pain

Drinking To Cope With Chronic Pain May Lead To Worse Pain

/ Thomas Cohn, MD

chronic pain alcoholAlcohol has a number of effects on our brain and body, and while it may be able to seemingly drown out some pain sensations in a very short-term manner, it’s obvious that turning to alcohol is not a smart or healthy way to cope with your chronic pain condition. That sentiment only becomes more true on the heels of a new study that found that turning to alcohol to cope with chronic pain can actually lead to worsening pain sensations.

Chronic Pain And Alcohol Use

To get a better understanding of the effects of alcohol and pain perception, researchers turned their attention to three groups of mice. One group was dependent on alcohol (excessive drinkers), another had limited access to alcohol (moderate drinkers), and the final group had never been given alcohol. The mice then had their access to alcohol restricted before having it reintroduced.

Researchers found that in mice that were dependent on alcohol, allodynia was a common symptom during alcohol withdrawal. Allodynia is a condition in which a normally harmless nerve stimulus is perceived as painful by the brain. In other words, the mice going through withdrawals were more likely to experience phantom pain.

Interestingly when these mice were reintroduced to alcohol, pain sensitivity decreased, which would likely only continue to worsen a dependency issue. However, that decrease in pain sensitivity was not the same across the board. About half of the mice in the moderate groups showed signs of increased pain sensitivity during alcohol withdrawal, but they did not see pain sensitivity decrease when reintroduced to alcohol.

Additionally, when researchers measured the level of inflammatory proteins in the animals, they discovered that specific inflammatory molecules were only increased in dependent mice. This suggests that different molecular mechanisms may be driving the two types of pain, but on a positive note, it may make it easier to create medications that targets these specific proteins.

“These two types of pain vary greatly, which is why it is important to be able to distinguish between them and develop different ways to treat each type,” said study first author Vittoria Borgonetti, PhD, a postdoctoral associate at Scripps Research.

The team hopes that their findings and their future research will be make it easier for medical experts to help treat chronic pain conditions that are being fueled or worsened by alcohol.

“Our goal is to unveil new potential molecular targets that can be used to distinguish these types of pain and potentially be used in the future for the development of therapies,” said co-senior author Nicoletta Galeotti, PhD, associate professor of preclinical pharmacology at the University of Florence.

So not only is alcohol unhelpful at treating the underlying cause of chronic pain, it can actually increase your risk of phantom pain signals. Instead of turning to alcohol, turn to a pain care provider like Dr. Cohn. We’re confident we can find the right treatment option for your unique pain condition. For more information, or to set up an appointment with Dr. Cohn, give his office a call today at (952) 738-4580.

6 Tips For Controlling Pain After Surgery

/ Thomas Cohn, MD

chronic painSurgery can be just what you need to overcome a painful and debilitating condition, but odds are you won’t experience that relief overnight. In fact, it’s common to experience pain and discomfort for a short period of time after the operation as your body works to adapt to the trauma of surgery. You can take solace in knowing that this post-surgical discomfort will fade, but life can be a little more comfortable if you work to control your post-op pain.

In today’s blog, we share six tips for controlling pain after surgery.

Managing Pain After An Operation

Here’s a look at six ways that you can work to control and decrease post-surgical discomfort.

1. Prehab – You don’t have to wait until after your surgery is complete to start working to become physically stronger. The stronger you are prior to surgery, the stronger you will be after your operation, and that can help to support joints and other structures that have been addressed during surgery. Ask your doctor for some exercises that you can perform before your operation.

2. Medication Management – Odds are you are going to be given some medications to help manage discomfort following your operation, but you need to take them in a specific manner in order for them to be most effective. Your care team will provide you with dosage instructions, but make sure that you understand how you are expected to handle your medications before you discharge or leave the pharmacy. Taking medications outside of your dosage instructions can lead to a number of issues, so if you have questions or are running into any issues, reach out to your care team.

3. Early Movement – You should always follow the specific recovery instructions of your treating physician, but don’t be surprised if they recommend early movement and activity. Odds are you won’t be told to stay in bed for weeks while your body recovers, because your body needs movement and controlled stress to improve circulation and become stronger. If allowed by your surgeon, make sure that you are up and moving as soon as it is allowed to help jump start the recovery process and limit pain or discomfort.

4. Physical Therapy –  In many instances, physical therapy will be the most effective treatment following an operation in terms of pain control and functional improvement. PT will help your structures become stronger, mobile and more stable, all of which help to control pain. Make sure that you are doing your PT exercises as directed and you never skip an appointment during your recovery.

5. Mind Your Mental Health – It’s easy to focus on your physical condition after surgery, but don’t overlook your mental and emotional health, because they are closely tied to your pain levels. Anxiety and depression can intensify pain sensations and our perception of pain, so make sure that you are caring for your mental health after an operation. Get outside, talk with friends or family and partake in activities that are energizing to your physical and mental health.

6. Connect With A Pain Specialist – If you are dealing with lingering pain or you just want to have some additional assistance managing a pain condition following your operation, connect with a specialist like Dr. Cohn. Pain is highly unique to the individual, but we will work hard to help find personalized ways to help you overcome your pain and improve your overall physical function. For more information, or for help with a different pain issue, reach out to Dr. Cohn’s office today at (952) 738-4580.

Tips For Being A Great Friend To Someone With Chronic Pain

/ Thomas Cohn, MD

chronic pain friendLiving with chronic pain can be extremely challenging for a number of reasons, and as we’ve talked about on the blog in the past, it can have a significant effect on your social life. You don’t want your friends to feel isolated or alone because of their pain condition, but being a great friend can take a little extra work because of the complexity and unpredictable nature of a chronic pain condition.

Because of this, we wanted to use today’s blog to highlight some of the ways you can be a great friend to someone with chronic pain.

Supporting A Friend Who Is Dealing With A Chronic Pain Condition

Here are some ways you can be a supportive friend to someone who is battling a chronic pain condition.

Listen More Than You Talk – As the old adage goes, we have two ears and one mouth, so we should do twice as much listening as we do talking, and that’s especially true when supporting a friend with a chronic pain condition. Let them vent their frustrations to you, or keep the conversation about anything other than their pain condition. Be a good listener and really hear them when they talk.

Know That Cancellations Aren’t Personal – You may have had those plans on the books for months, but temper your expectations and know that a last-minute cancellation is possible and that it is nothing personal. Many chronic pain patients don’t know when their next flare up is coming, and despite their best efforts, they may be having a bad day at the absolute worst time. Be understanding if they have to back out of a commitment and know that their decision to cancel plans isn’t anything personal.

Be A Positive Voice – It can be easy to focus on the negatives of a chronic pain condition, but doing so isn’t good for your mental and emotional health. Do what you can to be a positive voice of encouragement. If you notice that your friend is more physically capable or has made strides since the last time you saw them, let them know. This encouragement and positive talk may be more important to them than you’ll ever know, so try to avoid focusing on the negatives associated with a pain condition.

Be Persistent – Those dealing with a chronic pain condition are less likely to make plans or meet you out on a moment’s notice, so you can be a great friend by regularly asking them to do things. Remember that cancellations or unaccepted invites aren’t personal, but they’ll love that you’re reaching out and wanting to connect. Don’t stop reaching out even if most plans don’t come to fruition. It’s easy for social circles to get smaller and smaller as a result of chronic pain, so don’t stop reaching out even if it takes a while to make plans.

If you do these things and practice patience, you’ll be a great and supportive friend to someone battling a chronic pain condition. It takes a little extra effort, but we know from first hand experience how important it is to have friends like this if you’re working to overcome a chronic pain condition. For more information, or for help with a different chronic pain issue, reach out to Dr. Cohn today at (952) 438-4580.

New Findings On Why Poor Sleep May Lead To Chronic Pain

/ Thomas Cohn, MD

sleepA new study involving mice may have provided some more insights into why poor sleep and chronic pain may be linked.

According to the study, nerve injuries may cause certain brain cells to act excitedly during sleep, and this sudden excitement may lead to chronic pain onset. On a positive note, researchers say that stopping this hyperactivity during sleep could help provide significant pain relief

As we’ve talked about on the blog in the past, sleep disorders and chronic pain are closely related, but the exact nature of why certain sleep problems increase the risk of different types of chronic pain is not well understood. We’ve talked about how it can be hard to break out of the sleep-pain cycle, which theorizes that chronic pain makes it hard to fall asleep and stay asleep, and poor sleep quality can intensify pain sensations, but this recent study wanted to learn more about the exact connection between the two.

Sleep And Chronic Pain

For the study, researchers honed in on neuropathic pain, which is pain that derives from an injury or disease in the nerves that relays sensory information from the body to the brain. Researchers studied mice with injuries in one of the sciatic nerves, the large nerve that branches from the spinal cord through the hind legs. The team analyzed brain activity in the mice both before and after the sciatic nerve injury in order to see how the brain responded to this new pain. The team found that there were significant changes after the injury in the wrinkled cerebral cortex, which is the area that receives and stores sensory data from the hind legs. Moreover, certain brain cells became progressively more active in the weeks after the injury as the mice’s pain became chronic.

Perhaps most interestingly, this brain cell activity peaked during non-rapid eye movement sleep (NREM), which is when deep sleep occurs. Researchers said these neurons became hyperactive during NREM sleep as a result of an issue with the anterior nucleus basalis, a cluster of neurons located deep in the front of the brain. Researchers noted that the activity of the anterior nucleus basalis also increased after the nerve injury, and this triggered the cells to send a chemical response to the cerebral cortex. As a result of this chain reaction, the previously mentioned brain cells shifted into overdrive during NREM sleep.

This increase in brain activity was linked to an increase in pain sensitivity in mice, as researchers stated that once-painless stimuli suddenly became painful. In follow up experiments, researchers were able to relieve this pain by blocking cell hyperactivity along certain neural pathways during NREM sleep.

“Inhibition of this pathway during NREM sleep, but not wakefulness, corrects neuronal hyperactivation and alleviates pain,” the researchers concluded.

So while the study only examined mice, it does provide insights into how neural action during sleep can lead to increased pain during wake periods, and researchers are hoping that some of the findings would be similar in a human population. Future studies are sure to follow, and hopefully we continue to learn more about the connection between poor sleep and chronic pain onset.

For now, do what you can to prioritize healthy sleep if you have a chronic pain condition. Avoid caffeine late in the day, get regular exercise, go to bed around the same time each night and keep electronics out of the bedroom so that you have an ideal sleep environment. You may not be able to control what happens during NREM sleep, but you can work to break out of the sleep-pain cycle by making it easier for your body to fall asleep and stay asleep.

If you’re dealing with sleep issues as a result of your chronic pain condition, or you want help with a different pain issue, reach out to Dr. Cohn and his team today.

Five Ways To Get Your Doctor To Take Your Chronic Pain Seriously

/ Thomas Cohn, MD

painkiller abuse doctorChronic pain is nothing if not frustrating, and that’s especially true when you’re trying to get others to understand the extent of your chronic pain condition. People oftentimes fail to understand the depth of another person’s chronic pain simply because pain is so unique to the individual. And while you may not be much worse off if a friend or family member doesn’t take your pain seriously, you can feel helpless when it’s a medical professional who isn’t taking you seriously.

Not being taken seriously or not being believed is one of the biggest complaints we hear from patients who have had no success treating their pain condition with other providers. We strive to show that we take each patient seriously, but if you want to make it easier for your pain physician to believe your story, we have some tips for you. Below, we showcase some ways to get your doctor to take you chronic pain seriously.

How To Have Your Pain Taken Seriously

The best advice we can give is to search for a physician who takes your word at face value. We understand that’s not always easy, but if you want to make it easier for your physician to understand your pain and take it seriously, consider these five tips.

1. Be Detailed – Be very detailed about your chronic pain and discomfort. Many patients find it helpful to keep a pain journal so that both the patient and provider can get a better idea of how pain has impacted you recently. Don’t just note how intense your pain is, document what makes it better or worse, what foods you ate and what activities you pursued that day so that the total picture becomes clearer.

2. Follow Through – If you’re not willing to do what the doctor recommends, they may assume that you’re embellishing your pain a bit. If you’re skipping your physical therapy sessions, not seeking out exercise or failing to change your diet, then your doctor may assume that you don’t take your condition seriously, so why should they?

3. Have Two-Way Conversations – You may be in a lot of pain, but if you just show up to the doctor’s office and expect them to figure out what’s going on and the best way to treat it on their own, you may end up frustrated with your care. If you want to be taken seriously and have a better chance of finding the right treatment for your pain, the conversation can’t just be one sided. You need to open up to your doctor, ask them questions and then converse with them when they have questions for you. Being helpful and engaged during your appointments shows that you are committed to helping find the right treatment.

4. Ask About Active Solutions – As we’ve said on the blog numerous time in the past, pain medications can play an important part in your treatment, but a doctor will be more receptive to your care if you show an interest in active treatments instead of passive treatments like opioids. When you ask what you can do to help manage your condition with active treatments, it showcases that you’re willing to put in the work and aren’t just looking for the easiest solution.

5. Come To Dr. Cohn – Finally, if you’re sick and tired of not having your pain condition taken seriously, connect with Dr. Cohn and his team. Pain is highly individualized, and we promise to give you the personalized attention you need to figure out what’s going on and the best way to treat it. We strive to go the extra mile for each one of our patients.

For more information, or for help with a specific pain condition, reach out to Dr. Cohn’s office today at (952) 738-4580.