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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.

Service Dogs for Chronic Migraines

Dogs are truly amazing creatures. They can be trained to work with anyone and to identify all sorts of health-related problems. Due to their strong sense of smell, they can identify odors we humans can’t. As any dog owner knows, they are also extremely keen on our behavior and are able to pick up on subtle changes. If you or someone you love deals with chronic migraines, you may want to consider a migraine alert dog.

Early Warning Signs

There is nothing worse than a full on migraine. From time to time there are symptoms you can identify ahead of time. These early warning signs help you prevent the migraine from fully developing. Now, every individual has unique symptoms and you likely will be able to identify some of these triggers and patterns over time. You’ll also learn how to cope with some of these triggers. Yet sometimes, migraines still seem to come out of no where.

Migraine Alert Dogs

A migraine alert dog perceives changes in both physical and psychological behaviors that precede a migraine. Dogs are able to identify the prodrome phase, which often begins a migraine attack. The dog is then able to warn you so you can take yourself out of the situation or seek preventative treatment. The prodrome phase can start up to 48 hours before a migraine attack.

If you have a dog who seems to be trying to get your attention before you suffer a migraine, you might have a natural migraine alert system. In this case, consider training and certifying your dog as a service animal. Any breed or size of dog can become a service dog if they are intelligent and attentive, and if they undergo the appropriate training. Consider meeting dogs at your local shelter to find a good partner in pain management.

Coping with Chronic Knee Pain

Knee pain is a very common musculoskeletal condition. It’s the number one reason people seek out pain relief. Chronic knee pain can be long term, with swelling and sensitivity in one or both knees. Each person’s experience with knee pain will be different, so what someone else is going through may be quite different than what you are experiencing.

Causes of knee pain are many and varied. These include:

  • osteoarthritis
  • tendinitis
  • bursitis
  • rheumatoid arthritis
  • torn ligaments
  • bone tumors
  • meniscus tears
  • dislocation

Knee pain can be caused by a variety of movements or injuries that may include overuse, a sprain or strain, sports-related injuries, or falling. All of these incidents can lead to chronic knee pain where the pain feels as if it will never go away.

Chronic knee pain is pain that has been going on for two months or more with no satisfactory explanation. You may have had a leg or knee injury in the past, or you may have rheumatoid arthritis now. All you know is that there is some damage inside of your knee and it just keeps getting worse with each passing day.

Annoying pain can suddenly become more severe for seemingly no reason. Knee pain ultimately comes down to the wearing away of the cartilage which covers the entire knee joint area. Every time you walk, there is more friction on the joint and hence, the pain continues.

The good news is that Pain Stop Clinics, a pain management provider in Phoenix has solutions. These solutions mean that you can achieve real pain relief. There are lasting ways to remedy knee pain; chronic pain is not something you have to resign yourself to.

Treatment options are something your doctor will discuss with you. There are any number of effective treatments available to help you conquer knee pain, including:

  • Physio therapy and therapeutic exercises
  • Joint injections
  • Trigger point injections
  • Massage therapy
  • Low-dose steroid injections
  • Pharmacological intervention

When you decide you’ve had enough and want lasting pain relief for chronic knee pain, you’ll find there are many options open to you. Pain management in Phoenix is available and waiting.

Remember, if a knee problem isn’t treated properly, it can lead to chronic conditions. That, in turn, will lead to hip and back pain, all because your knee pain causes your body to compensate in other ways.

Chronic Pain and Depression

No one likes having to deal with pain. In a world where just about everything can be solved or has an endpoint, pain which goes on and on is certainly not welcome. Chronic pain is not good for your mental health and overall state of being. In fact, it can make things decidedly worse.

What is Chronic Pain?

Chronic pain is any pain that lasts longer than usual. You could almost compare it to an endless toothache. Long after an injury or problem has healed, the pain continues. It may cut into your daily life in that you begin doing things differently, or stop doing things altogether. Because all you’re looking for is pain relief, if not diagnosed and treated properly, chronic pain can often lead to substance abuse.

Your body will react in different ways with chronic pain. Chronic pain is characterized by low energy, muscle pain, abnormalities in brain hormones, mood disorders, and impaired physical and mental performance. As neurochemical changes in your body take place, chronic pain worsens.

This leads to pain in other parts of your body, where once you may have never experienced pain. Chronic pain leads to not being able to sleep at night, which means that during the day you are tired don’t feel like doing much of anything. Where once you had great enthusiasm for the day, now nothing matters because you don’t have the energy to deal with anything but the pain.

Depression can set in. If your chronic pain has led to depression, know one thing: you’re in good company and there are treatments available to help you.

Neurotransmitters in your brain, the brain chemicals that act as messengers between nerves, are shared by both depression and chronic pain. That includes some of the pathways in the brain and spinal cord as well. It’s no wonder that chronic pain can lead to a feeling of depression.

Think of depression as a magnifying glass. It’s bad enough coping with chronic pain, and depression only magnifies the pain you have. Given enough time, many things start to be affected: relationships, your job, hobbies, and your social network, whereby daily living becomes a chore.

Here’s the good news: because chronic pain and depression are so closely linked, there is pain relief, and they are treated together. It just makes sense doesn’t it, to treat the whole condition and not just a piece of it?

If you have chronic pain which has led to depression, know that pain management in Phoenix has the cure for you. Don’t make pain a part of your life. It doesn’t have to be that way.

Stop Sciatica Pain with Pilates

Sometimes back pain is sciatic pain. If you’ve been experiencing sudden pain in your back upon arising, a pain that travels down one of your legs, chances are it’s sciatic nerve pain. Sciatica is caused from either a herniated disk, tight muscles, or some type of injury to the nerves in the spine.

Other symptoms of sciatica include pain while bending, numbness, or tingling in the leg after prolonged sitting, a pins and needles sensation, or pain felt around the mid-buttock to the side. These are usually chronic in nature, meaning they don’t just appear and then disappear quickly.

Because the sciatic nerve controls most of your lower body’s sensorimotor activity, anything that puts pressure on this nerve can cause some type of sciatic nerve pain. There are exercises known as Pilates that can help to alleviate some of these sciatic symptoms.

Pilates exercises won’t cure sciatica, but they may go a long way to helping you with gaining sciatic nerve pain relief. It’s very unlikely that Pilates will cause sciatica, although it is true that certain exercises may make a sciatic situation worse. If you have any type of sciatica, do not engage in any exercises that have you rolling like a ball, where you are rolling back and forth on your spine. That said, there are several other Pilates exercises you can utilize, and pain management doctors in Tempe can help develop a Pilates routine to help you alleviate sciatica pain.

Mat Exercises

Exercises such as the cat stretch, where you kneel on all fours, and gently round your back to an upwards curve, can be useful in alleviating sciatica symptoms caused by spinal stenosis.

The swan exercise is best for a herniated disc. Lie face-down, flat on the mat, with your elbows and forearms on the floor and your fingers under your shoulders. Lift your head, neck and chest slowly from the floor, extending your spine. Return slowly to the floor and repeat 4 or 5 times.

Equipment Exercises

You can also gain sciatic nerve pain relief from the use of a Pilates chair. If you have a herniated or degenerated disc, lie face down on the machine with your hands against the pedals. Pushing down on the pedals, you can extend your spine.

Pilates exercises are best discussed with your pain management doctors in Tempe, in that they are qualified to recommend what will work best for your particular sciatica condition.

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