Pain Stop Pain Management Blog | AZ & MO Pain Clinics

Pain Relief Blog

10 Steps from Patient to Person from ACPA

Scratching an acceptable quality of life out of the mud that is chronic pain is difficult, but not impossible. The American Chronic Pain Association suggests 10 coping skills that will clear your way.

1) Acceptance

Pain is a part of your life that may not be curable. Wishing won’t make it true, but acceptance of pain has been proven to improve treatment outcomes. It even improves your emotional state and social functioning.

2) Be involved

Patient empowerment improves outcomes, too, so becoming active in your care will help your emotional state and enable you to fine tune your treatments more effectively.

3) Prioritize

Your life is still important, even if it’s mired in pain. List your life’s priorities so that you use your “spoons” wisely.

4) Create realistic goals

Make sure you can accomplish them, then celebrate your successes.

5) Know your rights

As a patient and as a friend, you have a right to respect, to make mistakes, and to defend your boundaries without guilt.

6) Honor your feelings

Your emotions have a powerful impact on your physical wellbeing. Notice them and cope with them because they’re one of your most important tools for dealing well with your pain.

7) Find peace

Stress makes pain worse and harder to manage. Tools like mindfulness and meditation improve both pain acceptance and quality of life.

8) Stay Active

Exercise can keep your muscles flexible so that they feel less pain. Develop a strength and flexibility program with your doctor or physiotherapist that respects your abilities while improving your condition.

9) See the whole picture

Your rights, priorities, and goals will show you that pain needn’t be your primary focus in life. You can live a normal life.

10) Ask for help

One in three people live with chronic pain. That gives you an enormous resource for support and learning.

If you are ready to take control of your pain, schedule an appointment at Pain Stop Clinics today.

Risks of Long-term Over-the-Counter Drug Use

“Over the counter” is not a synonym for “no side effects.” Any medicine that can treat a symptom will also be powerful enough to cause harm. If you don’t know what to watch for, you put your health at risk, especially if your care isn’t overseen by a doctor.

Kidney and Liver Function

Any prolonged or chronic usage of medications can be harsh on your kidneys and liver, which are responsible for detoxifying the body. If you regularly take NSAIDS, opioids, and anti-convulsants, your doctor should be checking your kidney and liver function every six months.

Stomach Ulcers

While NSAIDS are some of the safest OTC pain medications on the market, they can have surprising effects on some patients. They’re harsh on the stomach, so prolonged usage can cause stomach ulcers and gastritis. This is why your package inset tells you to take them after meals and for no longer than 10 days in a row. Their harshness doesn’t stop at the stomach: some can cause irritation throughout the gastrointestinal tract. Aspirin is equally corrosive.

Heart Attacks

The FDA has issued a warning of NSAIDs increasing the risk of stroke and heart attack.

NSAIDS and Blood Thinning

Aspirin and NSAIDS can thin the blood, making it difficult to clot, so they shouldn’t be taken with other blood thinners like Warfarin. Speak to your doctor about discontinuing them two weeks before surgery, too.

Hyponatremia

Tegretol and opiates can lower your sodium levels, causing cramps, headaches, drowsiness, and memory loss. It’s critical to have your sodium levels tested often if you take these drugs, and to treat these symptoms as emergencies until you know their cause.

Your doctor should be involved in your treatment, even if your medication is offered over the counter. Long-term use of any drug requires careful monitoring.

What is Biofeedback for Chronic Pain?

Neurofeedback techniques are heaving with contention, myth, and misunderstandings, so it’s no surprise they find themselves in evidence-based medicine blogs so often. The therapy works on the basis of abnormal brain patterns. Patients are hooked up to an EEG and trained to relax or focus. Neurologist Steve Novella calls biofeedback a cognitive behavioral therapy that teaches patients to “adapt and adjust”.

What Biofeedback Can and Cannot Do

It’s not possible to train the brain to have “normal” EEG patterns, but it is possible to learn how to relax. Your emotional state has a powerful effect on how well you cope with pain. It can even push your symptoms to new heights, throwing down the first domino in a complex anxiety/pain cycle. Neuropathic pain’s expression responds directly to stress, possibly because the chronic pain pathways intersect with the brain’s emotional center.

Neurofeedback is sometimes done with EMGs, which measure muscle tension. This may help patients to become more aware of their bodies’ response to pain. Relaxation techniques and mindfulness have a varied effect on different kinds of pain. Small trials suggest that lower back and neck pain may respond well to progressive muscle relaxation, which can be learned through EMG biofeedback.

Biofeedback’s reliance on brain wave patterns can distract from its role as a CBT technique. Any form of relaxation can benefit symptoms that are exacerbated by anxiety, including chronic pain. Since pain itself often causes depression and anxiety, cognitive behavioral therapy is a much needed and too often ignored treatment.

Magical Cures and Snake Oil

Alternative medicine practitioners have embraced biofeedback as a therapy for everything from ADHD to high blood pressure. Clinical trials have yet to show any results, but neurofeedback is as adequate as any other cognitive therapy for pain patients needing to reign in their anxiety.

The Relationship Between Emotional and Physical Pain

The space between physiology and emotion grows smaller with each passing study, and the reasons are more obvious than you might think: The physiological and emotional pain centers in the brain overlap.

fMRI studies show that pain intensity shrinks when the hippocampus reflects patients’ optimism, and other studies have shown that chronic pain damages some sections of the brain in the same way psychological trauma does. The anterior cingulate cortex is responsible for feelings of rejection and pain, but there are other, more important, regions involved in both. Some forms of emotional and physical pain share a neural pathway, which seems to respond to acetaminophen.

The Studies

In 2013, researchers found that Tylenol dulls your response to grief. More recently, 62 people were given acetaminophen or a placebo for three weeks and exposed to social rejection. A second study used MRIs to find out how the drug affected emotional pain. Chief researcher DeWall will be doing follow-up studies to find out if the aggression, risk taking, and overeating so often related to social rejection might be kept at bay by analgesics, too. The trials were small ones, but they follow years of research that’s showed similar results.

When Pain is a Healthy Response

The question emerging from these trials is whether turning to painkillers is the answer to life’s ordinary emotional ups and downs. Of course, when depression or other mood disorders are a part of the picture, medical treatment is critical, but if you’re facing nothing more than a broken heart, feeling your emotions might be necessary since numbing everyday pain is unhealthy enough to create an entirely new set of symptoms.

Medicating normal feelings is a disorder in itself. The best (and only) way out of emotional pain is through it, because numbness only postpones difficult emotions for later. As with physical pain, treating the cause beats treating the symptoms, and meaningful treatments often take time. That doesn’t mean you shouldn’t ask for help if you are really hurting, because you could benefit from short-term or long-term therapies. Talk to your doctor if you are worried about your quality of life.

Opioid Deaths Among Veterans Highlight Need for Better Treatments

Between 2000 and 2012, opioid painkiller prescriptions rose by an alarming 270%. Fatal overdose rates were twice the previous national average, and veterans were twice as likely to die from opioid overdose. The Wall Street Journal blames the Nineties prescription epidemic.

Opioids are also fueling heroin addiction, as users build tolerance to milder painkillers. Half of vets who were involved in Middle East conflicts report chronic pain, so the problem is dire for more than one reason. Alternative therapies such as physiotherapy and off-label prescriptions can help greatly. Opioids should not be the first port of call.

Signs of Addiction

Dependency and addiction are different things. The former refers to a physical set of symptoms, which arise in response to tolerance of the drug. If you have a dependence, your body has become so used to your painkillers that you will develop side effects when you stop using them, so your body may need help to wean off opioids safely. Since you will also crave opioids when you stop, it’s important to get professional support.

In contrast, substance abuse disorder includes these symptoms:

  • Repeated failure to fulfill social, work, and family obligations.
  • Repeated use that puts you in harm’s way.
  • Recurrent legal problems.
  • Continued use even though social and physical problems are exacerbated by it.

Opiate dependency can cause rebound pain and mood swings. As a vet, it might also exacerbate PTSD. This raises your odds of a fatal overdose, which is why opioid addiction among veterans has produced such startling effects.

Military-specific help is available for counseling to support recovery from addiction or psychiatric-behavioral issues. However, your chronic pain treatment partner is also core to your recovery. Pain Stop Clinics will cope with your symptoms without over-prescribing painkillers. You deserve reduced pain that doesn’t have negative consequences.

Opioid Overprescription Among Veterans With Chronic Pain

The Tomah facility earned its nickname, “Candyland”, for its over-prescription of opioid painkillers. Chronic pain is the most common reason Middle East veterans seek care. It’s often suffered together with post-traumatic stress disorder, with 66% of PTSD vets having a coexisting chronic pain condition. By the same token, 47% of vets in treatment for neck and back pain also have PTSD.

The VA is working on adding new types of chronic pain treatments to its arsenal, but many of the therapies it’s selected don’t come close to having a foundation in evidence-based medicine. This leaves veterans with few recovery options, but funding has been pushed through to improve the situation.

One of the most important tools to fight the prescription epidemic is by offering treatment alternatives that genuinely reduce pain. Since emotional states have a powerful impact on pain levels, treatment of psychiatric disorders is equally key.

Coping Tools

Over the last 30 years, multidisciplinary pain clinics have shown themselves to be 75% more effective than conventional care. Pain patients should be taught how to manage their pain behaviors and use cognitive tactics to manage their symptoms. Of course, physical care cannot be ignored, and there is a host of treatment options that don’t include opioid prescriptions.

Medical innovation leaps forward every day, and chronic pain is one of its core focuses. This has created an entire set of evidence-based treatment types that can reduce pain and symptoms of PTSD. Pain Stop Clinics offer the multidisciplinary approach that has shown itself to be so powerful among veterans. You deserve the best care, and that’s what we provide.

The Nocebo Effect and Pain Management

There’s an excellent reason some doctors don’t warn their patients about medication side effects. When you expect negative symptoms, you’re more likely to experience them, a phenomenon known as the nocebo effect.

When researchers used fMRI to uncover the physiology behind this tendency, they found that no less than 12 regions of the brain were involved. Everything from the rational prefrontal cortex to the more emotional temporal gyrus responded to health expectations. The brain is a powerful and mysterious organ, capable of changing how you experience your body. Expect pain, and you’re likely to feel it. Expect nausea, and your brain will make it happen, too.

Medical trials frequently suffer under the weight of the nocebo effect. 11% of placebo takers dropped out of a fibromyalgia study due to perceived side effects. 26% of the control group in a lactose intolerance trial suffered gastrointestinal symptoms. Getting beyond the nocebo effect is no easy task. If you’re a suggestible person, you’re likely to experience it at least once, and your healthcare worker is the best tool you have for combating it.

The Power of Words

Even the most sensitive healthcare workers can trigger a nocebo effect, so the only way over the hurdle is through awareness. Secret-keeping is not a solution. Your physician must understand the power of words, which can increase reports of bad reactions by as much as 2000 times.

JAMA nocebo researcher, Ulrike Bingel has found that clear and thorough communication is the best tool to overcome false adverse effects. Your physician should describe your drug’s effects and their likelihood clearly, without jargon. Doctors at Pain Stop Clinics remain aware of the power of the mind so that they can better guide patients away from their fears with active listening, sensitivity, and realistic hope.

Can Placebos Relieve Pain?

When doctors run clinical trials on animals, they have to do so in a way that doesn’t trigger the placebo effect. If this odd medical quirk is powerful in four legged creatures, how much more potent is it in humans? Ted Kaptchuk decided to find out. His study of sham acupuncture treatments and genuine asthma inhalers found that the placebo effect changed the way patients perceived their breathing, but did not change their lung function. Yet contrary to popular belief, the placebo effect isn’t a magical cure, and this must be respected.

Placebos and Pain Management

Chronic pain patients are particularly prone to suggestion. The pain threshold rises and falls in direct relation to your thoughts. When researchers told their subjects that ice water would improve their pain, they tolerated it better. When they were told the opposite, their pain tolerance shrank. The challenge of treating pain lies in taking patients’ reports seriously while simultaneously activating the placebo effect. Your mind is powerful enough to reframe your pain, help you to relax into it more, and endure it more easily.

Placebos vs. Evidence-Based Treatments

In another study, migraine patients who took a placebo labelled as a migraine therapy experienced almost half the pain relief of patients who took a genuine migraine therapy. There is thus no substitute for evidence-based treatments. Physicians who treat pain syndromes must never use the power of positive thinking as a substitute for genuine therapies. They must take place in an environment that is honest, positive, and empathetic, but doctors must also get to the core of the problem.

Remove the cause and you remove the pain, which is why Pain Stop approaches interventions at their root. Patients don’t merely want their pain to stop, but to stop permanently and with minimal side effects. That is what they deserve.

How Evolution Causes Back Pain

Mankind might be at the top of the food chain, but it’s not because we have perfectly adapted bodies. Evolution has done a fair job of providing opposable thumbs and an efficient brain, but perhaps the back could use some improvements.

A Body Made of Paperclips

Jeremy DeSilva said, “Evolution works with duct tape and paperclips,” and that applies more to the spine than most other body parts. It evolved to suit four-legged movement, and it’s not yet developed to suit bipedal postures perfectly. Richard Dawkins says the human spine is so similar to a gorilla spine that it’s barely adapted to a bipedal gate.

The back was built to arch like a bow so that it would carry the weight of organs in the undercarriage. Standing up threw the structure out of balance, curving the back in the other direction. This places pressure on the lower back, leading to pain.

The curvature of a normal human spine tends to cause a lesion between discs in the lower back. At its worst, it’s prone to scoliosis and sciatica. The spinal cord is also unable to heal fully if damaged because its neurons are too specialized.

Coping with Pain

The back is the most common region for chronic pain. Ergonomic living is an excellent preventative tool, but when the damage has already been done, more work is required. A pain management specialist may be needed to put together a treatment team for your unique problem. Stretches and other exercises may be used to release tight muscles, and specialized treatments such as low impact water therapy and neurological care may be indicated. Your Pain Stop Clinic will take a multi-disciplinary approach to your pain, giving you the best chance at relief.

Evolutionary Biologists Puzzled Over Pain

Painful tissue damage and inflammation tell you that they are there and need care, but even Richard Dawkins can’t find the evolutionary advantage of agony over a more tolerable, subtle ache or other signal. Without pain, you wouldn’t know that fire is dangerous or that your aching back needs treatment. Soreness is one of the crowning achievements of natural selection, but the body takes it to unnecessary heights.

Maybe the brain needs to tell us which sensations to prioritise. If you’ve not taken in fluids for two days, for example, your thirst is more important than your slightly bruised foot. If you’ve put your hand in a fire, though, it’s best to rescue your limb before you go hunting for the nearest stream. Varying intensities tell you what requires urgent action.

Neurology’s Viewpoint

People with disorders that prevent pain “usually come to a bad end,” says Dawkins. These patients must learn how to identify signs of harmful burns and breakages, but they often fail to adjust. They tend to suffer serious disabilities as a result.

It’s doubtful you’d take a more tolerable signal seriously, which lends credibility to the Darwinian explanation, but that doesn’t tell us the point of migraines and other painful disorders. Neuroscientist Vincenzo Bonavita believes that these seemingly useless pain signals force you to disengage from active life and get the necessary rest. In other words, even when that backache or headache isn’t pointing to tissue damage, you should take it seriously.

Pain is an important part of your health. Your nerves’ signals are as precise as a Geiger Counter. If you’re hurting, your body is telling you to hunt for a cause and some relief, so you need a pain specialist who takes your symptoms seriously. Pain Stop Clinics will do precisely that.

Your Pain STOPS Here. Become a Patient