in the habit of falling asleep and staying asleep. Also, avoid caffeine or alcohol late in the day as those beverages can make it harder to fall asleep and stay asleep.

Finally, you also need to pair this quality rest with activity. You need to put in some work to overcome your pain, whether that’s in the form of physical therapy, daily exercise or a regular stretching routine. These activites will help to increase our pain threshold and strengthen supportive muscle groups that can help prevent pain. Be active during the day and work on achieving quality sleep at night, and you may soon find your chronic pain under control! For help with any of this, reach out to Dr. Cohn’s office today.