ringback welcome to in good shape today's topics. pills or physio therapy what's better for your headache. c.b.d. does this compound found in cannabis have medical applications. and painkillers and there are side effects here's your host dr coston laid out. hello and welcome to in good shape paying it's not

a bad thing in and of itself because it wants you with it something wrong is going on inside your body but there's a problem when the pain gets chronic like an austere freitas or in migraines and then you have to see a pain doctor like doctor. here at the francisco's hospital in berlin and he's the head of the pain clinic. what's patients with severe chronic pain really need is a companion a professional companion who is helping them to fight the pain and to have a goal for the future. well i think we all have some pain medication at home and this is a case because if you've got a serious to say or a headache it's ok to take a pill but beware this can be dana. some patients have serious side effects it's

really harming the body. because i know it's 4 years ago she became a patient in her own clinic but chronic pain has become unbearable. madson have been i often feel pain in my back at work i forget my job requires me to lift heavy patients and push heavy beds around things like that. and so forth and so i've been in pain for about 20 years and. she's been through a lot of various doctors different therapies and lots of painkillers. but painkillers often have side effects. and if you think you can just keep treating pain yourself without going to a doctor and it's been going on for a long time it can get very dangerous. one reason is you might not be medicating in

the best way for the condition and the side effects can make your life difficult was. the reason the painkillers like i'm p. profound and aspirin have side effect is due to the way they work injured or inflame tissue releases certain fatty acids these are converted by so-called cox enzymes into messengers substances known as prostate gland and these messenger substances bind themselves to pain receptors at the nerve endings they transmit the pain signal to the central nervous system. profer an aspirin and similar drugs dampen the cox enzymes activity the body produces few a prostitute and the pain goes away across the plantains also regulate other bodily functions like blood clotting liver function and the regeneration of mucus membranes in the gut. an overdose of these over the. counter painkillers can cause

kidney damage liver damage which in some cases then requires organ transplants and you can have stomach bleeding asians are also more at risk of having a stroke especially patients who already had a heart attack so they should be very cautious about these drugs. is also a patient of the pain clinic she has multiple sclerosis and has had severe back pain for years several operations didn't help. month. you're always looking around for something to relieve the pain so of course i took over the counter drugs my experience was that they didn't help. but the side effects were terrible. my stomachs in terrible shape i often have no appetite and have to throw up. because the side

effects were so bad doctors switched like enough to prescription opioids opioids act directly in the central nervous system and the brain there they block the transmission of pain signals between nerve cells opioids don't cause the typical side effects of over the counter pain killers but there's the threat of overdose and addiction and their effect also diminishes over time. that's what happened to thinking a fuck. this was to me the opioid stopped having an effect that happens often if you take opioids over a longer period of time they stop having the desired effect. so marcus youngblood doesn't prescribe either opioids or over the counter painkillers as a daily treatment for pain. instead he and his team of specialists therapists and psychologists develop tailor made treatment plans for each of their patients.

mamas and. we give our patients a very thorough orthopedic examination from head to toe. it's not enough to simply look at an m.r.i. and say you have a herniated disc. or a constriction. especially with pain patients you have to take a holistic approach to get down to the different courses or consequences of. thank you enough doesn't need opioids anymore thanks to the therapy she received in a pain clinic she now only takes one medicine a cannabinoid spray that n.-s. patients often prescribed. and i'm glad that it still gives me some relief it's the only thing that does i'm also very careful with it because i'm too afraid that something will happen again. i ask yet. glitz and thank you know now both know that painkillers can't heal you they can reduce the symptoms but in

the long run they can also make you ill. just kinds of really doesn't make sense to just take painkillers for 4 days wonder why it's not getting better and hope it will go away on its own that's not a good approach. let's get some pain free but she's learned how to deal with the problem and she does exercises that help and definitely have no side effects. and i'm here with dr he's an anesthesiologist and a specialist in pain medicine thanks for having me today and let's start this kind of consultation let's kick it off with a question. krista from lima writes that his girlfriend often has a headache and she always pops tablets to treat the headaches another is the little concerned about the side effects so what do you think you have to take painkillers and headaches or where the limits are crossed of all i think it's to take pills

when you have severe pain because we have to function we won't be happy and want of air for life but we should not forget that these painkillers can every severe side effects especially if you go above the allowed limited dozers but we have much smarter ways especially when we can change our lives or behavior they have exactly the same a life ect so you little bit conservative about this and say you can treat headaches in the different way not all of us with pills but as a g.p. i know that there's something like a pain memory what about this we can have a pain memory which can be biological. nerve damage and then the whole brain is changing the structure but this is quite rare and much more common is the social pain memory. where we change our behavior. and we change our role from a normal person to the role of pain patients which is the so-called social pain memory

but sometimes you have to take medication you have to take a pill and then there are side effects they can be stomach pain stomach ulcers that can be bleeding and they can also be problems with the heart and patients must know about that so it's about the non steroids pain medication yes but there are newer drugs of the same class which are safer for the stuff we have the so called to coax hips which would cause really less problems with the stomach but they have exactly the same problems for the heart so if you have patients so who have a severe heart to seize coronary heart disease they should take these drugs only was caution so sometimes as a doctor we have to switch from those kinds of medication to more centrally acting structures and drugs like opioids so when we have to prescribe this are in general the opiates are not toxic so they do not cause damage to the internal organs and. i

prescribe them if i think they are useful so we try to determine a treatment goal. for example that the patients kind of a better sleep at night that they can walk better. they can sit longer they can think better have more happiness in life and then so we have this defined goal what we have and then we can we can figure out if with the help of these opioids we can attain this goal but addictive or kids can be addictive if they have a very rapid onset of action in the brain and this is if you take them intravenously or you take drops but if you take retard tablets or plasters there's no problem at all but there is an opiate crisis in the united states about 2000000 people got addicted and this is because the. prescribe. predetermining treatment i think and without any control of the patients the patient the physician. patient

to see a lot of patients. and it's very important to find out what type of. patients have. the right. casting henning's daughter nicole and granddaughter mira have come to visit us the 54 year old does her best to be there for her family. but the frequent pain she experiences means that even a simple meeting like this can be hard to keep. puzzling moment the worst thing is that the headaches come on at the most inconvenient times. that and then one that you might want to go out and then be hit with a headache. i try to avoid public events because it's lots of hustle and bustle so few tortue loud. and that's too much of a strain for me. to. keston suffered from different kinds of

headaches and she was a child. over time they got worse. she's learned to identify what kind of headache is coming on. now she can put into words the type of pain that she's experiencing as. tension headaches all involved pressure not a hammering or anything like that more of a pressure as if you were wearing something tight wrapped around your head. and migraines come either from the right or the left side and that's a kind of throbbing or hammering in your head. where the. rice to see you. these days she's managed to get the migraines under control thanks to a category of drugs called triptans. every 3 months she's given a low dosage injection of the neurotoxin botox to. see.

clusters that play a role in migraine formation it also blocks neurotransmitters that can trigger migraine attacks and patients get injections every 3 months for most the migraine is reduced to a much more bearable level. as most. can't and also takes antidepressants to alleviate her tension headaches. these kinds of drugs can help some patients have fewer and less severe headaches. but even if they're less painful than before cast and still get tension headaches almost every day. for additional relief she goes to physio therapy she suffers in particular from tension in her shoulder and neck a common complaint among patients with tension headaches. and bottoms you have to take a closer look at the tension headache to see where the tension is coming from the

tension in the neck because somewhere else so you have to examine it very closely. it can have its roots in stress or anxiety disorders there are quite a few different causes. exercises that help strengthen core muscles can help ease neck tension but regular training is key over the years cancer and got used to taking painkillers on a daily basis but that itself took its toll. so i wish to comment to you know i used to take drugs constantly just to get through the day . and of course i had to find a way to stop that because too many painkillers can cause even more headaches. and that's the opposite of what you want. just with. closing down on pain killers wasn't easy but captain hasn't given up she works full time in a large city far see

a big challenge for someone who is constantly in pain but she's found ways of coping. and if we are. in the past i would come home and do all the chores right away start i got up early in the morning and did everything. and if someone wanted something from me i didn't say no but now i'm taking a calmer approach we are on she now spent the evening during things she enjoyed the focus is on activities that help her to relax. we just saw in the report that pills cannot always solve the problem when it comes to chronic pain so how important are psychological aspects and pain management. psychological aspects of very very important builds just just working on one's specific small part of the pain. but we must know the pain is a it is just one aspect of the whole.