Depression Can Make Pain Worse

Brain imaging shows healthy people who feel sad find pain more unpleasant, researchers say

Since pain starts at the painful area of the body, but then travels to the brain to be felt, it makes sense that a brain that is also depressed will also interact with the pain to make it feel like its much worse than it is.

Depression makes pain worse.

THURSDAY, June 10 (HealthDay News) — Being depressed can make real physical pain feel worse, British researchers have found.

Noting that pain and depression often occur at the same time, the current observation blends two competing schools of thought, in which some believe that pain is "all in the head" while others contend that pain is "all in the body."

Pain starts in the body, of course, but the pain neurons travel up to the brain where that signal is processed.  There are some pain-gates along the way that could potentially block the pain, so it gets complicated once the signals enter the spinal cord.

To see how pain and depression might intersect, the research team — led by the University of Oxford’s Dr. Chantal Berna — used brain imaging to conduct pain tests on healthy participants who were induced to feel sad.

A depressed mood appeared to affect brain nerve circuitry responsible for emotion, resulting in a stronger perception of pain, according to the report published in the June 1 issue of Biological Psychiatry.

"When the healthy people were made sad by negative thoughts and depressing music, we found that their brains processed pain more emotionally, which lead to them finding the pain more unpleasant," Berna said in a news release from the journal’s publisher.

Berna’s team theorized that one’s ability to control the negative emotions linked to pain are short-circuited by depression, leading to a bigger punch when pain hits. In other words, depression may not only be a consequence of being in pain. It might actually exacerbate pain, making it worse than it would be for those in a positive frame of mind.

It looks like depression makes the suffering part of pain to be worse, rather than the actual pain itself.  There is a nuanced difference between pain and suffering.

"Our research suggests depressed mood leads to maladaptive changes in brain function associated with pain, and that depressed mood itself could be a target for treatment by medicines or psychotherapy in this context," Berna explained in the news release.

Following this line of research, the next step would be to study patients with chronic pain, because they often also suffer from depression, the researchers noted. The goal would be to find ways to more effectively treat the millions of people worldwide who experience chronic pain and depression, the authors explained.

In our overmedicated society, I suggest that conservative treatments for pain, like spinal manipulation and chiropractic care be studied in conjunction to the effect on pain and depression to see if that makes any difference.  We’re confident that chiropractic care is an effective treatment for pain, but will it also affect the way depression affects pain?

Todd Lloyd, DC
Sonoma Chiropractor

A study was done on over 10,000 people to see if exercise can prevent falls.  It does.  Men who don’t exercise regularly are twice as likely to fall as those men who DO exercise regularly. Interestingly, they found that in women, it makes no statistical difference if they exercise or not.  With all of the known benefits of exercise, I would take my chances and engage in regular exercise anyway, ladies.

From http://www.nlm.nih.gov/medlineplus/news/fullstory_99833.html

Todd Lloyd, DC
Sonoma Chiropractor

Here is Alexander eating rice cereal for the first time. Notice how he rejects it at first.  He then quickly takes it in and eats it with enthusiasm. Yes, this is the first time he is eating real food.

Todd Lloyd, DC
Sonoma Chiropractor

Here we have Alexander playing in his playpen on his five-month birthday.

Todd Lloyd, DC
Sonoma Chiropractor

An article in the New York Times shows us that students who exercise get better grades.

Exercise does several things that help your mind.  First, exercise burns off cortisol, the stress hormone that has been shown to make memory worse.  It’s important to have balanced hormone levels in a stress-free environment to learn new things properly. 

Second, Exercise stimulates the millions (billions? trillions?) nerve endings that relay information about movement.  The movement nerve signals enter the brain to increase brain activity.  This is called the Central Integrative State, and it is increased with movement.  A huge portion of this information comes from movement receptors in the spine, since the spine is at the core and the spine is phylogenically older than the rest of the body. Pylogenically older is evolutional speak saying that more rudimentary animals developed spines before they developed limbs. Stimulate the spine, stimulate the mind.

Third, exercise breaks up study sessions, so the mind has time to process the new information.  The new information is also integrated and associated with activities during exercise.  Have you ever listened to an audiobook while hiking? When you do, there are certain phrases that you heard in the audiobook that can be triggered the second time you walk, hike or run through the same area.  Even if you don’t listen to audiobooks while hiking or running, the mind will mull over what you have done in the previous hours, and will process that information for future reference.

Physical Activity makes you smarter.  Chiropractic care helps your physical activity levels stay high so you can remain at your personal best.

Todd Lloyd, DC
Sonoma Chiropractor

Your body’s core is an integral part of your golf swing, as it is a power source, a rotational force and can be vital in preventing back pain. This week’s episode of Golf Fitness Academy_Online provides explanation and exercises for taking care of your core, so it will take care of you and your golf swing.

Chiropractic care helps to maintain the proper mobility of the spine so the supportive muscles can provide the right amount of stability.

Read the rest of this entry »

Vicodin is a 40 year old drug that is highly addictive and is also the most prescribed drug in America, according to forbes.com.  the generic name for Vicodin is Hydrocodone/acetaminophen.  Vicodin, and the generics combine hydrocodone with acetaminophen.  Acetominophen by itself is know as Tylenol.

According to Forbes:

A panel of doctors recently recommended that it be banned; the FDA is still deciding what to do.”

So Vicodin is dangerous and addictive, but it’s still the most prescribed medication in the United States.

From MSM.com:

Vicodin is a drug that is crying out to be replaced. Vicodin has a supporting role on the television show House, M.D. because the protagonist, a Sherlock Holmes-like doctor, is hooked on it. It is particularly dangerous because when patients develop a tolerance for the narcotic they start taking too much. This can lead to liver failure from overdoses of the acetaminophen component of the combo. Most of the 400 deaths due to acetaminophen poisoning each year result from misuse of the Vicodin or similar drugs. Last June an FDA advisory panel recommended banning Vicodin. The FDA is still deciding whether to take this advice.”

I’m glad we have painkillers that you can take in a pinch.  For acute pain, sometimes you have to have something for temporary relief. However, temporary is the important key to this advice.  If you find that you are taking anything for too long to deal with pain, then there are some other things to look at. 

What of these things can you improve?  Because if you can improve in any of these areas, then you will be closer to living life pain-free again.

1. Muscle strength
2. Joint range of motion (chiropractic care)
3. Even muscle tone from left to right, from top to bottom, and from front to back. (chiropractic care)
4. Proper nutrition
5. Plenty of rest
6. Outlook on life, goal setting, relationships

Todd Lloyd, DC
Chiropractor in Sonoma

Here is an interesting story I ran across talking about chiropractic care and how it helps the body become more resistant to allergies.  The chiropractor explains that the chiropractic adjustment helps to expand the spaces between the rib-vertebrae to open up the lungs and to help the nerves running through those spaces work without interference. 

Also interesting is the comments section of the story where the mother who was highlighted in the story talked about the care from her point of view:

I am the mom in the segment featured here. In the segment Dr. Greg clearly states "Chiropractic does not treat that allergy”, and he truly means that. Chiropractic doesn’t TREAT anything, and the notion that chiropractors are purely “back doctors” is a myth.

What chiropractic care does do is remove nerve interference in the spine so that the body can do what it already innately knows how to do – heal itself – or in the case of wellness care, keep itself well and functioning at an optimal level. Babies are not born drug deficient and chiropractic supports the body and the immune system naturally, without drugs.

It is also stated in the segment that Dr. Greg does agree that some people do require medical intervention and he doesn’t discourage that. I agree with him 100%, and have used traditional medical interventions myself when needed for my son. Andrew has very severe allergies that can trigger anaphylaxis.

Allergies are not trivial matters in our lives.

However, if I can avoid a trip to the ER/hospital with a simple chiropractic adjustment, I am going to do that. Chiropractic is always my first line of defense (and offense), barring a true life-or-death emergency. More than 99% of the time it works well for my son.

My statements in this segment are just that – my statements. BUT they are also fact in my life, because I have seen the results with my own eyes. A child that is one day old, five weeks old or two years old does not know the term "bunk". They do not know what a "subluxation" is, nor do they care. They don’t make up symptoms or aches and pains. What they do know is how they feel, and it is blatantly obvious that chiropractic care is beneficial to my babies. It makes them feel better and they are always quick to let me know their adjustments make them feel good.

Chiropractic care has kept my son out of the hospital many times – as recently as this last Monday. I was on the verge of taking him in to the ER because […]

My statements in this segment are just that – my statements. BUT they are also fact in my life, because I have seen the results with my own eyes. A child that is one day old, five weeks old or two years old does not know the term "bunk". They do not know what a "subluxation" is, nor do they care. They don’t make up symptoms or aches and pains. What they do know is how they feel, and it is blatantly obvious that chiropractic care is beneficial to my babies. It makes them feel better and they are always quick to let me know their adjustments make them feel good.

Chiropractic care has kept my son out of the hospital many times – as recently as this last Monday. I was on the verge of taking him in to the ER because he couldn’t breathe, but was able to get Andrew in to Dr. Greg right away, and the adjustment cleared him up so he could breathe. By the time we left the office Andrew had stated “All better!”, and was laughing and starting to play again. By the end of the night you never would have known he’d been close to hospitalization just a few prior.

I truly and wholeheartedly believe that every child and adult should have regular quality chiropractic care as a part of their wellness regimen.

For more information on the benefits of chiropractic care for children and babies, please see the International Chiropractic Pediatric Association’s website at:http://icpa4kids.com/index.php

Sincerely,
Erika Roberg

Todd Lloyd, DC
Sonoma Chiropractor

Read the following case report.  A man gets hurt on the job.  Being managed with many therapies that did not work, he gets back surgery.  The back surgery did not work either, so the man develops what’s called “failed back surgery.”  This sends him in a downward spiral of using ever increasingly stronger narcotics and opioids to mask the pain and feed his addiction.  Finally, he needs to be hospitalized to detox from the pain meds.

Don’t let this happen to you.

Spine: 20 May 2010 – Volume 35 – Issue 12 – pp E549-E552

Iatrogenic Disability and Narcotics Addiction After Lumbar Fusion in a Worker’s Compensation Claimant

Parks, Philip D. MD, MPH, MOccH; Pransky, Glenn S. MD, MOccH; Kales, Stefanos N. MD, MPH

Abstract
Study Design. Case report.

Objective. Describe a case of chronic occupational low back pain with various treatments of questionable efficacy, leading to prolonged disability, iatrogenic narcotic addiction, and opioid-induced hyperalgesia.

Summary of Background Data. Concerns about narcotics and other questionable treatments for chronic low back pain are increasing, especially in those with work-related conditions.

Methods. Medical record review.

Results. The patient had significant, persistent low back symptoms, but good function at work and home. He underwent lumbar fusion to address persistent pain, and subsequently developed failed back surgery syndrome. He was prescribed increasing amounts of opioid analgesics and was recommended for an intrathecal morphine pump, without evaluation of the safety or efficacy of his current regimen. Subsequently, he was hospitalized for opioid detoxification and substance abuse treatment.

Conclusion. Patients with chronic low back pain are at risk for receiving ineffective and potentially harmful treatment. A focus on restoring function instead of complete pain relief may lead to better outcomes in these patients.

Todd Lloyd, DC
Sonoma Chiropractor

From Air Force Times:

After passing trial periods of performance evaluations, and gradually being worked into the military hospital system, chiropractic care is set to expand under this bill going through committee and set to be voted in by the house and senate.

As of now, chiropractic care is available to veterans at VA Hospitals at 60 designated military treatment facilities.  This bill, HR 1017: Chiropractic Care Available to All Veterans Act, will expand the requirement of chiropractic services available to all military hospitals.

This will be a tremendous benefit to all vets, and it should save the VA system money for the care of their vet’s musculoskeletal conditions, according to recent cost-saving studies.  It will also be safer. Remember that the American Heart Association recently took a stand against the damaging effects of COX-2 inhibitor type of anti-inflammatory drugs for body aches. Chiropractic care is a suitable substitute. Chiropractic care is also much more than the popular notion that it is just spinal manipulation; chiropractors also use a wide array of conservative tools to treat back pain, neck pain, headaches, and other body aches and function problems.

Chiropractors are trained and do very well with diagnosis, so this should help with the trend of a shortage of primary care physicians, and will help save money. While it is hard to recruit nurses, general practitioners and physical therapists due to lack of supply, there are plenty of well-prepared doctors of chiropractic available because there are few employment choices for new graduates from chiropractic college.  Most chiropractors are forced to start their own business to make a living.  While entrepreneurship can be rewarding, it is not for everyone, and there is a lot of untapped talent ready to report for chiropractic duty in the military.

This is a smart move by our legislatures because the military and our vets who served our country will gain some excellent clinicians providing a valuable service.

Todd Lloyd, DC
Chiropractor in Sonoma