Dr Oz: Plan To End Chronic Pain
Dr Oz shared that more than 100 million people have been in pain for six months or longer, and this information might change of those people’s lives. He talked to three women who have been living with chronic pain, saying that he some solutions for chronic pain that he hoped would help them. Dr Oz then said the medical community has a new understanding of chronic pain and he had a three-step plan to end it.
He welcomed NYU clinical assistant professor Dr Natalie Azar, who said there is more than one kind of pain. She said people can have acute pain, arthritic pain, or diabetic nerve pain. She explained that with chronic pain, the work-up, otherwise known as X-rays, MRIs, and other tests, come back normal, so people are often just told it’s in their head. She said the truth is that in some ways it is, because the problem is in the way the brain is perceiving and processing pain signals.
Dr Azar said a lot of her patients start by asking if they’re going to end up in a wheelchair. She said she reminds them that chronic pain syndromes tend to not result in a significant amount of dysfunction.
Dr Oz: Pain Medications
The first part of the plan has to do with pain medicines, because medicine that really work are essential. Dr Oz said traditionally, opioids have always been used, but Dr Azar argued that they could be the worst thing for people with chronic pain. Dr Azar explained that there’s been a movement called the right to pain treatment, which basically says people who have chronic cancers or acute pain, there’s a place for opioid treatment. She did not think it was appropriate for chronic non-malignant pain, for which they haven’t been able to prove that opioid use in the long term is either safe or effective.
Dr Oz talked to the three women who said they had all been prescribed narcotics for their pain. The medicine made them feel groggy, but didn’t provide them with pain relief.
Dr Oz: Medications For Chronic Pain
Dr Oz wanted to know why the opioids were being prescribed, and Dr Azar said part of it is that the patient is coming to the doctor in pain. They want quick pain relief without thinking about long-term effects of dependence. Plus, as doctors treating pain patients, it’s easy to fill a pain prescription rather than gather a team of multi-disciplinary doctors and therapists to treat the whole patient.
Dr Azar said she likes to use medications that raise levels of norepinephrine in the brain. She recommends SNRIs and Pregabalin or Lyrica to chronic pain patients. Dr Oz said you should talk to your doctor about the new medications you can take for your pain that are less addictive and therefore less dangerous to take.
Dr Oz: How Sleep Affects Chronic Pain
Dr Azar then explained that when a patient tells her they have pain, one of the first questions she asks is if they feel tired. She said 100% of the time, they will say yes. She then will ask them if they feel well-rested when they wake up in the morning, because if not, they may suffer from non-restorative sleep. She said poor sleep could be exacerbating the pain, or pain could be keeping the person up at night. She said it’s known that sleep and chronic pain go together.
Dr Azar said if you treat pain without addressing a sleep problem, you’re doing the patient a disservice. All three of the women Dr Oz were talking to said they don’t sleep well. Dr Oz said they’re not getting the sleep they need, specifically the deep sleep.
Dr Oz: Sleep Study For Better Rest
Dr Azar said for her patients who struggle to sleep well, she recommends a sleep study. A sleep study allows someone to study brain waves over night to see exactly at what quality the patient’s sleep is. They can also address other issues like sleep apnea. The sleep specialist will also go through what she calls sleep hygiene to ensure patients are getting the best night’s sleep they can.
Dr Azar said some patients taking the medications she was talking about will actually notice better sleep thanks to the calming of alpha inhibitors, which interrupt sleep.
Dr Oz: Establish Mind-Body Connection
The third step of Dr Azar’s plan was to establish a mind-body connection. Dr Azar said if you’re feeling anxious and you’re in pain, it can lead to depression, which can lead to even more pain. She said you want to try to flip that connection and find something like meditation or yoga to help you relax more and deal with each of the issues separately before bringing it all together.
Dr Oz showed a cycle of chronic pain. Chronic pain leads to depression which leads to stressors which leads to insomnia which causes chronic pain, and the cycle repeats. All four of them are interconnected, affecting the others.
Dr Azar explained that while depression and pain go together, they’re separate mechanisms of action, which means that you have to treat all of the factors. She said she loves Cymbalta because it does that.