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Are You What You Eat When it Comes to Chronic Pain?

The month of March marks a time of change: There’s the coming of spring, the start of daylight saving time, and even a chance to change your luck on St. Patrick’s Day. But March is also National Nutrition Month® — which presents an opportunity to change your eating habits, too. 

Turns out, paying attention to what you’re putting into your body isn’t simply good for your general health and well-being. Studies suggest that our diets can also help with chronic pain.

“A lot of chronic pain is the result of chronic inflammation,” says Dr. Fred Tabung, in a 2018 article from Harvard Health Publishing, “and the evidence is quite strong that your diet can contribute to increased systemic inflammation. But your diet is also one of the best ways to reduce it.”

Extinguishing the Flame of Inflammation 

Several sources can help point you in the right direction when it comes to identifying foods that either promote or prevent inflammation. The Fit Institute of Chicago, for example, recommends avoiding red meat, refined carbohydrates (in most cases: products made with processed white flour), soda, and fried foods to aid in inflammation reduction. Harvard Women’s Health Watch agrees, and adds margarine to the mix. 

Margarine (rather than butter) is on that list for a reason, as excessive consumption of omega-6 fatty acids (not to be confused with their cousins, omega-3 fatty acids), may also contribute to inflammation, according to The Arthritis Foundation. This means check the ingredients on your salad dressings, and moderate your intake of safflower, corn, grapeseed, peanut, sunflower, and vegetable oil. Mayonnaise may be a place where omega-6 fatty acids lurk, as well. 

“To reduce levels of inflammation, aim for an overall healthy diet,” Harvard Health Publishing recommends. Several studies suggest the Mediterranean Diet, with its focus on plant-based foods and whole grains, but the Mayo Clinic also breaks down their advice fairly simply when they suggest “eat more plants” and “cut the processed stuff,” among their five “simple rules of thumb for anti-inflammatory eating.”

Anti-inflammatory eating doesn’t just help with chronic and arthritic pain, either. Several sources, including The Foundation for Peripheral Neuropathy and The Neuropathic Therapy Center at Loma Linda University Health suggest it can benefit those suffering from peripheral neuropathy, too.

Can What’s in Your Stomach Also Go to Your Head?

Following the Mediterranean Diet and keeping omega-6 fatty acids low could also help with migraine headaches a 2020 study in Nutrients suggests, though the authors also encourage a willingness to experiment with solutions. Because of the more complex causes and contributing factors of migraines, one single diet plan may not be a fix-all. An elimination diet to identify more specific food triggers is recommended. Researchers also find ketogenic, modified Atkins, or an epigenetic diet may provide relief.

More reason to be flexible, and willing to experiment? The American Migraine Foundation says a variety of different foods may trigger migraine, including alcohol (especially red wine and beer), chocolate, aged cheese, cured meats, smoked fish, yeast extract, and artificial sweeteners. But even making sure you’re eating regularly is something the Foundation suggests may relieve this specific kind of pain. 

Pain in a Bottle

While alcohol shows up as a specific potential trigger for migraine, it has a variety of dangers for those in chronic pain. 

It may be tempting, for instance, to numb chronic pain with a cocktail or glass of wine, but the National Institute of Health warns that mixing alcohol with pain medications could cause dangerous problems. They also note that, as tolerance to alcohol’s effects develops, more alcohol is needed to reach the same analgesic effect. This can create alcohol dependence, and the consequential string of health risks associated with it, as listed by the CDC, including stroke, heart disease, and the risk of several cancers.

Keep in mind, whether you’re in chronic pain or not, alcohol is a well-established cancer-causing agent (among other health problems), and moderating your alcohol consumption is good practice for anyone concerned about their longevity.

Cup of Caffeine Instead?

Alcohol may be a clear thing to avoid, but advice about caffeine is a little less consistent. Though the American Migraine Foundation suggests limited caffeine might help treat migraine headaches (and acknowledges that caffeine is a common ingredient in many over-the-counter headache medicines), The Global Pain Initiative recommends caution with it:  “Caffeine actively causes pain by decreasing the pain threshold and making the nervous system more alert to pain.”

Tracking your consumption of and sensitivity to caffeine (as well as other specific foods) in a food diary may be the best way to help you narrow down the cause of (or solution to) the pain that ails you in this regard.

Find a Friend for This Relationship

Navigating the effects of chronic pain is complicated enough, without also having to sort out the best way to stock your fridge and pantry at the same time. Even when the relationship between what we eat and how we feel seems clear, the exact solutions aren’t always so easy to find. It’s why we recommend reaching out to a pain specialist for help crafting an individualized plan to address the whole experience of your chronic pain. Contact us any time to schedule an appointment and craft a comprehensive strategy (including what you eat) just for you. 

Safely Reach Out And Touch Someone if You Can (and Suggestions if You Can’t)

With Valentine’s Day falling smack in its center like a succulent cherry, February traditionally marks the month of love and affection. For many, the celebration of February 14th might include not only wine, roses, and a gourmet dinner, but also hugs, kisses, and possibly some sex. 

This year, however, February 2021 also marks the first anniversary of the United States’ public battle with COVID-19. In spite of 2020’s precautions and protocols (not to mention the current rollout of vaccines), the number of confirmed cases (and deaths) still increases daily. Nearly a year ago, Dr. Anthony Fauci suggested we may never shake hands with each other again, and the “air kiss” greeting has certainly been retired until further notice. Today, masks, social distancing, and sanitization remain vital requirements. 

So what does that mean for the Month of Love? Has our need and desire for physical affection become obsolete?

Touched by the Hand of Science

The answer is a resounding no. In fact, a scientific study in the Western Journal of Communication supports that positive physical touch is not only good for your mood and your spirit, but also for your heart — and then some. Another article in The Journals of Gerontology indicates that hugging and embracing, receiving a pat on the back, getting a supportive neck massage — or experiencing any other close physical contact — can lower heart rate, improve sleep and respiratory rates, and yield higher oxytocin levels.

Moreover, as reported in Research on Aging, high physical touch can be protective against high blood pressure. A study of 59 women (reported in Penn Medicine) has also demonstrated that women who more frequently hug their partners often have a lower resting blood pressure than those who rarely engage in physical touch. 

What’s Oxytocin Got to Do with It?

While lower blood pressure and heart rates seem to be obvious health benefits (especially during American Heart Month) why are higher oxytocin levels something worth our attention? Known commonly as “the Love Hormone,” oxytocin is generally linked to the mother-child bond and/or skin-to-skin contact. But higher levels of oxytocin help us all feel more peaceful and satisfied. 

For example, elevated levels of oxytocin have been linked to improved sleep, as well as the ability to tell our brain we’re full and don’t need that second helping of macaroni and cheese. As also summarized in Frontiers in Psychology, when our oxytocin levels are higher, it’s possible we’ll sleep better, eat more sensibly, and feel more relaxed — therefore avoiding the myriad health complications of lack of sleep and overeating. 

Oxytocin also has the ability to undo the potential negative effects of cortisol — a stress hormone — in our bodies. When at work, cortisol prioritizes the systems required for short-term survival, rather than those that sustain long-term health. Higher levels of cortisol can contribute to a weakened immune system, suppression of the digestive system and reproductive systems, and as the Mayo Clinic reported, in general, create a greater chance of getting sick.  

“Oxytocin is part of a complex system of neurohormones, but when it’s released by physical touch it can have many benefits, including laying the foundation for cognitive, social and emotional well-being.” Paula S. Barry, MD, physician at Penn Family and Internal Medicine Longwood

But What If You’re Not Romantically Involved?

A careful read of all these studies indicates that the most direct way to increase oxytocin levels is through mutually welcomed, positive, enjoyable physical contact — preferably with someone you love. But this kind of connection with a domestic or romantic partner isn’t the only type we benefit from. The Journals of Gerontology reports that even positive touch from associates or others outside our closest circles may also have benefits including improved sleep, lower blood pressure, improved respiratory rate, and decreased experience of pain. 

But we aren’t limited to contact with just people, either. Affection with our furry friends can also provide similar health benefits as that with another person. Many sources, including Johns Hopkins medicine, the NIH, and the CDC encourage interactions with animals to decrease cortisol, triglyceride and cholesterol levels, plus increase oxytocin, and reduce risks of cardiovascular disease. Even simply spending time outdoors in a natural environment with birds, plants, and other wildlife (according to the International Journal of Environmental Research and Public Health) is shown to improve immune functions, prevent illnesses, and reduce stress.

Hands Up for Hands-Free Positivity 

For all of us, the new landscape of the COVID-19 pandemic means safe physical connection of any kind can only happen between a few select other humans (or animals), if at all. Even Time magazine has speculated about the negative effects of this contact-deficient world.

Fortunately, there are still ways the most independent (and germ-conscious) individual can substitute the benefits of physical contact, and keep their physiology thrumming.  

  • Jump Around
    • You don’t need the CDC or Harvard to tell you physical activity of nearly any kind has myriad positive effects on the body, including improving brain and cardiovascular health, strengthening bones and muscles, reducing your risk of type-2 diabetes, and even preventing some cancers. Whether walking, running, doing yoga or resistance exercises, or dancing around your apartment, 30 minutes of exercise five times a week will provide a boost like almost nothing else. 

Whatever you’re doing to love yourself through February, we’re here for you. If you’re not already monitoring your heart and cardiovascular health, if your stress levels appear to be increasing, if you’re concerned about a lack of physical contact — or anything else regarding your well-being — please reach out. As always, there’s a lot we can do to support your whole health, even without touch. Contact us any time to schedule an appointment

How Do You Stop Migraines?

Anyone who has experienced a migraine understands that they are much more than “just a bad headache.” In addition to a throbbing headache, migraines often include nausea, vomiting, and loss of appetite. Bright lights, loud noises, and activity can all make migraines worse. Migraines can be debilitating both during and for some time after each episode.

About 15% of adult Americans experienced a migraine in the past three months, and as many as 20% will experience migraines at some point in their life. Migraines are three times more common in women than in men.

The causes of migraines are still not well understood, although some common triggers have been identified, including stress, hormonal changes, lack of sleep, and dietary changes. People who suffer from migraines often try to limit these triggers to reduce the frequency of their migraines.

There is no cure yet, although chronic migraines sometimes become less frequent or severe with time, age, or menopause and may eventually cease altogether. Many people suffer with them for years.

However, modern, migraine-specific medicines, combined with a better understanding of the condition, can do a lot to manage the symptoms of migraines and reduce their frequency.

Emergency Treatment for Acute Migraines

The pain of migraines can be severe enough to bring people into the ER. According to the Migraine Research Foundation, “Every 10 seconds, someone in the U.S. goes to the emergency room complaining of head pain, and approximately 1.2 million visits are for acute migraine attacks.”

It’s not unusual for emergency room doctors to use opioids to treat the pain, however mounting evidence suggests that opioids can actually increase the likelihood that they will become chronic. (This is all in addition to the general risks of opioid addiction and abuse.)

Opioids are also typically less effective than two other kinds of pain relievers called triptans and non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen, although pregnant women and the elderly are sometimes advised to avoid such medications.

In 2019, two new non-opioid, non-narcotic medications were approved for treating acute migraines: lasmiditan and ubrogepant. Both have been shown to be effective at rapidly treating acute migraine symptoms.

If you have recurring acute migraines, you can discuss with your pain management specialist whether one of these medicines is right for you.

Prevention

While no treatment has yet been found to prevent all migraine episodes, there’s a lot that pain management specialists can do to reduce their frequency and severity.

Migraine-Prevention Medicines

Botox has long been used to prevent chronic migraines, and in 2018 the FDA approved a new self-injected drug, erenumab, that reduces the frequency of migraines for many patients.

According to the NIH, several drugs “originally developed for epilepsy, depression, or high blood pressure … have been shown to be extremely effective in treating migraine.”

Again, these are all options you can discuss with your pain management specialist.

Address Risk Factors and Triggers

Stress, anxiety, depression, obesity, and asthma have all been linked to a higher risk of experiencing migraines. Treating these risk factors may help lower the frequency and severity of migraines.

Many other factors can trigger migraines. These vary from person to person, but they often include bright (especially flashing) lights, loud noises, missing meals, consuming too much caffeine, not getting enough sleep, and eating foods with nitrates or aspartame in them.

Not all triggers affect all migraine sufferers, so it’s important to pay attention to potential triggers and discuss them with a doctor.

Cognitive-Behavioral Therapy

Many people who suffer from migraines are able to better manage their symptoms and reduce the frequency of migraines through cognitive-behavioral therapy (CBT) techniques. CBT strategies can help migraine sufferers relax, reduce stress, manage triggers, and better pace their activities to avoid overdoing it and triggering a migraine episode.

Conclusion

While we don’t yet know what causes migraines and can’t cure the condition, pain management science has come a long way in the pursuit of better treatment and prevention. If you’re experiencing migraines or serious headaches for any other reason, contact United Physician Group Pain Management to schedule an appointment with one of our pain management specialists.

Why Is it Important to Know Your Family’s Health History?

Thanksgiving has long been a time for families to come together. Since 2004, by declaration of U.S. Surgeon General Richard Carmona, it has also been National Family History Day, a day for families to talk about their health histories so that everyone can better understand and manage their personal health risks.

It can be difficult enough to remember all the details of our own personal medical histories. If you’ve ever struggled to fill in your family medical history on a doctor’s intake form, you know how little many of us know about the medical histories of our parents, siblings, grandparents, aunts, uncles, nieces, nephews, and other close blood relatives. Sometimes all it takes is a question to discover that a close relative had a health problem of which you were completely unaware.

With the COVID-19 pandemic still keeping many families apart this year, your extended family may not be crowding around the dinner table for a shared feast. Many families will find other ways to connect, whether through video conferencing or well distanced outdoor gatherings. However you come together, consider taking a little time this Thanksgiving to ask about your family’s medical history.

Why Should You Know Your Family Medical History?

According the book Understanding Genetics, “your family history might be one of the strongest influences on your risk of developing heart disease, stroke, diabetes, or cancer.” Family history may also increase your risk of developing osteoporosis, depression, asthma, Alzheimer’s, and many other conditions. Certain less common but serious genetic conditions, such as sickle cell anemia, can be almost entirely dependent on genetic inheritance from our ancestors.

Healthy lifestyle choices still matter. Regardless of your family history, you’re more likely to stay healthy if you eat a balanced diet, exercise regularly, maintain a healthy weight, stop or never start smoking, drink alcohol only in moderation or not at all, and get regular check-ups and screenings as recommended by your doctor.

However, your family medical history may alert you and your doctor to areas where you have a higher risk than the general population. While you can’t change your family history, you can make lifestyle changes that are well informed by your higher risks. Your doctor may also recommend that you get screened for common diseases at an earlier age or more frequently. (These may include mammograms, colorectal cancer screenings, blood-sugar tests, and more.) In some cases, your doctor may recommend preemptive treatments, such as calcium and vitamin D supplements for those with a higher risk of osteoporosis.

How Do I Ask My Family About Their Medical History?

Depending on your family dynamics, it may feel a little awkward at first to ask your family members about their personal medical histories, and, sure, you probably don’t want to ask your dad to “pass the potatoes and tell me about your prostate.” Framed right, however, this can be a very loving conversation that highlights the deep connections in your family and shows your kind concern for everyone’s health.

The Surgeon General created National Family History Day in part to help start those conversations. Over Thanksgiving, you can tell your family that it’s National Family History Day, talk about the importance of knowing your family medical history, then make it a family activity to gather that history. Because a comprehensive family medical history includes information about ethnicity — some diseases are more common in certain ethnic and racial groups than others — you may even learn something new about your family ancestry.

November is American Diabetes Awareness Month, which gives you an excuse to ask about a family history of diabetes. It’s “Movember,” a month to focus on men’s health issues such as prostate and testicular cancer, and men’s mental health issues. And last month was National Breast Cancer Awareness Month, so it’s certainly not too late to use that as a conversation opener.

The CDC and the NIH’s National Human Genome Research Institute have also created printable and online tools to help you collect all the relevant family health information. The National Human Genome Research Institute’s Families SHARES program provides printable worksheets for children and adults to fill out, assessing their risks of breast and colorectal cancer, Type 2 diabetes, and heart disease. The CDC’s My Family Health Portrait is an online tool that guides you through gathering your complete family health history in a downloadable and printable file to share with your family and doctor. (While the tool is online, no personal data is shared or stored with the CDC.)

What Should I Do With My Family Health History?

In short: save it securely, and share it with your family and doctors.

Whether you collect your family history in digital or paper form, save it somewhere secure so you’ll have it available whenever you need to update or reference it.

Consider sending copies to your close relatives. Just as their medical history can help you assess your health risks, your history can help them do the same.

Most importantly, share your complete history with your doctors. Together, you can discuss what risks are revealed in your family history. Your doctor may then recommend any lifestyle changes, screenings, or preemptive measures that will lower your risks and help you and your family live healthier.

Would you like help collecting your family health history? Or would you like to discuss your family history with a doctor? Make an appointment with a United Physician Group Family Medicine doctor.

Will Exercise Help or Hurt Your Chronic Pain?

If you’re experiencing chronic pain, you’re not alone. Persistent pain or discomfort is one of the most common reasons adults seek medical care. For some people, it’s a mild nuisance. For others, chronic pain can overwhelm your resilience and overpower your life.

Wherever you are on the spectrum of pain, exercise probably isn’t the solution that first comes to mind, yet lack of exercise could actually make your pain get even worse.

Exercise and Chronic Pain: Do They Have to Be at Odds?

Lacing up to go for a run probably doesn’t sound comforting when your knees or hips ache just getting out of bed. But that doesn’t mean you have to give up exercising altogether. In fact, regular physical activity can have many health benefits for people experiencing chronic pain, including:

  • Weight loss or maintenance, which can minimize stress on your joints
  • Improved muscle strength to help stabilize your joints
  • Increased flexibility to improve joint function and reduce your risk of falls

Beyond these physical benefits, experts say exercise can actually activate areas of the brain that make pain more tolerable. According to neuroscientist Benedict Kolber from Duquesne University, physical activity engages the body’s natural opioid system. Exercise activates areas of the brain that create a sense of euphoria sometimes referred to as a “runner’s high.” In other words, exercise can trigger the same effects as prescription painkillers, but without the side effects or risk of addiction. Exercise also often reduces stress, which can otherwise increase your sensitivity to chronic pain.

Breaking Down the Barriers

Of course, it’s understandable if you’re hesitant to get moving more when you’re suffering chronic pain. Pain sends a powerful warning signal that something’s not right, and it’s only natural to respond to that warning by moving less. The fear that working out will make your pain worse is a powerful barrier to regular exercise.

Our ideas about exercise can get in the way too. Physical fitness is so often portrayed in the media as people in peak health who are flawless and pain-free. It’s also largely promoted as a means of achieving some quantifiable goal, such as beating a marathon personal record or losing a certain amount of weight. For people with chronic pain, however, fitness can be both less and so much more than all that. Combined with appropriate treatment by a pain management specialist, exercise can help you get your life back.

You can reduce any risks, quiet your fears, and reframe your expectations of fitness by getting good advice from your pain management doctor and recognizing that you’re in complete control of your exercise. You can stop immediately any time something doesn’t feel right. You get to decide what your fitness looks like, then establish an exercise routine that works best for you.

Which Exercises Are Best for Chronic Pain?

It’s very important that you first talk with a pain management specialist — who may also refer you to a physical therapist — before you start a new exercise program. They can guide you to the exercises that will keep any risks low while doing the most to help you manage your chronic pain.

Here are some exercises they may recommend and that you may find helpful, depending on the cause and severity of your chronic pain.

Range-of-Motion Exercises

Gentle, rolling exercises are particularly well-suited for people with arthritis and other types of joint pain. These movements ease stiffness and improve joint mobility. Try neck rolls, raising your arms slowly up and down, and shoulder rolls for the upper body. Do gentle standing hip and knee circles to loosen up your lower body.

Walking

Moderate aerobic exercise increases stamina, giving you more energy to get through the day. Walking is a perfect choice: it’s convenient and can be done virtually anywhere. Consider starting off with ten-minute walks and gradually increasing the length if your joints tolerate it well.

Yoga

Pictures and video clips of yoga often feature experienced yogis in advanced poses. But yoga doesn’t need to be nearly that complicated. In fact, one of its most powerful benefits is that it’s rooted in deep breathing. Taking deep, cleansing breaths can help you manage stress and ensure your body gets the oxygen it needs to perform its best.

Once you’ve developed that foundation of deep breathing, you can begin trying simple, therapeutic poses. Gentle or restorative yoga classes, either online or in a studio, are ideal for people with chronic pain. If you have chronic back pain, stretches such as seated twists may help ease tension in your back muscles.

Modified Strength Exercises

Cable machines and free weights at the gym can be daunting for people with chronic pain. Fortunately, you can bypass them altogether, or choose to work your way up to them. You already have everything you need to get a low-impact strength workout at home. Limit the intensity and range of motion with modified exercises such as wall push-ups, standing planks, and chair squats to strengthen the muscles that support your joints.

Swimming

The water’s buoyancy supports your body weight and minimizes the stress on your joints and spine. It’s often ideal for anyone with chronic back pain. To keep it low-intensity, consider gentle water aerobics or a slow, steady swimming style, such as the breaststroke. Even “pool walking,” in which you walk from one side of the pool to the other, can give you a great workout. The resistance of the water will challenge your muscles in new ways without putting excess strain on your joints.

Cycling

Whether on the road or on a stationary bike, cycling provides an aerobic workout that adapts well to your current fitness level. You can dial the intensity up or down, modifying factors like speed and resistance to suit how your body is feeling. Like swimming, cycling is an excellent low-impact aerobic workout.

Finding Your Balance

Chronic pain calls for an individualized approach. The pain management specialists at United Physician Group Pain Management can develop a comprehensive pain management plan to help control your symptoms. Schedule an appointment at one of our locations to begin tackling your pain today.

How Can You Keep Your Family Active When Team Sports Are On Hold?

We’ll surely return one day to the courts, fields, rinks, and gyms, but for now the future of youth team sports is uncertain. Social distancing restrictions have been lifted in some areas but only recently imposed or reimposed in others, so it may be some time before school locker rooms are filled with kids again. Yet, while your children’s school and sports clubs may be on hold for now, there are still plenty of ways to keep your family active.

Why Exercise Matters

Sports give your children an outlet for using up their extra energy, and there are several important health benefits of regular physical activity for kids and teens. The CDC reports that for children, routine exercise:

  • Boosts cardiorespiratory wellness
  • Supports strong bones and muscles
  • Helps to maintain a healthy weight
  • Controls symptoms of depression and anxiety

Staying fit can also minimize the risk of many serious conditions, including heart disease, certain types of cancer, obesity, high blood pressure, and type 2 diabetes. The benefits may even extend into other areas of a child’s life. For example, teens who engage in sports may be less likely to smoke, drink, or do drugs. Exercise can also improve a child’s self-esteem and improve their ability to focus, which could help them do better in school.

According to the American Academy of Pediatrics (AAP), routine exercise should begin in children as young as infants. Babies can get 30 minutes or more of “tummy time” each day, while children ages three to five should have at least three hours of physical activity per day. Children who are six or older should get an hour’s worth of exercise most days of the week, including vigorous exercise at least three days a week.

Unfortunately, even before COVID-19 restricted our options, we’d all become less active. Smartphones have captured the attention of all generations, and young children and teens are no exception. Screen time is replacing what would normally be playtime. Now, with most team sports on hold during the pandemic, children may become even more sedentary if parents don’t intervene.

Your Physical Fitness Matters Too

Encouraging your children to get active even when they can’t get to practices or games can help them build a habit of physical fitness that stays with them through adulthood. But what about your fitness? Parents need exercise too, for many of the same reasons children do. According to the CDC, adults who exercise regularly have better brain health and weight management, along with stronger muscles and bones. Exercise also reduces the risk of cardiovascular disease, type 2 diabetes, and some cancers. Working out can even deliver mood-boosting benefits by releasing endorphins. During stressful times, supporting your mental health is more important than ever.

Ideally, adults should get at least 150 minutes of moderate-intensity exercise each week. This breaks down to 30 minutes of physical activity, five days a week.

Creative Ways to Get Exercise

Even though we may not see a typical sports season for a while longer, you can still help your children burn through their excess energy and maintain their fitness year-round. Here are a few ways you all can stay active:

  • Create a backyard “obstacle course.” Set up child-friendly obstacles like a crawl tunnel, hopscotch, balance beam, and ball toss. (You can even adapt this to a large room if you don’t have access to a yard. Just mind the breakables!) Time your little ones and encourage them to beat their own records.
  • Have a family game night. Let children take turns deciding which game you’ll play together. Frisbee, capture the flag, driveway basketball, and backyard kickball are all good ways to use up some energy.
  • Take to the trails. Hiking can be an excellent cardiovascular activity, but it also appeals to children’s curiosity. Grab a trail map and head to a new spot in the woods to immerse the family in nature while discovering new sights.
  • Go for a family bike ride. Whether it’s through the streets of your neighborhood or at a park nearby, you can get a cardio session in by pedaling your way around. (Make sure you’re all wearing helmets and minding any cars, of course.)
  • Take an after-dinner walk. The one upside of sports cancellations is that everyone is more likely to be home for family meals. Take advantage of the time the kids are spending at home by going for a stroll after dinner.
  • Head to the lake (or beach). The busy tourist season tends to slow down by early fall, but the weather is still plenty warm in many places for your favorite water-based activities. Paddle boarding and swimming are both excellent full-body activities that will get the blood flowing.
  • Have a family yard work day. Many hands make yard work easier, and it’s good exercise too. Challenge your children to pick up as many sticks as they can on lawn cleanup day.
  • Bring fitness into daily routines. Throughout your day, consider other creative ways to get active as a family. Watch your favorite show together, but do jumping jacks during commercial breaks. Or if you’re headed to the grocery store together, park at the back of the lot and count the steps it takes to get to the door.

Keep Your Family Active & Healthy

Regular physical activity is an important way to keep your family healthy, but it’s only one piece of the wellness puzzle. Your children should still have their annual physicals, even if youth sports are on hold. You can schedule physical exams for your family with your neighborhood doctor at United Physician Group Family Medicine. (Strict COVID-19 prevention protocols are in place to keep you safe.) Your doctor can also guide you on well-rounded practices for your family’s good health both now and for a lifetime. Make an appointment today.

Does Diabetes Make COVID-19 More Dangerous? (And What Can I Do About It?)

Note: Please see our post “What Your Doctor Wants You to Know About Coronavirus (COVID-19)” for more information about COVID-19 prevention and symptoms, and for guidance on what you should do if you think you may have the virus.

Risks of Catching COVID-19 vs. Risks of Complications

As far as we currently know, anyone can contract COVID-19 and anyone can have its most severe and life-threatening symptoms. However, some groups of people do seem to be more susceptible, such as older adults and people with compromised immune symptoms. If you or someone you love is diabetic, you may have heard that diabetes puts people at greater risk, and you’re probably wondering what you can do to lower that risk. You might only be wondering does diabetes make COVID-19 more dangerous?

COVID-19 is still a very new virus, and we’re learning more about it every day. However, the best research we have available today suggests that people with diabetes are not more likely to contract COVID-19, but they are more likely to experience the disease’s more serious symptoms and life-threatening complications.

Managing Your Risks

Whether you are diabtetic or not, the most important thing you can do is take proper precautions to avoid exposing yourself to the virus. Disciplined social distancing and quality personal protective equipment can greatly reduce your risk of exposure, but they won’t completely eliminate the possibility that you will catch COVID-19.

Fortunately, a recent preliminary study in the journal Cell Metabolism found that you can lower your risk of severe complications by managing your blood sugar levels well. The study looked at hospitalized patients in China who had type 2 diabetes and a positive test for COVID-19. Those whose blood glucose levels were well controlled during their hospitalization were significantly less likely to develop life-threatening complications. Most strikingly, 11.0% of those with poorly managed blood sugar died while in the hospital, compared to 1.1% of those with well managed blood sugar.

As the authors acknowledge, there are several limitations to this study. It looked only at type 2 diabetes patients, and only at COVID-19 patients who had to be hospitalized. We don’t know how well they managed their blood sugar before or after being hospitalized. We don’t know their long-term health outcomes. And of course, if you are hospitalized, much of the responsibility for managing your blood sugar will be taken on by the hospital.

But we do know that hyperglycemia (high blood sugar) can harm your immune system, making you more susceptible to all kinds of infections. It also increases your risk of heart attacks, stroke, and other serious health problems.

If you contract COVID-19, there’s good reason to believe that carefully monitoring and managing your blood sugar could help save your life. You or the hospital will have to monitor it more frequently than normal, because the disease may put your body under unusual levels of stress. The disease may also put you at greater risk of diabetes complications, such as diabetic ketoacidosis (DKA).

Even if you don’t catch the virus, good blood sugar monitoring is more important than ever for continued good health. Fortunately, there’s a lot you can do to manage your blood sugar well.

What You Can Do

Now is a good time to reassess how you currently manage your blood sugar and take steps to improve. Hopefully, much of the advice below is already part of your practice, but take a good look and examine how you can do better. Also consider asking your doctor for advice, especially if you’re struggling to manage your blood sugar effectively.

According to the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDKD) of the National Institutes of Health (NIH), the following practices will help you manage your blood sugar and live a healthy life with diabetes:

  • Check your blood sugar levels regularly — with a blood glucose meter or continuous glucose monitor — as directed by your doctor.
  • Take diabetes medications and insulin as prescribed and directed by your doctor.
  • Have your A1C tested regularly to assess your average long-term blood sugar levels.
  • Check your blood pressure regularly and talk with your doctor if it’s high.
  • Have your cholesterol levels tested regularly, and talk with your doctor if your numbers are outside the healthy range.
  • Quit smoking (or don’t ever start).
  • If you are overweight, ask your doctor how you can work safely toward a healthier weight.
  • Eat a healthy diet with lots of fruits, vegetables, whole grains, and lean proteins.
  • Exercise regularly and try to live a more active lifestyle.
  • See your primary care doctor at least twice a year, and more frequently if you’re having trouble managing your diabetes.

Better Health Beyond the Crisis

While we don’t know for certain that managing your blood sugar well will lower your risks with COVID-19, we have good reason to believe that it might. And we know that these practices will help you live a healthier life, now and long after the current health crisis has passed. So whether you do it to protect yourself from COVID-19’s worst complications or to work toward a better long-term quality of life, we hope you’ll consider how you can live well with diabetes.

Call your primary care doctor or any United Physician Group Family Medicine practice if you’d like some help or want more information on does diabetes make COVID-19 more dangerous.

Why is My Nerve Pain Worse at Night? (And How Can I Sleep Better?)

If you suffer from nerve pain caused by diabetic neuropathy, physical trauma, sciatica, lupus, arthritis, or other causes, you may find that your pain gets worse at night. While not everyone experiences this, it is quite common for people with nerve pain to report greater pain later at night or whenever they get in bed.

The pain may make it harder for you to get quality sleep, and that may in turn make your pain and overall health and wellbeing even worse. It’s a vicious cycle.

Let’s look first at why your nerve pain may be worse at night, then we’ll look at some ways you may be able to get better rest.

Why Nerve Pain is Worse at Night

Just as chronic pain can have many causes, so too can increased pain at night. Not all causes are fully understood, but here are some possible reasons you may be hurting more at night.

Body Position

When you lay down, the weight of your body may put pressure on your nerves in ways that it doesn’t when you’re upright. This is particularly common with sciatica and other chronic pain caused by pinched or compressed nerves.

Temperature

Cooler temperatures help many people sleep better. However, cold can also make arthritis pain worse. Neuropathy may make you more sensitive to cold and more likely to experience it as pain.

Attention and Distraction

You may simply be more aware of your pain at night when there is less to distract you from it. This doesn’t mean the pain isn’t real — it is — only that you may be noticing it more at night than you do when you have other things to occupy your mind.

Hormone Levels

As your body prepares itself for sleep, your hormone levels, metabolism, and many other biochemical processes adjust. Some of these changes may heighten your pain. Cortisol, for example, has anti-inflammatory effects. However, your cortisol levels drop through the first half of your sleep cycle to let you rest, potentially making pain from rheumatoid arthritis worse.

Medication Timing and Dosage

The medications that control your pain well during the day may be wearing off too soon at night. Or your nighttime biochemistry and symptoms may require a different dosage or medicine.

How to Sleep Better with Chronic Pain

You and your pain management specialist may have to take an experimental approach to sleeping better. What works well for one kind of chronic pain may not work well for another, and your body will respond in its own unique way. Here are some strategies that may help you reduce your nighttime pain and get better sleep.

Try Sleeping in Different Positions

If your chronic pain is caused by pinched or compressed nerves, adjusting your sleep position may relieve some of the pressure. For example, people with sciatica who prefer to sleep on their side often find it helpful to sleep with their affected leg on top. People with hip or knee pain may find relief by sleeping with a pillow between their legs.

Adjust the Temperature

Experiment with different room temperatures when you sleep. It may take some time to find the best temperature for you: cool enough to help you sleep, not cold enough to make your pain worse. Consider keeping a journal of each night’s room temperature, sleep quality, and pain, then see what patterns you notice over time.

Get Appropriate Exercise During the Day

Exercise during the day can help reduce some kinds of chronic pain, and it may help you rest better too. Talk with your pain management doctor about what kinds of exercise are appropriate and safe for you.

Practice Good Sleep Habits

While the day’s stimulations may distract you from your pain, they won’t help you sleep. Develop a sleep routine that helps prepare your body for rest. This might include turning off the TV and other screens 1-2 hours before bedtime, reading a book, or taking a warm bath. Anything that helps you relax and unwind before you head to sleep.

Prepare Your Mind for Rest

The stress of chronic pain can make it even harder to rest. Try meditation or deep breathing exercises to lower your stress and help reduce your perception of pain. They also give you something else to focus on instead of your pain.

Talk With Your Doctor About Your Medications

If the medications you’re taking to manage your pain are wearing off or not working as well at night, tell your doctor and discuss your options. For example, if you have rheumatoid arthritis, your doctor may recommend modified-release corticosteroids to prevent nighttime inflammation.

Good Sleep for Better Health

Whatever you do, don’t suffer sleeplessly in silence. Chronic poor sleep will only make your chronic pain worse, and it robs you of a better quality of life. Less nighttime pain and better sleep will help you feel better all day long.

If you’d like some help managing your pain for better rest and health, you can make an appointment with any United Physician Group Pain Management practice. We offer effective treatments that bring lasting relief. We’ll help you rest well and get your life back.

Keeping You Safe While Getting You the Care You Need

Note: Please refer to our post “What Your Doctor Wants You to Know About Coronavirus (COVID-19)” for more information about COVID-19 prevention and symptoms, and for guidance on what you should do if you think you may have the virus.

The spread of COVID-19 around the world has rightly focused a lot of attention on preventing and treating this dangerous viral infection. But while COVID-19 is a serious public health emergency, it’s also important that you and your family continue to receive the other preventative and therapeutic care you need for your health and wellness.

That’s why we’ve enhanced our already strict procedures to prevent the spread of germs and diseases, including but not limited to COVID-19. And it’s why we’re offering telehealth virtual visits and remote patient monitoring, where appropriate, so you can receive personalized care from the safety and convenience of your home.

Keeping You Safe

Even in ordinary times, all United Physician Group practices follow rigorous best practices to protect our patients and healthcare providers from the spread of infection and disease. During the COVID-19 crisis, we’re doing more than ever to keep everyone safe.

Disinfecting

In order to keep every United Physician Group facility sanitized and safe, we are:

  • Using disinfectant cleaning solutions recommended by the CDC to wipe down all surfaces.
  • Disinfecting every exam room thoroughly after every patient.
  • Disinfecting all chairs, exam tables, and high touch areas such as door knobs multiple times per day.

Screening

As usual, we’re making reminder calls 48 hours prior to each patient’s appointment. During those calls, we’re now:

  • Asking patients screening questions to assess any symptoms of or exposure to COVID-19 and converting all affected patients to telehealth virtual visits. 
  • Making sure anyone who has an elevated risk of carrying the virus gets appropriate care and monitoring, and…
  • Either rescheduling their original appointment or converting it to a telehealth virtual visit.

When patients arrive for their appointments — and before they enter the building to check in — we’re:

  • Taking their temperatures.
  • Asking them the same screening questions.

Distancing and Limiting Contact

We’re taking several measures to prevent patients from coming into close contact with one another:

  • Scheduling fewer appointments so that fewer patients are in our facilities at any one time.
  • Re-arranging our waiting rooms to keep everyone at least six feet apart.
  • Quickly bringing patients back to private exam rooms.

We’re also offering parking lot visits, where appropriate. Your doctor and nurse will come out to your car and stay six feet away from you, so you never have to enter the facility.

Telehealth Virtual Visits and Remote Patient Monitoring

We’ve also expanded our telehealth services, including virtual visits and remote patient monitoring. Using video conferences, remote testing and monitoring, and our patient portal, we’re able to:

  • Make initial assessments of patient health and healthcare needs.
  • Conduct many routine follow-up visits.
  • Manage and monitor chronic disease testing and care.
  • Refill and monitor prescriptions. 

Telehealth isn’t appropriate for all conditions and concerns, and we’re still asking all new patients to come in for their first visits. However, in many cases telehealth allows us to provide good care remotely while protecting you from any potential exposure to disease.

Whether you’re at higher risk of contracting COVID-19 or just not comfortable coming into the office, telehealth is one more way that we’re working every day to give you the best in personalized care.

If you’re interested in a telehealth visit, please contact your United Physician Group provider for more information.

The Care You Need

These are difficult times we’re all going through, but we’ll get through this together with proper precautions, a little technological assistance, and the expertise of your neighborhood United Physician Group doctors.

Don’t let fear of COVID-19 keep you from receiving the personalized care that will help you stay healthy and well. Whether you’re feeling sick, experiencing chronic pain, or due for a check-up or screening, get the care you need by scheduling an appointment. Contact your United Physician Group provider today.

Does Stress Make Chronic Pain Worse?

In these uncertain times, it’s natural that many of us are feeling more stress and anxiety. Even if you and your family are healthy and safe at home, fear of the unknown and the troubles of others can weigh heavily on all our hearts and minds.

If you or someone you love experiences chronic pain, you may wonder whether all this stress can make that pain worse. Or maybe you’re already experiencing more severe pain and wondering whether stress is to blame.

The Cycle of Stress and Pain

Let’s first acknowledge the obvious. Chronic pain can be a source of stress. It may make it harder for you to work or care for your family. It may interfere with your rest and sleep. And hurting all the time is inherently stressful. Your body is always looking for a way to relieve or escape the pain.

So pain can absolutely cause stress. But can stress also make the pain worse?

While the answer is less clear, there is a growing consensus among researchers and pain management specialists that it can. This is not to suggest that the pain isn’t “real.” It’s very real. But stress may be making it worse.

According to an article published by the Institute for Chronic Pain (reporting on a manuscript in the Journal of Pain), stress can activate the immune system and cause increased inflammation. And inflammation can aggravate many causes of chronic pain.

A 2015 meta-study published in the Malaysian Journal of Medical Sciences found that stress can cause both analgesia and hyperalgesia: reduced or increased sensations of pain. While the results were complex, increased pain seemed more common in cases of chronic stress than with occasional, isolated stress. Negative emotions also heightened the impact of stress on pain. (A stressful but enjoyable experience, such as competing in a sport, may be less likely to increase pain.)

And in a 2017 manuscript published by the Department of Health and Human Services, the authors suggest that chronic pain and chronic stress are two parts of the same underlying neurobiological system, interrelated in subtle and intricate ways.

Research in this area continues, and we don’t yet fully understand how pain and stress are related. However, if you’re experiencing chronic stress, it may very well be making your chronic pain worse.

What Can You Do to Ease Anxiety?

If stress is making your chronic pain worse, there’s a lot you can try to ease that stress and possibly ease your pain too. Your United Physician Group family medicine doctor or pain management specialist can help guide you to effective stress relief and pain management.

Your options may include:

Lifestyle Changes

  • Regular exercise: If your chronic pain doesn’t prevent it and your doctor approves, exercise can help you manage stress.
  • Quality sleep: Chronic pain and stress can make it harder to sleep, but, if you can develop good sleep habits, the rest may ease your stress.
  • Good nutrition: A healthy diet keeps your body in balance and better able to handle each day’s challenges. Also consider moderating or eliminating caffeine and alcohol, which can make stress worse.
  • Complementary treatment: Yoga, massage, meditation, guided breathing, and other supportive treatments may help ease your stress.

Therapy

Cognitive Behavioral Therapy (CBT) can help you develop skills to better manage stress.

Medicine

Some prescription medications, such as selective serotonin reuptake inhibitors (SSRI) and antidepressants, may treat chronic pain and chronic stress simultaneously.

You Don’t Have to Figure This Out Alone

If you’re hurting and under stress, the most important thing you can do is to reach out for help. You don’t have to have all the answers. Reach out to your pain management specialist, and let us know what you’re going through. We’ll help you figure it out.