Chronic Pain Linked To Dementia, Stroke and Alzheimer’s

August 26, 2021 / Thomas Cohn, MD

A new study published in Regional Anesthesia & Pain Medicine found that untreated widespread pain has been linked to an increased risk of other cognitive and cardiovascular disorders, like dementia, Alzheimer’s disease and stroke.

Widespread pain is a subtype of chronic pain that involves musculoskeletal disorders and related conditions. Previous studies have found an association between widespread pain and conditions like cancer, peripheral arterial disease and an increased death risk, but the latest study puts an even greater emphasis on the importance of working to successfully treat chronic pain.

Chronic Pain Research

For their study, researchers relied on data from 2,464 second-generation participants of the Framingham Heart Study. After an individual assessment, participants were grouped into three subsets:

Those with widespread pain (defined as pain above and below the waists or on both sides of the body).
Those with other pain (defined as pain in on or more joints).
No pain.

Lifestyle factors like BMI, employment status, depression scores, medication history, marital status, education level and other relevant health data were also collected, and then participants were continuously monitored for the beginning stages of cognitive decline, clinical dementia or their first stroke. During the monitoring period, 188 participants were diagnosed with dementia, and 139 people had a stroke.

After analyzing this data based on the previously created groups, researchers concluded that patients with widespread pain were 43 percent more likely to develop any type of dementia, 47 percent more likely to develop Alzheimer’s disease and 29 percent more likely to have a stroke than patients without widespread pain. When only looking at patients over the age of 65, those numbers changed to 39 percent, 48 percent and 54 percent respectively.

And while the study only found a correlation, not causation, researchers felt the findings were strong enough to conclude that “these findings provide convincing evidence that [widespread pain] may be a risk factor for all-cause dementia, [Alzheimer’s disease], and stroke.”

Simply put, if you are dealing with widespread or chronic pain, it’s imperative that you work with a pain management specialist or another professional to help treat the pain. You may think that it’s no big deal to just put up with annoying discomfort, but other areas of your health are in jeopardy if you don’t treat the problem head on. For more information, or for help diagnosing or treating your chronic pain, reach out to Dr. Cohn’s office today. We’re confident that we can find a solution to your chronic pain issue.

Addressing Racial Inequality In Pain Care

August 19, 2021 / Thomas Cohn, MD

Pain care should be readily accessible for all patients, but a recent look into the landscape of pain management across the US found that race oftentimes affects the level of care a patient receives.

According to a new study out of Dartmouth College, the US medical system provides less pain relief to black patients than white patients, and this trend has been in place for some time now. Perhaps the most notable finding in the study is that while black and white patients receive the same number of pain relief prescriptions, doctors routinely prescribe significantly lower doses for black patients.

“Our findings likely reflect systematic racial bias throughout the course of care leading to pain medicine receipt,” said the study’s lead author, Nancy Morden. “We hope our system-level reporting will prompt dialogue and commitment to deep exploration of this inequity — its causes, consequences, and tireless testing of potential remedies.”

Pain Care Differences By Race

For their study, researchers analyzed data from 310 health systems that provide primary care to black and white patients. Overall, black and white patients were equally likely to be given prescriptions for pain relief, but there was a big discrepancy when it came to the dosage. In 90 percent of healthcare systems monitored for the study, white patients received higher doses on an annual basis than black patients. In most of those systems, the difference in prescription strength was around 15 percent or greater.

So what is driving this divide? According to researchers and other medical experts, a number of different factors could influence this disparity. Some of those believed factors include:

Racial bias
Belief in untrue stereotypes
Decentralized health system that fails to address racial inequality
Lowered patient expectations

On the last point of lowered expectations, some medical experts theorize that black and white individuals approach medical treatment differently. They believe that white patients may be more demanding when it comes to access to stronger opioids because they feel like they have a right to those medications, whereas black patients may not rate their health as being as bad as it actually is when compared to others they know.

While these results are concerning, they can help start a conversation to bring about change. At our clinic, we do everything in our power to help every patient on an individual level, no matter their age, race or sexual orientation. We’re singularly focused on helping you achieve pain relief. At the same time, we also want to acknowledge these racial inequalities in pain management, because they certainly exist. We will continue to not only provide the best care we can, but also keep our team aware of how the potential for overlooked racial biases can negatively affect a patient’s level of care.

Hopefully the pain community as a whole learns from these findings and makes necessary changes to ensure every patient gets the care they deserve. If you feel like you are not getting the highest level of care from your pain provider, we urge you to reach out to Dr. Cohn and his team today.

Why Chronic Pain Management Is A Lot Like Dieting

August 11, 2021 / Thomas Cohn, MD

dieting Chronic pain is a common health condition that affects millions of Americans each and every day. Similarly, millions of Americans have attempted to lose weight through a diet program at some point in their life. When you think about it, a chronic pain management plan and a successful diet are a lot alike in a number of ways. In today’s blog, we explain why chronic pain care is a lot like a diet program.

Chronic Pain Care Is Like A Diet

If you have chronic pain and you’ve ever tried to go on a diet in the past, you probably realize that they share a number of key points, which are:

1. There’s No Magic Pill – Whether it be chronic pain or losing weight, there is no quick fix to the problem. You’re not going to find a magic pill that will cure your pain or have you shed 15 pounds overnight. Stop looking for the easy fix, because that’s only going to distract you from the helpful treatments.

2. It’s Going To Take Work – Piggybacking off the above point, dieting and pain management are going to require a significant commitment on your end if you want to see the best results. The more work you put in, the better results you’ll see. We’ve never had a patient say “I wish I would have tried less to manage my chronic pain,” but we’ve definitely heard people say they wish they would have worked harder. In pain management or dieting, you get out what you put in.

3. String Together More Good Days Than Bad – While this is sometimes easier sad than done, it’s important to realize that every single thing you do doesn’t have to be perfect when it comes to dieting or chronic pain care. It’s fine to reward yourself with a snack after an intense workout, and it’s not the end of the world if you have to cancel plans because of your chronic pain. Not everything needs to be perfect so long as you’re working to have more good days than bad. Doing your physical therapy exercises each day and making healthier food choices more often than not can help you string together more days where you feel like you helped yourself get healthier, and that’s what’s most important.

4. Celebrate Your Progress – Don’t just focus on your end goals and measure your success off of that. We understand that you often have specific weight goals or want to be completely free from chronic pain, but make sure you also celebrate the progress you’re making towards that goal. If activities are less painful or you’re losing weight (even if it’s not as much as you originally hoped), celebrate these wins instead of only viewing success as the final result. It will make it easier to continue working towards your goals if you celebrate the progress you’ve made so far.

5. A Specialist Can Compliment Your Approach – Finally, a chronic pain specialist or a dietitian can help provide individualized advice and give you that extra assistance you need to reach your goals. Never be afraid to ask for help or reach out to a professional for assistance, because that’s what we’re here for. So if you want a little extra help managing or overcoming your chronic pain condition, reach out to Dr. Cohn and his team today.

The Five Best Things You Can Do To Treat Your Chronic Back Pain

August 5, 2021 / Thomas Cohn, MD

Back pain is incredibly common, and while it is unique to the individual, oftentimes it can be treated in a similar manner if you follow some smart conservative care techniques. These care techniques are by no means guaranteed to help relieve your pain, but many people find partial or full pain relief by pursuing these options for an extended period of time. In today’s blog, we take a look at the five best things you can do to treat your chronic back pain.

Five Smart Ways To Treat Your Spine Pain

Here’s a look at five ways to help put an end to your chronic back discomfort:

1. Exercise and Activity – If you have back pain, you may feel like the best thing you can do is to rest and let healing run its course. While rest can be great in the immediate aftermath of a painful flareup, it’s not a great long-term solution. Light exercise and simple stretching techniques can help to promote healing and improve blood flow, so work to stay active if you want to help quell your symptoms.

2. Mind Your Diet – If you’re overweight or obese, your spine is going to be asked to deal with excess stress. Working to lose weight can reduce the pressure that is put on your lumbar spine when you move, which can help eliminate your chronic back pain. Even if you’re at a healthy weight, poor dietary choices of excess sugar and fat can lead to the onset of spinal inflammation, which can make movement painful. Strive to eat healthier if you’re dealing with chronic back pain.

3. Hydrate – Staying hydrated is one of the simplest ways to care for your spine. That’s not to say drinking water will magically cure your spine, but it can help improve muscle function if spasms are causing your discomfort. Staying hydrated also helps to improve blood flow, which can help ensure areas get enough oxygenated blood to function properly. Drink plenty of water throughout the day and be wary of excess caffeine or alcohol intake.

4. Care For Your Mental Health – As we’ve said on the blog numerous times in the past, chronic pain is not just a physical condition. There are also significant psychological and emotional components. So while you may want to focus on your physical pain, make sure you’re caring for your mental health. Take time to clear your head each day, and work to limit anxiety and stress when possible. If you’re in a good mental space, it will be easier to care for your physical health.

5. Connect With A Pain Specialist – Finally, if all else fails or you really want to fight back against your chronic pain, connect with a pain management specialist like Dr. Cohn. He’ll be able to give you a comprehensive diagnosis and set you up with an individualized pain management plan. Chronic pain can be very tough to treat, and it’s always helpful to have an expert in your corner. Let Dr. Cohn and his team be your guide.

For more information, or for help with your chronic back pain, reach out to Dr. Cohn’s office today.

Chronic Pain Can Affect Your Ability To Regulate Negative Emotions

July 29, 2021 / Thomas Cohn, MD

A new study out of Australia has found evidence that chronic pain can alter the brain in such a way that a person may have a harder time regulating negative emotions.

The news isn’t all that surprising, especially since there have long been links between chronic pain and feelings of anxiety or depression, but it does help to provide more hard evidence that it’s imperative that you care for your mental health if you’re been diagnosed with the physically debilitating condition of chronic pain. It’s clear that chronic pain doesn’t just cause physical pain, it also affects how we process and regulate emotions, which can make treatment all that more difficult.

Pain And Emotion Regulation

For the study, researchers compared 24 individuals with chronic pain to 24 individuals with no history of chronic pain. Researchers examined the GABA levels of each patient, which is an inhibative neurotransmitter in the medial prefrontal cortex. Lower levels of these transmitters means that brain cells can’t communicate as effectively, which can make it harder to regulate emotions like anxiousness or worry. Researchers found that patients with chronic pain were found to have significantly lower levels of the neurotransmitter than the control subjects, regardless of what type of chronic pain condition they were suffering from.

“A decrease in GABA means that the brain cells can no longer communicate to each other properly,” said Sylvia Gustin, lead researcher on the study. “When there’s a decrease in this neurotransmitter, our actions, emotions and thoughts get amplified.”

Researchers said that the study only found a correlation between chronic pain and neurotransmitter imbalances, but they also believe that it’s possible that pain could be the root cause of these brain changes.

“Everything starts with stress,” said Gustin. “When someone is in pain, it increases stress hormones like cortisol, which can trigger massive increases in glutamate. This happens during the initial, acute stage of pain.”

They believe that immune cells in certain parts of the brain then attempt to regulate this downturn in neurotransmitter ability, but this process can make it harder for the body to manage certain emotions.

“As a result of this disruption,” said Gustin, “a person’s ability to feel positive emotions, such as happiness, motivation and confidence may be taken away – and they can’t easily be restored.”

Hope On The Horizon

However, it’s not all doom and gloom when it comes to chronic pain. With this further understanding, researchers hope to conduct additional testing that can better understand this connection and in turn develop some treatment techniques that specifically target GABA and gluatmine levels in the medial prefrontal cortex. And while those treatments are being developed, the study also shines a spotlight on the importance of mental health management if you’re dealing with chronic pain.

So if you are battling chronic pain and you’ve noticed that you’re having a tough time regulating emotions or that mood swings have become more frequent, reach out to a specialist who understands the importance of managing the chronic pain condition in its entirety. Dr. Cohn and his team can help find an individualized treatment that’s right for you and that accounts for your mental and physical needs. For more information, reach out to his clinic today.