pain

Obesity and Pain – How are they Related?

/ Thomas Cohn, MD

obesityMany people who have pain are also obese.  A common question in these cases is which came first – the obesity or the pain? Additionally, will solving one issue make the other go away?

The answer is not simple, but both of these subjects are much related.  Obesity is a severe problem in developed countries like the USA.  Obese people stress the body, and develop pain in areas like the back and leg joints.  Having pain in the low back, or joints, and being obese does not mean that losing weight will resolve the problem since permanent injury may already be present.

Problems Associated with Obesity

Obesity is a primary problem affecting a large segment of society.  Treatment is varied – one single strategy will not work for everyone. Obesity can lead to many health problems that cause pain like:

Treating obesity before these problems occur is important.  Once permanent damage to the body is done, reversing the injury is often impossible and treatment can only be aimed at symptom management.  If you are obese, work with medical professionals to bring your weight under control to prevent permanent side effects.

Obesity & Low Back Pain

Having low back pain and obesity often makes symptoms worse.  Being overweight by 50 pounds is like constantly carrying 5 one-gallon jugs of water with you 24 hours a day without ever having a break. However, low back pain is often related to permanent changes in the lumbar region including the joints, discs, and bones.  Losing weight will not reverse the permanent changes present but may allow easier pain management.

Joint pain, especially degeneration of the knees and hips occurs with obesity.  Increased weight is a common factor that promotes increased wear and tear on the knees and hips.  Once the damage has occurred, the changes are usually permanent.  Weight loss will make the symptoms more manageable, but will often not cure degeneration that has occurred.

Obesity is a major health issue.  If it were easy to solve, then we would not be facing such challenges in society today.  Treating obesity early helps reduce secondary problems such as pain.  But solving obesity will often not solve a pain problem.  Keeping healthy, strong, and mobile will make many things better, and hopefully decrease obesity and pain.

4 Foods that Decrease Pain (and 3 that Increase Pain)

/ Thomas Cohn, MD

foodFood is an everyday part of our lives. But many people are so busy with work, school, and other things that they don’t think much about what they are eating. With obesity rates at such high levels, Americans are becoming more and more aware of the foods they consume. But food doesn’t just impact your weight – some foods can increase or decrease pain levels and inflammation in the body. Here we will examine a handful of foods on both sides of the aisle – those that can increase pain, and those that help fight pain.

Foods that Increase Pain

Here are some foods to avoid if you are experiencing inflammation or pain:

  • Soda, or “pop” as it’s known in Minnesota, is loaded with sugar that can increase inflammation, rot your teeth, etc.
  • Salt. Most processed foods contain a LOT of salt for preservation purposes. But too much salt can lead to joint inflammation and pain. So read the labels carefully, paying attention to the sodium levels of the foods you buy.
  • Corn Oil. It’s high in omega-6 fatty acids that can spark inflammation.

While it may be difficult to cut out these items from your diet, there are much better, healthier alternatives that can even reduce your pain.

Foods for Pain Relief

Here are some foods that can help relieve pain:

  • Olive Oil. Compared to corn oil, olive oil has omega-3 fatty acids that can actually help reduce inflammation, and has been shown to help people with arthritis.
  • Garlic. Several studies have shown that the antioxidants in garlic can help relieve pain from rheumatoid arthritis and other conditions.
  • Salmon is loaded with antioxidants and protein, as well as fatty acids that can decrease joint pain.
  • Ginger. This root has been used to relieve pain for thousands of years. A recent study found that it might be just as effective as some NSAIDs in relieving pain.

The food you eat has a great impact on your bodily health. So remember to be conscious of your food choices, especially if you are in pain.

How to Identify & Treat Tension Headaches

/ Thomas Cohn, MD

tension headacheMuscle tension headaches are the most common type of headaches in adults.  They have a tight “band-like” quality on both sides of the head. The headaches are not affected by routine physical activity and they can last from 30 minutes to several days. Pain intensity is mild to moderate.

The frequency is variable, from occasional to chronic daily.  Up to 80% of adults have tension headaches occasionally, and approximately 3% are chronic daily sufferers.  Women tend to have headaches twice as frequently as men.  Most people have only one or two of these headaches a month.

Causes of Tension Headaches

Muscle tension headaches have no single cause. They involve the muscles in the back of the neck or elsewhere in the head tightening up.  The most common cause is mental or emotional stress, or depression with anxiety.   Other common causes include:

  • Poor posture
  • Lack of sleep
  • Overexertion

Understanding the cause of the muscle tension helps determine the possible solutions. Muscle tension headaches are not caused by significant problems in the brain.  Tumors, bleeding in the brain, and brain injuries have different symptoms.  Tension headaches do not require brain scans or sophisticated imaging of the head.  Sometimes fairly routine blood analysis may be helpful to determine if there are any chemical imbalances in the body contributing to the problem.  Most important to the diagnosis is a good history and physical exam.

Treatment for Tension Headaches

Treatment of muscle tension headaches is multifaceted.  Tension and stress most often have physical, mental, and emotional components.  Recognizing and having insight into the factors causing the headaches may be difficult.  Professional help may be necessary to deal with emotional and mental factors contributing to symptoms.  Here are some common treatment options for tension headaches:

  • Medications to deal with stress and anxiety
  • Physical therapy to help with physical components of muscle tension
  • Massage, acupuncture, and manipulations
  • Injections to muscles, joints, and nerves as well as Botox injections

Most people can be treated by their primary physician with good control of symptoms.  When headaches become frequent and are not controlled, Neurologists and Pain physicians can determine a logical more complex and comprehensive treatment and management strategy.

A medical specialist should treat chronic daily muscle tension headaches.  The medications used for occasional headaches may make daily headaches worse.  Pain medications, some anxiety drugs and muscle relaxers can cause rebound headaches and worsening of symptoms.  A specialist can determine different treatment strategies that may be more effective for the individual.

Read more about other types of headaches in our previous blogs:

Top 4 Pains you Should Never Ignore

/ Thomas Cohn, MD

head painEveryone experiences and deals with pain in their own way. Some people rush to the emergency room every time they get a headache, while others refuse to see a doctor when they are clearly experiencing great pain. Ideally, you should strive to strike a balance between these two extremes. Toughing it out through certain types of pain can be dangerous (and even deadly).

Here are four pains that you should never ignore. If you are experiencing any of these pains, seek medical attention as soon as possible.

Chest Pain 

Pain in your chest can be a sign of many things, including:

  • Heart Attack
  • Heart Disease
  • And more

It could also just be the worst heartburn of your life, but it’s always best to err on the side of caution considering the deadly possibilities.

 Severe Stomach or Abdominal Pain

Intense stomach pain can indicate a bevy of problems such as:

  • Ulcers
  • Gallbladder issues
  • Appendix issues

Pain from an infected appendix is especially dangerous. If you ignore it too long, the appendix is likely to burst, leading to even more intense pain, and even death in the worst-case scenario.

Burning Feet

If you feel a burning sensation in your feet, it could be a sign of diabetes or diabetic neuropathy. If not treated quickly, amputation may be necessary.

Intense Headache

Headaches are a common ailment. They can accompany colds and sinus infections, or be associated with a more serious condition like:

A good rule of thumb is that is you feel like you’re having the worst headache you’ve ever had get it checked out, especially if you can’t pinpoint what exactly caused the headache.

These pains can all be signs of serious underlying health issues. Pain is your body’s way of communicating to you that something is wrong. Don’t ignore these signals – listen to your body and address pain as it arises.

Post-Concussion Headaches: Cause & Treatments

/ Thomas Cohn, MD

concussion headacheConcussions have been a recent hot topic in the news and in medicine. But for Neurologists and Physical Medicine physicians, this is actually a very old topic.   Recently, due to high profile athletes having problems with concussions, the general public is better understanding the significance of this disorder.

What is a Concussion?

Concussions are traumatic brain injuries.  The severity of symptoms is highly varied.  Neurologists have long been in the forefront with diagnosis of brain injuries and Physical Medicine doctors as part of their training have extensive experience treating and coordinating care for these patients.

Concussions result from blows to the head.   They are a “mild” form of traumatic brain injury.  Loss of consciousness is not necessary for problems.  The severity of the blow to the head also does not correlate to severe symptoms.   Any blow to the head, or sudden shaking of the head can cause problems.  The trauma to the brain is felt to cause microscopic damage to the brain and connections between neurotransmitters.  The first symptoms may occur almost immediately with the person being slightly dazed or confused.  Recognizing a possible concussion is important such that a person is removed from further injury and healing can be facilitated.

Concussion Headaches

Headaches are one of the most common symptoms of concussions.  The headaches are diffuse throughout the head, and often are worse with noise, bright light, and movement.  Accompanying symptoms can include:

  • Memory issues
  • Mood changes
  • Irritability
  • Fatigue
  • Balance problems and dizziness

The symptoms can appear immediately or within one to two weeks.  If one has had head trauma, and has symptoms of a possible concussion, see a physician and seek treatment.  Remember, the suggestion to seek evaluation is to help the brain heal and prevent further damage.  It is not a punishment to keep a person out of sports or other activities.

The diagnosis of concussion and headaches from injury is made clinically; it is based on history and exam.  MRI scans of the brain or spine may be done to evaluate for possible problems contributing to symptoms or to see if there may be subtle tissue changes in the brain that are consistent with exam.  If dizziness is an issue, then an Ear specialist may also be involved with symptom evaluation and management.

Concussion Headache Treatment Options

Treatment of post–concussion syndrome and headaches is dependent on severity of symptoms.  Initially, it is recommended to rest and avoid too much activity and stimulation to the brain.  That may mean no computer use, no reading and no watching TV or videos.  As the headaches improve, gradual increase in activity as tolerated.  The brain needs to heal on its own time frame without being damaged or stressed.  Medications that are used are the same medications we use for muscle tension headaches or migraines, but we start simple and hopefully they will be unnecessary very quickly.  Repeated concussions often heal very slowly if ever.

Concussions and headaches from them are serious problems.  Medicine and everyone else is just starting to become aware of the seriousness of these injuries.  Treating ongoing headaches from concussions is serious; ignoring them may lead to long-term issues.  Once a diagnosis is made, follow the doctor’s orders and allow the brain to heal.  There is no such thing as brain transplants, so allow the brain time to heal.

For more information on headaches, check out our other posts: