NPR did a great piece on an integrated program that treats patients with chronic pain using exercise, nutrition and education. Sound familiar? The program is sponsored by Kaiser Permanente in response to the opioid epidemic and the growing concerns around using opiates as "front line" treatment for pain complaints. Restore Fx is proud to say that we have been providing this type of integrative care for the past 12 years! Listen to the podcast and we think you will see the similarities -- not only is their program interdisciplinary (as is ours) but it has all of the practitioners/healthcare providers in the same location functioning as a team (again, like ours!). Kudos to Kaiser for making this program available to its clients in Colorado. We hope that other insurance providers take note and start to offer this kind of care to their clients.
There has been a lot of research coming out on loneliness as a risk factor for health and longevity. Some studies have even gone as far as to say that loneliness is a higher risk factor for mortality than cigarettes. So what does social support (or it’s inverse, loneliness) have to do with chronic pain?
Well, there have been studies done on this subject and the results probably won’t surprise you. For example in one study of almost 200 patient, people who described their families as being supportive reported significantly less pain intensity, less reliance on medication and greater activity levels (Jamison,R., Virts, K. The influence of family support on chronic pain. Behaviour Research and Therapy. 1990. Volume 28, 4, 283–287). Several other studies have found that a lack of social support is associated with higher levels of depression and poorer pain adjustment (Campbell, Clauw & Keefe, 2003; López-Martínez et al., 2008; Romano, Turner & Jensen, 1997; Tsai et al., 2003).
So what can be done with this information if you are living with chronic pain? Check your social support network. Who do you see every day? Who can you call if you need help or a favor? If your social circle has dwindled down to one or two people then it’s probably time to expand it. Thanks to the internet there are all kinds of “Meet-Up” groups one can find, for everything from learning to macramé to people who love poodles. Or consider checking out a church, synagogue, mosque or temple. Religious and spiritual communities can be a great place to meet others and feel supported. Volunteering is another great way to meet new people as well as take the focus off of yourself. You can check out volunteer opportunities in Austin at www.volunteermatch.org or http://www.austin360.com/entertainment/night-life/austin-volunteer-opportunities/d73i07tUhqIJcz63ZPD74I/. Or contact your favorite charity—The American Red Cross, American Diabetes Association, American Cancer Society, Easter Seals…the list is practically endless. Even if your chronic pain keeps you from working you can probably find a volunteer situation that would work for you. It may be sitting for an hour stuffing envelopes for a charity drive or taking calls on a help line. Or sorting donations for a church garage sale. The opportunities can be one-time or repeating. You would be surprised at how much you can get out of giving back to others, even when you yourself are not feeling so great.
I hope that this topic inspires you to do a wellness check on your social support and take action if it is lagging. Your pain will be less and your spirits will be better!
Yours in health,
The following excerpt was taken from Dr. Andrew Weil's website and is an interesting investigation of things that impact pain tolerance. We have long known that different things increase or decrease pain tolerance such as sleep, mood and social support.
More Friends = Less Pain
The more friends you have, the higher your tolerance for pain, according to a new study from the U.K. Researchers at the University of Oxford wanted to know whether our social networks affect the activity of endorphins in our brains, perhaps enabling these natural compounds to better tamp down pain in people with a wide circle of friends. To test this idea they recruited 101 adults ages 18 through 34 and asked them to respond to a questionnaire on their social contacts. The associations asked about were not limited to the people the participants saw or talked to daily but also those they were in touch less frequently, including once a week and once a month. The respondents also rated their stress levels and fitness and the researchers assessed such traits as “agreeableness.” To determine pain tolerance the researchers asked the volunteers to squat against a wall with their knees at right angles and stay in that uncomfortable position as long as they could. Combining the information about the size of the participants’ social networks and the length of time they were able to squat, the researchers found that those with more friends were better able to tolerate pain, suggesting that our endorphins are positively influenced by how well connected we are to others.
My take? Although the study was somewhat unconventional, this is an interesting finding and plays into my long held view that we haven’t evolved to be alone. We need the intimate support of a family and are meant to be part of larger communities, bands and tribes. In addition, the kind of connectedness you can get by playing a role in your community – working with others for common goals – can give you great satisfaction. There are many rewards to being part of a wide social circle. This study suggests that greater tolerance for pain may be one of them.
-Dr. Krista Jordan, Program Director, Restore FX
Dr. Jordan recommends the following article: http://www.foxnews.com/health/2014/10/21/write-your-way-out-chronic-pain/?utm_source=feedburner&utm_medium=feed&utm_campaign=Feed%3A+foxnews%2Fhealth+%28Internal+-+Health+-+Text%29
Dr. Jordan recommends the following article that appeared in a recent issue of AADEP Advisor.
Fibromyalgia linked to decreased brain connectivity
from Medical News Today
Fibromyalgia syndrome is a common and chronic condition of unknown cause that mostly strikes in middle age, although symptoms can often present earlier. Sufferers typically experience fatigue with long-term pain in several areas of the body, plus tenderness in soft tissues such as the muscles, joints and tendons. We don't know why, but while men and children can also have it, the vast majority of those diagnosed with fibromyalgia are women.
Continue to the full article here: http://www.medicalnewstoday.com/articles/283346.php
For those of us who work in chronic pain it’s easy to see that patients who have persisting pain for more than 6 months almost always struggle with depression. And research has also shown that those who had depression before they developed pain are much more likely to have that pain become chronic. But the mechanisms linking these two disorders have not always been fully understood.
At Restore Fx we aim to provide the most research-based and current treatments for chronic pain. Our staff constantly reviews medical journals to inform our treatments and improve care for our patients. Just today I came across an interesting article that may help to explain the link between depression and chronic pain on a brain level. Researchers were able to stimulate increased release of serotonin (a neurotransmitter/brain chemical) in mice and found that it significantly reduced their sensitivity to pain. They did this through a clever use of light-sensitive neurons that produce serotonin. For more detailed information on their study please see:
Optogenetic Recruitment of Dorsal Raphe Serotonergic Neurons Acutely Decreases Mechanosensory Responsivity in Behaving MiceGuillaume P. Dugué, Magor L. Lörincz, Eran Lottem, Enrica Audero, Sara Matias, Patricia A. Correia, Clément Léna, Zachary F. MainenResearch Article | published 22 Aug 2014 | PLOS ONE
This may help to explain why taking an antidepressant helps in reducing pain. It’s also good to note that exercise, which is helpful in painful conditions such as arthritis, also reduces depression. So what’s good for your depression is probably also good for your chronic pain.
Stay tuned for more scientific advancements on understanding chronic pain and how to best treat it.
Wishing you well,
Krista Jordan, Ph.D., ABPP
Program Director, Restore Fx
Restoring Functional Life
Krista Jordan, Ph.D., ABPP