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Sarah Silverman’s Response to a Chronic Pain Sufferer

Did you hear about Sarah Silverman’s response to a chronic pain sufferer who called her a name on Twitter? It’s been widely covered, but it moves us to comment on what we can learn from her response.

A cynic might joke that in order to get affordable health care, all you have to do is insult the right comedian. Who knows? She might take the high road and decide to help you out!

But chronic pain isn’t a laughing matter. In fact, chronic pain isn’t pretty. Quite frankly, it can make a person cranky on a bad day. It can make a person tired, and frustrated with repeated attempts to seek effective treatment. The celebrity’s empathy and understanding that human beings sometimes lack charity when they’re deeply hurting led to her constructive response.

We should also acknowledge Jeremy, the man on the receiving end of her help. It took some courage for Jeremy to take down his defenses and admit he was having trouble with back pain and emotional trauma. Many pain sufferers make this admission multiple times as they seek help. Continuing to open up and seek help over months and years of suffering until you finally find a path to success takes resilience.

Culturally, we praise and value independence. Supporting yourself financially while handling the activities of daily living feels like success. The flip side to that: not being able to work feels like failure. Needing assistance can feel like failure. We shame victims and shame ourselves if we are victims, as if we should be able to magically overcome all obstacles without outside help.

The truth is far more complicated. The circumstances of your life can only be improved if you acknowledge and respect those circumstances. Healing happens when the community around you acknowledges and respects those circumstances. You might not get everybody in the world to understand your needs, but you at least deserve a treatment team that works with you to understand and improve your condition.

Wherever you are in your pain management journey, you can find your treatment community at Pain Stop Clinics. Find a pain management specialist near you.

Happy New Year from Pain Stop Clinics

How did you feel at this time last year compared to now? If you struggle with chronic pain, you know there’s only one way to approach this journey: one tiny step at a time.


Give yourself credit for choosing to live a better life. We know it can be frustrating when there are false starts and steps back in treating your symptoms, and yet you know it’s worth it. You know you’re worth pain management and treatment that addresses the cause of pain safely and effectively. From all of us at Pain Stop Clinics, may you have a happy and healthy 2018. Thank you for choosing us.


How to Make New Year’s Resolutions You Won’t Regret

A crammed medicine cabinet will only take you so far with pain. Lifestyle factors can have a drastic effect on your symptoms, so why not make the New Year your opportunity to heal?

Exercise to Reduce Pain

Pain is worsened by stiff muscles and lack of circulation, so keeping your body moving can have a powerful impact. Yoga will stretch out your spasms, strengthen your core, and get blood flowing to the areas that need it. Even regular walks will serve you, and if muscle stiffness is holding you back, try water aerobics in a heated pool. You need a minimum of three half-hour exercise sessions a week. If your pain prohibits you from exercising, see a pain specialist to identify exercises that will help.

Improve Your Sleeping Hours

Fourth stage sleep regenerates tissues and heals the damage of the day. Excellent sleep hygiene will not only improve your symptoms, but give you the serenity to cope with your pain more easily. Sleep hygiene supports this. Turn off electronics an hour before bedtime, stay out of bed during the day, and buy an appropriate mattress to support your spine.

Set a Date to Quit Smoking

Smoking impedes healing and worsens musculoskeletal conditions. If you’re planning surgery or are simply looking for new ways to improve your pain, setting a quit date will have a powerful impact on your life. Before that date, cut out habits that you associate with smoking, and speak to your doctor about medications that can support your new way of life by reducing cravings.

Rearrange Your Office

Your posture and physical work habits might be worsening your pain. An occupational therapist can assess your living conditions and create an ergonomic environment in your workspace.

Make 2018 the year you annihilate your pain. You deserve excellent quality of life, and simple habits can help you achieve it. If you suffer from persistent pain and need help managing it, schedule an appointment at Pain Stop today.

Another Reason to Quit Smoking: Prevent Lower Back Pain

The last 10 years have seen an inexplicable increase in functional disability caused by lower back pain. Despite improved treatments, pain and physical function in these patients is worsening in around 100 million U.S. patients. A simple symptom frequently devolves into a complicated condition affecting the entire central nervous system.

Several studies have drawn a link between smoking and lower back pain. A 50-year 2001 John Hopkins survey proposed a link, but at the time, the finding remained unproven and even unexplained. Researchers have since painted a fuller picture of the link. Smoking impacts upon knee, rotator cuff, and disc injuries because it:

  • Increases inflammation
  • Prevents healing
  • Reduces blood supply to wounds
  • Demineralizes bone
  • Impedes the supply of nutrients
  • Reduces bone metabolism
  • Increases the risk of postoperative infection

Lower back pain is associated with a sedentary lifestyle and high body mass index, but surveys are limited in that they use samples from hospital records. They consist of more surgical patients, which means they have higher rates of disability. This limits the survey to only the severest conditions. Those with mild back pain haven’t been covered quite as well.

Even so, smoking’s effect on wound healing is well understood, impacting upon everything from dental surgeries to burns. Nicotine and carbon monoxide constrict veins, limiting red blood cell transport and the macrophages needed for recovery. Oxygen transport to cells is also reduced by the hydrogen cyanide found in cigarettes.

Smokers also recover poorly from surgeries, which severely limits their treatment options.

The progress researchers have made in understanding smoking’s effects on back pain raises an important question. Should smokers be given an entirely different care strategy than nonsmokers? Doctors have wrestled with this problem for decades, but it can only be confronted on a case by case basis.

In any case, if you needed another reason to quit smoking in 2018, pain management makes the list.

Diets for Chronic Back Pain

Chronic back conditions are known to be more burdensome than any other syndrome, but many patients feel they have little control over their symptoms. People who suffer back pain need a balanced diet that supports bone strength, healthy cells, and good collagen formation. You have a new year ahead of you, so make it a pain-free one by choosing a diet to improve chronic pain.


The spine is made almost entirely of water, which offers the flexibility needed to keep your vertebrae protected against shock.


Collagen accounts for 30% of dry bone weight, and it needs a constant supply of amino acids and vitamin C. Glucosamine is an important component in connective tissues, so keep your protein levels where they should be with almonds, meat, broccoli, and quinoa.

Calcium and Magnesium

If you have poor bone density, calcium and magnesium should be core parts of your diet. You need a synergy of minerals to absorb these nutrients well. Keep your levels up with bok choy, dairy products, tofu, and green leafy vegetables. Vitamin K distributes calcium, so you also need to include cheeses, egg yolks, and kale in your diet.

Vitamin D aids calcium absorption and is found in salmon and egg yolks. Some cereals and dairy products are fortified with it, too.



Omega-3-rich foods combat inflammation, so flax, chia seeds, and oily fish could improve your symptoms.

Alcohol and Soda

A daily cola habit can impede your absorption of important nutrients, while alcohol interferes with calcium absorption. Alcohol also suppresses the central nervous system. Combined with certain medications, it can cause breathing difficulties and impaired motor function.

Your diet is the building block of your medical care. Without wholesome food, even the most potent medications and therapies cannot bring their best benefits. Food has a profound effect on our short-term and long-term health outcomes, so fill your plate with nutrients that help your body recover from pain conditions.

Great Gifts For Pain Management

If a loved one suffers from chronic pain, a soothing care package could offer much needed support. Chocolate cures just about every ill, of course, but a more evidence-based gift would be appreciated just as much.

Gifts for Migraine Sufferers

Migraines are a neuropathic and vascular condition that can last days. Their cause isn’t well understood, but their triggers are. Light, noise, flashing, and certain food products are common triggers. Give a migraine sufferer:

  • a pair of tinted glasses.
  • total blackout blinds.
  • ice packs or an adjustable ice wrap.

Tension Headaches and Back Pain

When muscle tension causes pain, targeted heat therapy can relieve symptoms and make them feel tolerable. Give your muscle pain patient:

  • heated mattress pads with dual side control.
  • an infrared heat therapy pad for deeper heat delivery.
  • a deep tissue massage or spa voucher for serious spoiling.

Diabetes-Related Nerve Damage

Sensory diabetic neuropathy and ulcers are often worsened by poor circulation. Dry heat is needed, as soaking can prevent healing. Avoid heating pads, which can cause burns when used on numb feet. Give your diabetic family member:

  • podiatrist-recommended flexible slippers.
  • memory foam insets.
  • insoles designed specifically for those with plantar fasciitis.


Many pain conditions are caused by spasms and are highly responsive to massage. Give your chronic pain sufferer:

  • a massage stick roller with comfortable handles.
  • an electric massage device or pillow.
  • an ergonomic chair.
  • a massage ball.

Better yet, take your loved one to Pain Stop Clinics for proactive medical support. Resist the temptation to offer miracle cures or solutions that worked for a completely different person with a completely different condition, as well-meaning gestures can create frustration.

Remember that the most valuable gift you can give is yourself. Pain can make life challenging, so offer your friend a shopping trip, frozen meals, or your baby-sitting services. Comfort is often in short supply when you’re not feeling well, and friendship is the warmest cure.

How Much Does Exercise Reduce Pain?

Chronic pain encourages a sedentary lifestyle, but recent research suggests that curling up in bed waiting for your aches to disappear could make your condition worse. Exercise not only improves lower back pain symptoms, but reduces your odds of ever developing the problem in the first place.

Positive Effects of Exercise on Back Pain

A daily walk, combined with patient education, reduces risk by between 27 and 33%.

If your lifestyle is currently inactive, you reduce your risk of developing lower back pain by up to 38%, simply by taking up exercise.

Occupational health specialist, Dr Rahman Shiri, suggests strengthening and stretching your core muscles, even if you’ve already developed spine issues. Muscle spasms set your posture off balance, which causes even more spasms, pain, and pinched nerves. By loosening up your back and strengthening your core, you encourage the right muscles to support your body weight.

Add some feel-good aerobic exercise to your routine, and you’ll flood your body with pain-reducing hormones. If you have poor posture, Pilates and yoga can teach you better habits.

The Wrong Kind of Exercise for Back Pain

If you have a painful condition, exercise can worsen your symptoms as much as improve them. Any movements that put your weight onto your back should be avoided. Substitute toe touches with half crunches. Avoid sit-ups, leg lifts, and any movements that place pressure on the hollow of your back. Avoid jarring exercise and take a moderate approach to stretching. If you’re unsure about your routine, your physician or physiotherapist is there to guide you.

Patients who exercise tend to be slow to ask for medical help or take necessary sick leave. It’s commendable to take your health into your own hands by exercising, but try not to view exercise as your only option for wellness.

Taking control of your health has mental benefits as well as medical payoffs. By taking action, you’ll find your emotional response to your pain will improve.

Opioids Rarely Help Bodily Pain: A New Pain Assessment

Pain rating scales have become a medical standard for excellent reason: They give doctors important information about changing symptoms and have led to better outcomes in clinical trials. The pain intensity numeric scale (PI-NRS) and patient’s global impression of change (PGIC) contribute to better care but bring a heavy dose of subjectivity to the consulting room. Partly as a result of this subjectivity, doctors may be too quick to prescribe opioid medication when other treatments would be preferable.

Anaesthesiologist Myles Gart proposes an objective way to assess acute pain. The metrics can be remembered with a cheeky mnemonic based on the acronym ORHBP: Opioids Rarely Help Bodily Pain.


Pain often shows in mood and behavior, but so do symptoms unrelated to pain. By ruling out hypoxemia and other conditions, physicians can assess whether a patient’s pain is intolerable. Gart suggests that analgesics should only be given to patients who have hit 10 on the PI-NRS scale.

Respiratory Rate

The link between respiratory rate and pain has not been proven in trials, but Gart believes that intolerable pain causes a rate higher than 20. He proposes that when rates fall below 12, opioid treatments should not be given.

Heart Rate and Blood Pressure

Rehabilitation doctors often use heart rate to assess pain levels, a link that hasn’t yet been established in trials. A small University of Sherbrook study showed that men’s heart rates rise in the presence of pain. Women’s heart rates weren’t affected.

Similarly, pain might cause high blood pressure during the initial stages of chronic, but not acute, pain. However, studies show that pain often brings blood pressure down, making this an unreliable measure.

Pupil Size

Pupil size is used by anaesthesiologists to detect pain response. As long as the patient is not sedated and medicated with drugs that cause dilation, pupil response can add another layer of objectivity to pain assessment.

The medical world has been searching for an objective way to evaluate pain for decades. Gart’s proposals could bring doctors a step closer to achieving that goal, though it needs more evidence-based support. In its current form, it comes with the caveat that different objective measures, such as vital signs, mean different things for different patients.

The History of Prescription Opioids

Opium first appeared in the historical record in 3400 BC Mesopotamia. Its mind altering effects were so celebrated that it would ultimately cause a war. The ancient Greeks and Romans were the first to discover their analgesic strength, which led to the creation of morphine and, eventually, codeine. Heroin was only synthesized in the late 1800s when the famous pharmaceutical company, Bayer, began to sell it as medicine. Bayer’s current catchphrase is “Science for Better Life,” a distinctly ironic slogan considering the unforeseen chaos heroin has caused among addicts.

In reality, research takes time to collect and analyze data for long-term effects. In the quest for fast pain relief (and profits), new treatments sometimes jump the gun.

Today, the DEA lists all opiates as having a high risk of physical and psychological tolerance. Their addictive properties don’t undermine their usefulness, but they do underline a need for caution. The U.S. government called the opioid abuse crisis a “public health emergency” in 2017, but awareness of its dangers is not synonymous with having a realistic best practice for overcoming the problem.

Patient Rights and Mortality

Profit-seeking is one of the most destructive aspects of the pharmaceutical industry. Patients have a right to pain relief, but if pharmaceutical companies studied tolerance and addiction patterns during their first trials, the current crisis might have been diverted early.

Opioids receive more bad press than most other drugs, not merely for their addictive qualities, but also the fatal effects of their abuse–another issue that should have been addressed before the drugs went to market. Had solutions, such as addiction specialist support and abuse screening tools, been rolled out to doctors during post-market studies, fewer lives would have been lost.

One of the most powerful solutions to the opioid crisis is education. Chronic pain patients deserve pain-free and safe lives. The pharma sector can and should put those rights ahead of profits.

Virtual Reality for Chronic Pain Works

Morphine’s long-term efficacy and safety remains contentious. In studies, it has reduced pain by between one and three points on the numeric pain rating scale, so while it certainly has its place, more effective, safe analgesic therapies are desperately needed. Hope might come from an unexpected place: virtual reality software.

The Studies Supporting VR for Chronic Pain

In March 2017, researchers at Cedars Sinai Medical Center studied the effects of calming virtual reality content on 50 pain patients. They reported a 24% drop in pain—equal to that of morphine. Two dimensional video and music brought a 13.2% improvement.

Psychologist, Hunter Hoffman, tried out a different virtual reality environment called Snow World on burn victims during and after wound care. Patients reported 60% to 75% less pain during their sessions and 30% to 50% less afterwards.

The Brain Hijack

Researcher Brennan Spiegel thinks that virtual reality works as an “immersive distraction” that “hijacks the senses.” It keeps the brain from processing pain, an effect that still needs to be tested over longer periods of time. Spiegel has already begun a larger trial, which will look into how virtual environments affect the length of hospital stays.

The study isn’t as spurious as it may seem. The brain and mood’s impact on medical outcomes is well documented. Optimism not only encourages recovery from surgery, but lowers death rates.

Pain is a strange and stubborn creature. To endure it, you must use all your personal resources. Patients must alter their perceptions of what they feel and find optimism at a time when it’s least available. Many treatments support this difficult task.

Chronic pain constantly occupies a place in your brain, which leads to depression and insomnia. PainStop Clinic understands your suffering and will support you with a range of therapies that replace risky opioid-based medications.


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