Friday, 16 June 2017

Chronic Nerve Pain Linked To Cognitive Problems: So What! It Changes Nothing!

Today's post from (see link below) takes another look at the current 'hot potato' on the nerve damage internet forums and that is, the link between chronic pain and memory loss, dementia, Alzheimer-like symptoms and general cognitive disorders. Although anybody would agree that it's no surprise that chronic persistent symptoms such as those suffered by neuropathy patients, is likely to have an effect on your mental health, it remains a serious concern for many people especially as they get older. The point is, if it's true, how does that change your situation? This article argues that the drugs we have to take over a long period of time, are just as likely to cause cognitive issues than the pain itself. That seems highly likely, so in that respect, can we do something about stagnating cognitive health by modifying the drugs we take? The problem is that the current series of drug treatments for neuropathy symptoms haven't changed in decades and although progress is being made, they're unlikely to change in decades to come. Will knowing that they are affecting our cognitive abilities help us in any way? Of course not, because the drugs are essential to reduce the severity of the symptoms and frankly, we'd rather have less pain than less memory! So it's incumbent on the drug companies to get a move on and develop the drugs and research into stem therapies and genetic modification that we know are in the pipeline. In the meantime we're stuck between a rock and a hard place and while study outcomes such as this (cognitive degeneration due to chronic pain or the drugs used to control it) may confirm what we've always suspected, they're pretty much academic in relation to our daily lives.

Does Chronic Pain Increase Likelihood Of Cognitive Decline? 
June 6, 2017 / Thomas Cohn, MD

Recently, a new report published in the Journal of the American Medical Association suggests that there may be a link between chronic pain and the eventual onset of cognitive issues. But do these findings really suggest that chronic pain leads to an increased risk of cognitive decline, or is there something bigger going on? We take a closer look in today’s blog.

For their study, researchers at the University of California at San Francisco decided to look at how chronic pain impacted a person’s mental health. They began by examining data collected on more than 10,000 individuals over the age of 60 who were taking part in a different nationwide study. Patients in that study were surveyed about their pain scores and cognition in 1998 and 2000. Patients were then monitored over the next decade.
Chronic Pain and Brain Health

After looking at the data at the end of the study, researchers found that individuals who said they were persistently bothered by moderate or severe pain declined 9.2 percent faster in cognitive and memory tests over the next 10 years compared to those who said they were not in pain. Moreover, patients who complained about persistent pain exhibited a 7.7 percent greater chance of developing dementia than patients who did not experience regular pain.

“A persistent report of moderate to severe pain, which may reflect chronic pain, is associated with accelerated cognitive decline and increased dementia probability in a large population-representative data set of elders,” wrote first author Elizabeth Whitlock, MD, a postdoctoral fellow in the UCSF Department of Anesthesia and Perioperative Care. “Clinicians should be aware of this association, which persisted after extensive statistical adjustment for confounding health and demographic factors. Patients reporting ongoing pain may be at higher risk for current and incident cognitive impairment and physical debility.”
Pain Can Compound Mental Health Issues

The authors go on to make another key point about the problems associated with persistent pain and the onset of cognitive problems like dementia. Since individuals with pain oftentimes take opioids or other painkillers, cognitive decline can make it difficult for the patient to remember to take their pills or to get the correct dosage, which can be downright dangerous.

“Elderly people need to maintain their cognition to stay independent,” said Whitlock. “Up to one in three older people suffer from chronic pain, so understanding the relationship between pain and cognitive decline is an important first step toward finding ways to help this population.”

However, the study says the results don’t paint a perfect picture of the link between chronic pain and cognitive decline. Since a good deal of patients are on a variety of different pain medications to help control their pain, researchers said that the pills could be contributing to dementia and other cognitive problems, and pain may not play a role.

Hopefully future studies will look closer at the role opioids may play in cognitive decline. Regardless, this study is just more proof that we need to be investing more time and energy into seriously working to find solutions to the myriad of chronic pain problems in the US and throughout the world.

Thomas Cohn, MD
Interventional pain doctor helping Minnesotans manage back, neck, foot, and other pain. Board-certified in physical medicine and rehabilitation with additional board-certification in pain management from the American Board of Anesthesiology (ABA), the American Board of Interventional Pain Physicians (ABIPP) and the American Board of Pain Medicine (ABPM).

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