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Category Archives: Pain Management

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.

 

Healthy Spine Tips to Prevent Back and Neck Pain

Lower back pain is responsible for more global disabilities than any other problem. It affects 80% of people at some point in their lives. Up to 90% will also suffer from tension headaches at least once, and posture, neck spasms, and stress can all contribute. The evolution of the human spine has been slow and, at times, painful. It’s simply not ideal for upright walking, so getting your pain under control requires a little effort and support. Causes include:

  • Osteoporosis
  • Muscle strain from overstretching or carrying heavy objects incorrectly
  • Poor posture and badly designed work stations
  • Sports injuries
  • Herniated discs
  • Curvature

A typical strain creates swelling, sets your posture off balance, and causes spasms that create even more pronounced posture problems and swelling. Sports injuries, curvature, and even herniation can create a similar cycle, so two of the most important ways to bring healing are through stretching and spasm release. Physiotherapy, yoga, and stretching achieve this.

You can prevent back pain by

  • Maintaining a healthy weight
  • Lifting with your knees bent and your back upright
  • Taking walking or stretching breaks when you do desk work
  • Using ergonomic furniture
  • Sleeping on your side
  • Quitting smoking. Smokers have more spine problems than nonsmokers and recover from surgery more slowly.

Back Pain Associated with Aging

Osteoporosis, disk degeneration, and spinal arthritis often require more invasive solutions, but your lifestyle can greatly improve your symptoms. Solutions include:

  • Keeping calcium and magnesium levels optimal
  • Strengthening core muscles to support your spine better
  • Stretching and loosening your back muscles
  • Treating strains with ice and compression

The health of your spine is a core contributor to quality of life, and a little loving care can have powerful effects. Want to learn more about ways to relieve back pain? Ready for personalized care? Find a Pain Stop Clinic near you.

Opioid Alternatives for Chronic Pain

Almost half of opioid overdoses in the United States involve prescription drugs. A thousand people a day receive emergency room care for misusing their prescribed painkillers. As a temporary measure, there are few medications quite as efficient at erasing pain than opioids, but this may change in the next five years. Kineta, Inc, a biotech company that specializes in immune modulating drugs, recently began phase one human trials for a new class of chronic pain treatment—and this one does much more than treat mere symptoms.

A New Non-Opioid Painkiller

For the moment, Kineta is calling their new drug KCP-400. It’s a chemical component of cone snail venom that blocked pain signals where they began in animal trials. The drug seems to act at the site of the injury, and its disease-fighting effects also promote healing and reduce inflammation. It will be administered as a weekly injection, and side effects remain unknown. Since it doesn’t cross the blood/brain barrier, it shouldn’t cause tolerance or addiction.

Alternatives to Opioids In Development

Kineta’s search for an opiate replacement is not isolated. Several pharmaceutical companies are working on a new molecular approach that binds opioid receptors along a different pathway than morphine. Researchers hope that by removing the risk of addiction, the new drug class could save thousands of lives and add quality of life to millions of patients.

The DEA is working on the problem from a different angle: by cutting down the production quota of drugs like morphine and oxycodone. Some pharma companies are supporting that effort by making their drugs difficult to crush to prevent patients from injecting them, but this does little to ease the legitimate suffering of chronic pain patients.

A new drug is desperately needed, but until it’s discovered, PainStop Clinics will guide you through your pain using non-opiate therapies whenever possible. Stop in for a consultation.

Over Half of Opioid Prescriptions Given to Adults with Mood Disorders

Almost 10% of the U.S. population suffers from a mood disorder, and 19% of them use prescription opioids. Patients with depression, anxiety, and bipolar disorder are vulnerable to highs and lows caused by medications that directly influence their moods, are prescribing them to this vulnerable group is a contentious issue. Some physicians suggest opioids as a last port of call for lifting depression, but this off-label effect is so short lived that it has little genuine value. To make matters worse, long-term opioid use frequently causes depression and manic episodes, and psychiatric patients are more likely to abuse their medications, due to the psychological drivers behind addiction.

The Depression/Pain Cycle

The opioid problem is so far ranging that the CDC has called for a new social policy to cure what it refers to as over-prescribing. Psychiatric illness poses a particular challenge to chronic pain patients. Depression can worsen your pain, and pain can worsen your depression and anxiety. There is no question that the toxic cycle needs to be broken, and opioids are far from the only option for doing so.

The reason 51% of opioid scripts are given to mood disorder patients is unclear, but it could be that depression and anxiety change the way people respond to pain. Doctors may also be more sympathetic to this group of patients. In other words, if your psychiatric health places you in this vulnerable demographic, it’s crucial that your pain be treated as proactively as your mood is. Every therapy must not only be assessed according to how effective it is, but also how it influences your psychiatric condition.

Surgery, physiotherapy, non-opioid analgesics, and occupational therapy all have an important role to play in chronic pain management. Pain Stop Clinics take a multi-pronged approach that takes our responsibility to whole patient health seriously.

Depression and Chronic Pain

Your frame of mind is inextricably linked to how well you cope with illness. Depression is not just chronic pain’s intolerable result, but its catalyst as well. The two are so commonly connected that 65% of depression patients suffer from pain. In the past, this link was poorly understood, and people with a desperate medical need were labelled malingerers. Researchers are still struggling with a chicken-or-egg riddle of which comes first. Does depression cause pain, or does pain precede depression? The answer seems to be both.

Research Findings on Depression’s Effect on Pain, and Vice Versa

To establish causation, researchers must find an unbiased way to assess these patients from the moment of their first psychiatric and physiological symptoms—and that’s a challenge that’s not been overcome yet. Researchers do, at least, know that physiological pain feels more intolerable when depression exists. The human body is remarkably reactive to feelings of optimism, as Amy Donaldson et al. discovered when they measured the pain intensity of coronary artery bypass surgery patients. The more optimistic they were prior to their procedures, the less pain they reported afterwards.

A sense of hopelessness and confusion can make symptoms more unbearable. Investigators have found that the more precise the diagnosis is, the less pain depression patients experience. Those with more than one symptom were also three times as likely to become depressed. Similarly, depression is linked to poorer outcomes.

Depression cannot simply be fixed overnight. If people with depression could simply decide to be more optimistic, there would be no depression. Understanding the link between depression and pain is not meant to discourage patients with both, but to examine ways that both can be treated to break the depression-pain cycle.

The studies of the last decade have led to a better understanding of how to care for people who have comorbid depression and pain. Specialists with a comprehensive understanding of these two conditions can mean all the difference for the prognosis of both. Pain Stop Clinics employ clinical staff from a range of different disciplines. This way, each unique case is treated from all angles by a clinical team.

Do Opioids Lead to Heroin Addiction?

Drug overdoses kill 29,000 Americans a year, with the majority of those deaths being from opiate and heroin abuse. While campaigners like to draw a link between opioid and heroin abuse, no studies have revealed anything beyond correlation. Most heroin abusers have used opioids before because most Americans have used opioids at least once in their lifetimes. By the same token, most heroin users have used soap in the past. This doesn’t mean cleanliness caused their addictions. The DSM, fortunately, provides a better idea of addiction’s cause.

Addiction vs Dependency

The DSM-V separates addiction into two separate diagnoses:

  • Substance dependency, which is a physiological tolerance to a substance without psychiatric involvement.
  • Addictive/Substance abuse disorder, which involves behavior.

The psychopathological model sees mental disorders as the cause of addiction. Saying opioid painkillers lead to heroin addiction is thus like saying razorblades are the cause of self-mutilation.

When Medication Creates Addiction

The circumstances surrounding a patient’s need to take painkillers should be carefully monitored. For example, if they are prescribed painkillers after undergoing a traumatic event, they may be at higher risk for self-medicating, which can lead to addiction.

If you’re taking opiates due to a substance dependency, the odds are excellent that you’ll never pick up heroin. If you have an underlying pathology like substance abuse disorder, your drug of choice is probably “more”—of anything, whether it be heroin or stronger opioids or a bottle of vodka.

It’s critical that opioid users receive the correct diagnosis because a substance abuse disorder requires specialized care. Those who have developed a dependency are generally able to take narcotic medications without abusing them, but those with substance abuse disorders should avoid that entire class of drugs, from benzodiazepines to pseudoephedrine and Oxycodone.

This doesn’t make dependency a pleasant problem. If you’ve developed a tolerance and are suffering from severe rebound pain, you deserve freedom from a toxic cycle that’s likely leaving your body in constant crisis. Besides, long-term side effects can create more health problems down the road. At Pain Stop Clinics, we treat pain with a holistic approach based on each unique patient profile.

Does Pilates Improve Posture?

You’d be hard pressed to find a fitness guru more obsessed with posture than your average Pilates instructor (perhaps a classical ballet instructor? We digress). Both forms of exercise focus on moving efficiently, and that requires core strength. If you’re relying on your superficial muscles to support you, you probably suffer from at least a little pain. Headaches, pinched nerves, and hip pain can all happen as the result of slouching, and Pilates will address the problem from a few different angles.

Why is Good Posture Important?

If your spine is poorly aligned as you work and play, some muscles must compensate while others become knotted and contracted. Your range of motion will be limited and some of your organs will be compressed. Inflammation can result from nerve compression, too.

Pilates teaches balance, which requires you to rely on core strength while teaching you to balance your weight onto the middle of your foot. You’ll learn a neutral spine position, which keeps your curvature relaxed and natural. If you overcompensate by opening your chest too widely and pushing your shoulders too far back, you will lose your balance, so the process teaches you good habits intuitively.

Pilates for Back Pain

Core strength is an obvious support for back pain, but flexibility has a role, too. By stretching out the muscles around the spine, it releases contractions while reinforcing a healthy curvature. Pilates is so effective at its job that trials have demonstrated improved endurance, flexibility, and posture within only 12 weeks. You needn’t turn your exercise into an obsession to enjoy results. Even mild Pilates routines, when performed twice weekly, have an impact.

Pilates specifically targets the hunched kyphotic lordotic posture, which brings hip spasms, neck tension, and weak abs. Your back pain deserves a proactive solution, and Pain Stop Clinics can help you design a treatment plan.

What is the WHO Pain Ladder?

The vast majority of doctors’ consultations focus on pain management, but before 1986, there was no universally understood way to communicate pain levels. Doctors had to intuit their way through pain care one adjective at a time. The World Health Organization developed the pain ladder as a three step grading system to solve this problem.

The WHO Pain Ladder has evolved from a cancer pain guide into a treatment framework for all chronic pain conditions. The ladder leaked into the medical industry, acting as a catalyst for global teaching campaigns that improved pain awareness. It also came at a cost, triggering a cataclysmic opioid crisis.

Treatment-Based Pain Relief

The ladder doesn’t only guide the kind of treatment you receive, but acts as a flag to alert doctors if your condition requires extra investigation. It’s divided into three levels:

  • Step Three: Severe pain levels: Morphine and other opioids are indicated.
  • Step Two: Moderate, constant pain: Codeine and milder opioids are suggested.
  • Step One: Mild pain rated at 1-3 out of 10: Nonsteroidal anti-inflammatories and acetaminophen are best.

The Problem with Pills

Pain management has come a long way since the Eighties. New, non-opioid medications have been developed that address the cause of pain instead of its symptoms without introducing risky, addictive substances. Symptoms should be taken seriously, not stifled thoughtlessly. All unrelieved pain deserves a second and even third assessment. Pain is, after all, a signal that something is wrong. There is a massive range of therapies, from spinal fusion surgery to neuropathic solutions, that treat the foundation of pain.

The pain ladder fails to address each unique case on its own merits. In medicine, it’s often said that you should treat the patient, not the numbers. Physicians must advance towards a more personalized approach to care. Pain Stop Clinics will support you and your condition compassionately.

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.

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