Many Rotator Cuff Surgeries May Be Unnecessary

By Pat Anson

Since I write about chronic pain and the many different treatments for it, it’s not uncommon for readers to ask if I’ve ever experienced it myself.

The answer, unfortunately, is yes. 

About 15 years ago, I started feeling a dull pain in my left shoulder that wouldn’t go away. It progressively grew worse, and my arm became so painful to move that I had trouble putting on a shirt or sleeping in the same position for more than a few hours. 

Only then did I finally see a doctor. An MRI confirmed there was a “wrinkle” in my rotator cuff,  and that the ligaments, muscles and tissue in my shoulder were inflamed. I had adhesive capsulitis, also known as a “frozen shoulder.” 

The doctor gave me a cortisone shot and prescription strength ibuprofen, and when neither of them helped, he recommended rotator cuff surgery or physical therapy. I opted for the latter. 

Everyone thinks their lived experience with pain is unique, and I’m no different. But it turns out my experience with shoulder pain is all too common and is likely a normal part of aging. 

According to a new study in JAMA Internal Medicine, almost everyone over the age of 40 will experience a rotator cuff injury.

Using MRI images, researchers in Finland studied the shoulders of over 600 people between the ages of 41 and 76. Although only 1 in 6 had complaints of shoulder pain, virtually everyone had a rotator cuff injury of some kind, ranging from a full tendon tear to age-related joint damage.

The findings challenge the value of advanced imaging like MRIs, which may be diagnosing shoulder problems that don’t need fixing — or at least don’t need to be treated with invasive injections and surgeries.

“In this population-based study, RC (rotator cuff) abnormalities were nearly universal after age 40 years and showed poor concordance with shoulder symptoms,” wrote lead author Thomas Ibounig, MD, an Orthopaedic Surgeon at Helsinki University Central Hospital.

“These findings suggest that RC abnormalities often represent normal age-related changes rather than disease and call into question the clinical value of routine imaging for atraumatic shoulder pain.”

Ibounig and his colleagues found that many people can have inflamed tendons (tendinopathy), full tendon tears (FTTs) and partial tendon tears (PTTs) in their shoulders without experiencing pain or any other symptoms. Only when they get medical imaging are the rotator cuff abnormalities found, which sets in motion a process that can lead to invasive treatments. 

About half a million rotator cuff repairs are performed annually in the United States, with the surgeries increasing at a rate of about 2% a year for patients 50-64 years of age. Their success rate is mixed, from about 90% for PTTs to as low as 50% for FTTs. Full recovery from rotator cuff surgery may take several months to a year. 

The Finnish study suggests that many of those surgeries are unnecessary and that shoulder pain should be accepted as a normal part of aging.  

“Given that tendinopathy, PTTs, and even FTTs may be incidental findings, clinicians should consider their high population prevalence when interpreting imaging results and deciding on interventions targeting these abnormalities. Reframing many of these findings as normal age-related changes rather than disease may help guide more appropriate care and reduce unnecessary interventions,” they concluded.

It took several months of physical therapy before my shoulder pain subsided. It still aches occasionally, but I no longer have the sharp stabbing pain that I used to get. And it’s no longer chronic.

I still use the stretches and exercises that I learned during physical therapy to keep my left shoulder from “freezing” again. It’s a good thing I learned how to do them, because now my right shoulder aches too. 

As Anxiety Grows, More Americans Turn to Antidepressants

By Phillip Reese, KFF Health News

After a grueling year of chemotherapy, surgery, and radiation to treat breast cancer, Sadia Zapp was anxious — not the manageable hum that had long been part of her life, but something deeper, more distracting.

“Every little ache, like my knee hurts,” she said, made her worry that “this is the end of the road for me.”

So Zapp, a 40-year-old communications director in New York, became one of millions of Americans to start taking an anxiety medication in recent years. For her, it was the serotonin-boosting drug Lexapro.

“I love it. It’s been great,” she said. “It’s really helped me manage.”

The proportion of American adults who took anxiety medications jumped from 11.7% in 2019 to 14.3% in 2024, with most of the increase occurring during the covid pandemic, according to survey data from the Centers for Disease Control and Prevention. 

That’s 8 million more people, bringing the total to roughly 38 million, with sharp increases among young adults, people with a college degree, and adults who identify as LGBTQ+.

Even as psychiatric medications gain public acceptance and become easier to access through telehealth appointments, the rise of a class of antidepressants called selective serotonin reuptake inhibitors, known as SSRIs, has triggered a backlash from supporters of the “Make America Healthy Again” movement who argue they are harmful. 

Doctors and researchers say medications such as Prozac, Zoloft, and Lexapro are front-line treatments for many anxiety disorders, including generalized anxiety disorder and panic disorder, and are being misrepresented as addictive and broadly harmful even though they’ve been proved safe for extended use.

Health and Human Services Secretary Robert F. Kennedy Jr. has decried broadening SSRI use. During his 2025 confirmation hearing, he said he knows people, including family members, who had a tougher time quitting SSRIs than people have quitting heroin. More recently, he said his agency is studying a possible link between the use of SSRIs and other psychiatric medications and violent behavior like school shootings.

Food and Drug Administration Commissioner Marty Makary has also suggested that SSRI use among pregnant women could lead to poor birth outcomes.

SSRIs’ common side effects include upset stomach, brain fog, and fatigue. Some SSRIs also can reduce libido and cause other sexual side effects.

For many people, however, the side effects are mild and tolerable and the benefits of treating chronic anxiety are worth it, said Patrick Kelly, president of the Southern California Psychiatric Society. “The statements about SSRIs were just not grounded in any sort of evidence or fact,” Kelly said of Kennedy’s comments.

A recent comprehensive study showed that over half of people with generalized anxiety disorder taking an SSRI saw their anxiety symptoms reduced by at least 50%. Side effects prompted about 1 in 12 to stop taking an SSRI.

“When it’s being done right and when you’re also using appropriate therapy techniques, SSRIs can be really, really helpful,” said Emily Wood, a psychiatrist who practices in Los Angeles.

MAHA Blames Anxiety on Poor Diet, Lack of Exercise

Supporters of MAHA have partly blamed poor dietary choices and the increase of a sedentary lifestyle for the rise of a number of health problems, including anxiety, depression, and other mental health disorders. 

As a remedy, they have called for measures such as reducing consumption of ultraprocessed foods, which studies in recent years have connected to depression and anxiety, and cutting back on screen time in favor of exercise.

Psychiatrists often encourage a healthy diet and exercise as an adjunctive therapy for anxiety and depression. Wood said those who can manage anxiety without medication should also consider talk therapy. 

The proportion of American adults using mental health counseling boomed from 2019 to 2024 as teletherapy grew in popularity, federal data shows. “Anxiety disorders are amongst our psychiatric disorders that really respond well to cognitive behavioral therapy,” she said.

But medication can help.

Studies show the risks of taking SSRIs during pregnancy are low for mother and child. By contrast, “depression increases your risk for every complication for a mother and a baby,” Wood said, adding that recent statements by government officials about SSRI use during pregnancy are “potentially leading to real harm for these women.”

Some people who stop taking antidepressant medication will experience nausea, insomnia, or other symptoms, especially if they quit suddenly. But “the concept of addiction simply does not apply to these chemicals,” Kelly said, a statement backed up by studies.

Addiction, though, is a possibility with benzodiazepines such as Xanax that are often a second line of treatment for anxiety. These controlled substances can also increase the risk of opioid overdose in patients taking both types of drugs. During congressional hearings last year, Kennedy also decried benzodiazepine overuse as a problem.

While benzodiazepines are effective for short-term use, they require monitoring and care, Wood said.

“Those are really great meds for acute anxiety and not great as long-term anxiety medications, because they are habit-forming over time,” Wood said. “If you’re taking them on a daily basis, you’ll need more and more to get the same effect, and then you have to come down from them in a tapered way.”

And an increasing number of people are also occasionally taking beta-blockers such as propranolol for anxiety. Some people use beta-blockers to prevent a racing heart before a public speech or other big moments, even though they are not FDA-approved for treating anxiety and are prescribed “off-label.”

Beta-blockers can cause dizziness and fatigue, but they are “nonaddictive, really helpful for bringing down the autonomic nervous system, going from fight or flight to something more neutral, and really safe,” Wood said.

Social Changes Drive Increased Use of Anxiety Meds

A number of leading theories could explain why so many more people are taking anxiety medication, including increased social media use, more isolation, and heightened economic uncertainty, physicians and researchers say.

Plus, the medicines are relatively easy to get. Many people obtain SSRI and benzodiazepine prescriptions from their primary care physician. Others obtain the medications after a brief teletherapy appointment.

Many social media influencers talk about their mental health struggles, easing some stigma among young people and encouraging them to get help. About a third of teens in a recent study said they get mental health information via social media.

Still, increased access to anxiety medication can be a problem when combined with a trend of self-diagnosis based on social media trends. A Google search for “buy Xanax online” leads to sponsored promises of same-day treatment, though fine-print disclaimers clarify that a prescription is not guaranteed.

“I think increased access is good, but that’s not the same thing as, you know, ordering Xanax online,” Kelly said.

Young adults are largely driving an increase in anxiety medication use. The proportion of Americans ages 18 to 34 taking anxiety medication rose from 8.8% in 2019 — the first year such survey data became available — to 14.6% in 2024. By contrast, the rate didn’t change much among adults 65 and older, CDC data shows.

The pandemic and covid lockdowns greatly increased stress among many American adults, particularly young adults.

And data shows more women than men take anxiety medication. Jason Schnittker, a department chair and professor of sociology at the University of Pennsylvania, said that’s because they’re more likely to need them. They are also likelier than men to report when they feel anxious, and doctors are “inclined or see anxiety more readily in their female patients than their male patients,” Schnittker added.

Broader trends could also be at work. Schnittker said studies have shown anxiety growing more prevalent among ensuing generations for much of the 20th and 21st centuries. 

Schnittker, author of Unnerved: Anxiety, Social Change, and the Transformation of Modern Mental Health, said growing income inequality could be partly to blame, with people feeling stress over improving their economic status. Social and religious activities have been replaced by more isolation. And people have become more suspicious of others, creating a sense of unease around strangers.

For Zapp, the cancer survivor, it took a few months on Lexapro before she started seeing clear results. When she did, she said, it felt like her mind was less noisy, making it easier to focus. She also underwent talk therapy, but now her chronic anxiety is stabilized on medication alone.

“It definitely helped me get back to my day-to-day in a way that was productive and not just riddled with my anxieties throughout the day,” she said.

KFF Health News is a national newsroom that produces in-depth journalism about health issues.

Tapering Plan Led by Pharmacists Shows No Benefit for Seniors

By Crystal Lindell

If pharmacists helped taper elderly patients off opioids and benzodiazepines, would that reduce their risk of falling?

Turns out, the answer is no. Having pharmacists get involved in a senior’s treatment plan doesn’t significantly reduce fall risk or prescriptions for the medications, according to research recently published in JAMA..

Falling is a significant risk factor for seniors, because their bones fracture more easily and it takes longer for them to recover. Medications that impair balance – such as opioids and anti-anxiety drugs – raise the risk of falling, especially in seniors who take them concurrently. 

Researchers at the University of North Carolina School of Medicine recruited 15 primary care clinics to participate in the study. Nearly 2,100 patients at the clinics met the study criteria, which was being over the age of 65 and having a long-term prescription for opioids and/or benzodiazepines. 

Over 95% of the patients on opioids had chronic pain and about a third of them had a fall in the past year..

Pharmacists for about half the patients were encouraged to “deprescribe” them, when appropriate, by recommending a voluntary taper plan to their doctors  The other patients received usual care from their doctors, without any tapering recommendations, and served as a control group.

A year later, doctors followed the pharmacists’ advice by tapering 21.4% of patients off of opioids. But that was only slightly more than the control group, which saw opioids discontinued for 19.9% of patients. The tapering rates for benzodiazepines were similar and “not statistically significant."

Notably, there was little difference in falls between the two groups, which were essentially “unchanged” by the tapering.

In other words, having a pharmacist make tapering recommendations to doctors had very little, if any, impact. Tapering occurred in both groups, whether a pharmacist was involved or not.

“Although reductions occurred in both groups, the intervention did not significantly reduce prescribing or falls at 1 year. Still, pharmacist recommendations were feasible to implement and accepted more often than rejected, indicating general practitioner receptiveness,” researchers concluded. “These results suggest that a consultant pharmacist–led intervention is feasible to implement in primary care clinics.”

Note the word, "feasible" rather than "effective." Sure, it can be done, but that doesn't mean it should be done.

I would guess that the program did not reduce prescriptions for opioids and benzodiazepines anymore than the control group because prescribing had already been reduced. At the start of the study, the average daily dose of opioids was 23.6 morphine milligram equivalents (MME), which is a low to moderate dose.

Given how much these medications are already being restricted, few patients are getting opioids or benzos if they don’t desperately need them – not even seniors.

Beyond that, I think it’s really important to take a step back when looking at research like this and consider the patient’s perspective. 

How were the tapering plans presented to patients? Were they asked to weigh the pros and cons? Did they have a voice in their treatment?  

I suspect if they were given the option of staying on a medication or reducing their fall risk, many seniors would choose to stay on the medication. 

Unfortunately, the study authors seem to take the wrong lesson from the research, at least in my opinion. Although their study failed to prove much of anything, they concluded there should be “more intensive or sustained deprescribing strategies.”

There are a lot of studies looking at ways to reduce opioid prescriptions — I suspect because those are the easiest to fund — and I’m honestly glad this one failed. 

The biggest problem many seniors face today is that they cannot get access to effective pain and anxiety treatment. If anything, researchers should be working to address that problem, rather than making it worse.

Instead of working on blanket reductions for these types of medications, I wish they would look at finding alternatives that actually work.

If you lost a loved to suicide after a change in their prescription pain medication, please consider participating in a survey to help researchers learn more about these tragic situations. Click here or on the banner below for more information.

Opioids Effective for Many Acute Pain Conditions

By Pat Anson

As pharmaceutical companies scramble to develop new non-opioid treatments for pain, a large new review found that opioid analgesics are effective for many acute pain conditions and come with little risk.

Led by researchers at the University of Sydney, the study looked at 59 clinical studies for dozens of short-term acute pain conditions.

They found “high-certainty” evidence that opioids were effective in treating abdominal pain, postpartum pain and dental pain; “moderate-certainty” evidence that they relieve pain from sciatica, post-operative pain and ten other acute conditions; and “low-certainty” evidence that they work on nine other short-term pain conditions.

There was no high quality evidence that opioids are ineffective for acute pain, but there was moderate and low quality evidence that they provide little relief for some acute conditions, such as pain from minimally invasive surgeries.

Adverse events were limited to vomiting and nausea, with no serious events like overdose, death, or addiction reported in any of the 59 studies.

“This paper is best understood as a broad evidence map, not a simple yes/no verdict on opioids for acute pain. It shows that opioids have helped in some acute pain conditions, but benefits are mixed, often modest, and vary by condition and timepoint,” said Lynn Webster, MD, a pain management expert and Senior Fellow at the Center for U.S. Policy, who was not involved in the study.

“The authors did not find a significant increase in serious adverse events in these short-term trials, but they also emphasize that harms reporting was incomplete.”

In short, opioids work for many acute pain conditions, depending on the dose, and pose no serious risk of harm, at least over the short-term.

“There was no high certainty evidence showing that opioids were not efficacious,” researchers reported in the journal Drugs. “There was no significant increased risk of serious adverse events in any review.”  

‘Opioids Aren’t Effective’ 

But that is not how the study was portrayed in a University of Sydney press release, which warned in a headline that “opioids aren’t effective for many acute pain conditions.”

The release quoted one author as saying opioids work “only slightly better than a placebo” and are not worth the risk.

“Our review found that they did not provide large or lasting pain relief compared with placebo for the vast majority of acute pain conditions, with pain relief typically lasting only a few hours,” said lead author Christina Abdel Shaheed, PhD, an Associate Professor in the School of Public Health at the University of Sydney. 

“By showing that the benefits are generally small, short-lived, absent for many common conditions, and sometimes harmful, our research challenges the widely held belief that opioids are the most effective ‘go-to’ option for acute pain.”

Shaheed and several of her co-authors have participated in other studies that take a dim view of opioids. One is a controversial 2023 trial, known as the OPAL study, which found that low doses of oxycodone work no better than a placebo in relieving acute back or neck pain. 

“Opioids should not be recommended for acute back and neck pain, full stop,” said Christine Lin, PhD. a Professor of Public Health at the University of Sydney, who was the lead investigator of the OPAL study and a co-author of the new study. 

Critics complained the OPAL study’s conclusions were too broad, not supported by evidence, and “misplaced and dangerous.”  In reply, Lin agreed that they may have gone too far and that their findings “might not be generalizable to all patients.”

Dr. Webster takes a similar view of the new study, saying it would be wrong to draw conclusions about the effectiveness or harm caused by opioids, given the low quality of most studies that were reviewed.

“The paper is best viewed as a map of evidence gaps and variable-quality evidence, not a final word,” Webster told PNN. “Most of the underlying reviews were rated critically low quality, so the paper is very useful for mapping what we know and what we still don’t know. Broad conclusions about opioid efficacy would be inappropriate.” 

One of the co-authors of the new study is Jane Ballantyne, MD, a former President and current Vice-President of Physicians for Responsible Opioid Prescribing (PROP), an anti-opioid activist group. Ballantyne reported no conflicts of interest, although in the past she has acknowledged serving as a paid expert witness in opioid litigation cases.

Why Are Women More Likely to Have Chronic Pain? Blame Hormones

By Crystal Lindell

Chronic pain typically lasts longer for women than men, and new research suggests hormones could be to blame. That’s according to a study at Michigan State University, published in Science Immunology. 

We’ve known for some time that women are more likely to have chronic pain, and that is likely because it takes longer for their pain to resolve. Acute pain becomes chronic when it lasts longer than three months. 

The researchers looked into the potential causes of this phenomenon, and found that differences in hormone-regulated immune cells, called monocytes, seem to be the culprit.

A subset of monocytes releases a molecule – called interleukin-10 or IL-10 – that can “switch off” pain. Those cells are more active in males because of higher levels of sex hormones such as testosterone. Females, however, experienced longer-lasting pain and delayed recovery because their monocytes were less active.

When the team tested their theory on laboratory mice, they discovered the same pattern they saw in human patients. They performed five different tests on the mice to make sure what they saw wasn’t an anomaly. Each time, the results were the same.

“The difference in pain between men and women has a biological basis,” lead author Geoffroy Laumet, an associate professor of physiology at MSU, explained in a press release. “It’s not in your head, and you’re not soft. It’s in your immune system.

“This study shows that pain resolution is not a passive process. It is an active, immune-driven one.”

These findings could mean those immune cells can be manipulated into producing more signals to calm pain.

Laumet hopes this research could one day help millions of people experience relief with non-opioid treatments — and ensure women’s pain is taken more seriously. Such treatments could help acute pain resolve faster, instead of relying on analgesics to block pain signals.

The next step is to investigate how treatments could target this pathway and boost IL-10 production, although Laument admits that could take years. 

“Future researchers can build on this work,” Laumet said. “This opens new avenues for non-opioid therapies aimed at preventing chronic pain before it’s established.”

In the meantime, hopefully this type of research will encourage medical professionals to believe women when they say their pain is not going away. 

The MSU study was funded by the National Institutes of Health and the Department of Defense.

Exercise Is Hard for Me. Now I Know Why

By Madora Pennington

Exercise is difficult for me. I’m lucky I can do it at all. I am extremely double-jointed because my tendons and ligaments are excessively stretchy as a result of hypermobile Epstein-Danlos Syndrome (hEDS), a connective tissue disorder I was born with.

When I play sports, go the gym or even swim, I see others moving with an ease that is out of my reach. I wonder what exercise feels like for them. I get so worn out — and no matter how fit I get — this does not change. What exactly is different about exercise for me, I never fully understood.

I am hardly alone. Here are some typical comments in online support groups from people with hEDS or Hypermobility Spectrum Disorders (HSD) looking for advice on exercise:

“I try now and then to walk on the treadmills for a slow 20 min, but it just makes me feel worse.”

“I’m 27. When I exercise, I get migraines and all over muscle tension. I always fail at physical therapy. My body does not respond like others.”

“Exercise intolerance hardly describes it. I can’t keep up with my peers. I have severe pain and fatigue. If I exercise, pain starts in my legs, builds and becomes intolerable.”

“I went to Disneyland. I couldn’t stay more than two hours before I was in so much pain, I could barely make it to the car.”

Recently, Canadian researchers published a study on the mechanics of walking in people whose joints are loose to better understand why it might be so painful and exhausting for them. They compared 11 hypermobile adults with 11 healthy (non-hypermobile) adults of the same age and gender, and found why walking can be such an arduous affair for those of us with loose joints.

Tendons and ligaments — the connective tissue that connect bones to bones and muscles to bones — should be like tight rubber bands. They should bend, but not stretch. Part of their job is to transfer force and energy like a coiled spring back to muscles.

When tendons and ligaments are stretchy or hypermobile, not only do they fail to hold joints in place, they cannot return unused energy back to the muscles to power more movement. Simply moving a body with loose joints is, in fact, a very big problem.

To understand the difference between the two groups, study participants had ultrasound images taken of their legs, the stiffness of their Achilles (ankle) tendon measured, and their ankles’ range of motion recorded. They walked on a treadmill and had their oxygen consumption and muscle electrical activity measured.

The results showed that if you are double-jointed:

• Your muscles have to shorten excessively to compensate for too much “give” in the tendons. This is extra work for a muscle that does not enhance performance.

• A stretchy tendon cannot send energy back to the muscle, so energy is drained, not recycled back into the system, even as muscles are working harder.

• Neighboring joints and muscles have to participate in walking in ways they normally would not to compensate for the lack of stability. That’s yet another energy drain.

In short, researchers found that each step takes more energy, and is less powerful and less efficient. That’s why walking with loose joints can be so exhausting and painful.  

“In this investigation, people with HSD/hEDS showed a significantly higher energy cost of walking and lower muscle strength. These differences were accompanied by significantly higher ratings of pain and higher muscle coactivation during stance following walking at, above and below their preferred walking speed,” researchers concluded.

Individualized physical therapy or gait training designed for people with hypermobility could help them become better walkers. After all, mobility —  being able to get around and do things for yourself — provides quality of life and better health. Good mobility also reduces the likelihood of falling injuries. 

While increasing strength and physical fitness won’t solve hypermobility issues, it can make exercise safer, less of an effort, and more enjoyable.

Illicit Use of Rx Opioids Down Significantly

By Pat Anson

The illicit use of prescription opioids by patients undergoing addiction treatment has fallen dramatically over the past decade, according to a new analysis by Millennium Health. 

The drug testing company analyzed nearly 1.7 million urine samples collected from patients diagnosed with substance use disorder (SUD). The findings show that opioid pain medication now plays only a minor role in the nation’s drug crisis, while the use of stimulants is growing.  

In 2016, up to 80% of the patients who tested positive for illicit fentanyl also tested positive for a prescription opioid that was not prescribed to them. 

By 2025, only 4.9% of patients tested positive for both fentanyl and an illicit prescription opioid. There was a lot of regional variability in the numbers, with 9.1% of SUD patients in the South testing positive for both fentanyl and Rx opioids, compared to only 4.1% in the West.

Positive Drug Tests for Fentanyl and Prescription Opioids

SOURCE: MILLENNIUM HEALTH

“Within the population using fentanyl, we've seen a continued drop in the detection of prescription opioids in those using fentanyl. In 2025 the positivity rate for prescription opioids, I’m talking about hydrocodone, hydromorphone, oxycodone, oxymorphone, tramadol as a group, are at all-time lows in our database,” said Eric Dawson, PharmD, Vice President of Clinical Affairs at Millennium Health.

The findings suggest that fewer prescription opioids are being diverted into the illicit drug supply. That makes sense, as opioid prescribing has fallen sharply over the past decade and the medications are difficult for many pain patients to get. According to the DEA, the estimated diversion rates for hydrocodone (0.53%) and oxycodone (0.69%) in 2026 are both well under one percent.

In their place, illicit drug users have increasingly turned to stimulants, such as methamphetamine and cocaine. Millennium’s data shows that while fentanyl and opioid use have declined in recent years, stimulant use has risen steadily.

Positive Drug Tests for Fentanyl, Opioids and Stimulants

SOURCE: MILLENNIUM HEALTH

“It makes us wonder if we're now moving to something more prominent, larger. I don't know the right word there, but a stimulant era,” Dawson told PNN.

“I continue to hear it everywhere I travel. Stimulants, methamphetamine and cocaine, are just incredibly plentiful in so many communities, and extremely inexpensive. And so, if you present a drug in front of a population that tends to use drugs and it's cheap or free and potent, they tend to gravitate toward that.” 

Another trend that appears in Millenium Health’s drug testing data is the growing detection of kratom and its alkaloids, mitragynine and 7-hydroxymitragynine (7-OH).

In 2016, less than 1.5% of patients nationwide being treated for SUD tested positive for a kratom alkaloid. By 2025, that had grown to about 3 percent, with even higher levels in the South.

Positive Drug Tests for Kratom

SOURCE: MILLENNIUM HEALTH

Part of that growth can be attributed to the wider availability of kratom and increased awareness that the herbal supplement can be used to treat pain, anxiety and other health conditions. 

The federal government estimates that 1.7 million Americans used kratom in 2021. The American Kratom Association, a kratom advocacy group, puts the number much higher, at 10 to16 million Americans.

The growing awareness about kratom has spread to addiction treatment providers. In 2016, only about a third of Millennium Health’s urine drug tests included a request from a provider to test for kratom. By 2025, over 77% of urine drug tests included an analysis for kratom.

How to Successfully Taper Off Medication – From Someone Who’s Actually Done It

By Crystal Lindell

The problem with tapering off a medication is that, before you even start, you first have to get past all the cultural messaging that tells you that going cold turkey is the morally superior method.

Often framed as a worthy struggle that “cleanses” the body of an addictive drug and the “sin” of needing it, cold turkey is frequently depicted as the narrative arc in movies and TV shows. Someone abruptly stops taking a drug, endures the immense suffering of withdrawal, and magically comes out the other side “fixed.”

That’s not real life though.

In my experience, slow tapering is the far superior way to successfully stop taking a medication long-term. I have found it works best for multiple types of drugs, ranging from opioids to antidepressants like Cymbalta, and even caffeine.

But “tapering” is a very broad term that can mean different things to different people. It’s something I myself had to figure out through years of personal trial and error.

So, here are three real-world tips for tapering off a medication that will actually work. Or at least they have for me and the people I know.

Just a quick reminder though, I am not a doctor. I am just a patient with lived experience. If you are able to talk to a doctor for help, you should do so.

1. Go Slower Than You Think You Need To

Tapering is a slow process. I have found it works best to drop your dose over a longer period of time than you first expect.

While it may be tempting to try to do it over the course of say, a week, you’re a lot more likely to stick with it if you taper slowly over something like 6-8 weeks.

I know, I know. It sounds like forever. But think of it as similar to weight loss. If you try to lose 20 pounds in the first week, you’re going to fail. It will be too overwhelming and you’ll end up quitting before you even lose that first pound. 

You’re a lot more likely to actually lose 20 pounds over 15-20 weeks, without rebounding by gaining the weight back.

The same is true with tapering off medication.

For example, if you are trying to go off 40 mg of hydrocodone, go down to 35 mg for at least 1-2 weeks or even longer. Then go down to 30 mg for at least another 1-2 weeks. And so forth and so on.

Trust me, it will be so much easier to stick with it, and so much easier on your body.

2. Taper Both Dose and Time

This was the biggest revelation for me, the first time I tapered off hydrocodone. You have to slowly taper down both the dose and the amount of time between those doses.

For example, if you are on three 10 mg pills a day, and you want to go down to two 10 mg pills, you should not taper down by taking them every 12 hours instead of 8.

Rather, it usually works better to take the reduced 20 mg of hydrocodone across three doses during the day, as that makes it much easier to tolerate.

Which brings me to a subsection of this tip: Consider cutting pills in half, or thirds, or whatever you need. A lot of pills will break in half using your hands, but if not, you can use a pill cutter or a knife. 

And if a pill can be cut in half, you can use that to come up with good doses as you taper.

Unfortunately, some medications come in capsules, like Cymbalta, which you can’t cut in half. For that medication, I actually opened the capsules and dumped out the tiny beads a little more each time as I tapered the dose. Most doctors and pharmacists advise against this practice, but it’s the only method that I found to be effective, because the lowest dose of Cymbalta is too high to get off of cold turkey. 

You can read more about how I took myself off Cymbalta here.

3. It’s Okay to Backtrack and Take a Break

It can feel like failure if you have to stop the tapering process or go slower than you planned — but it’s not. Just attempting the whole thing in the first place is itself a victory.

Whether or not you decide to attempt again, at least you have learned things only experience can teach you.

So, if you get started on a taper and you realize it’s too overwhelming or things are moving too fast, it’s okay to linger at a dose for a while until you’re ready.

In fact, it’s usually okay to taper back up to your original dose, as long as you do it slowly. Just keep in mind that for a lot of medications —and especially opioids — your tolerance level resets a lot quicker than most people realize.  So don’t jump back up too fast, or you could risk an overdose. 

You can read more tips for going off opioids here.

There’s so much about tapering off medications that a lot of people cannot fully understand until they go through it themselves. Make sure to give yourself lots of grace, and ignore anyone who tries to criticize your attempts – especially if they don’t have any personal experience in the matter.

All of these tips can go a long way toward making the whole process more tolerable and more successful. 

It may take time to find what works best for your body, but as long as you keep at it, you’ll figure out what works best for you.  

If you lost a loved to suicide after a change in their prescription pain medication, please consider participating in a survey to help researchers learn more about these tragic situations. Click here or on the banner below for more information.

Chronic Pain and Suicide: Three Ways to Recognize and Reduce Risk

By Dr. Thomas Rutledge

Suicide is a cause of death that haunts the living in perpetuity. After a suicide event, those left behind are tormented by questions:

"Could I have done something?"  "What did I miss?" "How could this happen?" "Was it my fault?" 

Even the best answers fail to return the person lost, and natural grief is often compounded with unnecessary blame.

Discussions about suicide prediction and prevention primarily focus on known risk factors such as mental illness and suicidal ideation. 

In comparison, far less attention is paid to another common contributor to suicide present among a staggering 24.3 percent of the adult U.S. population. That makes this risk factor as prevalent as clinical depression, yet far more likely to be overlooked due to suicide stereotypes.

This unheralded suicide risk factor is chronic pain. In this post, we'll dive into three specific ways that chronic pain increases suicide risk, practical signs by which to recognize the patterns, and general strategies to help.

The Perfect Storm for Suicide

More than perhaps any other medical condition, chronic pain poisons the emotional well of what it means to be human. Although people differ in countless ways, our similarities are even more striking. Across time and cultures, for example, people universally share fundamental needs for meaning, interpersonal connection, safety, contribution, personal growth, and adventure, as articulated famously in psychological theories such as Maslow's hierarchy.

Many medical conditions compromise our ability to fulfill these fundamental human needs. Emotional struggles and mental health conditions are often a result of a medical condition impairing a person's ability to function in an important human need domain. Yet what makes chronic pain uniquely psychologically damaging is that it doesn't impact just a single human need. Chronic pain jeopardizes all of them.

As a psychologist who specializes in helping U.S. military veterans living with chronic pain, my aim is to share three of the most common patterns I see where pain becomes an existential threat.

1. Pain Without Purpose

One of the most profound ways that chronic pain increases suicide risk is by taking away a person's North Star for living. Like a sailor at sea without stars or a compass to guide them, chronic pain can remove the sense of purpose that allows people to endure in the face of suffering. Without sufficient purpose, pain becomes unbearable.

Scenarios: A retiree whose pain leaves them mostly housebound, estranged from friends, and increasingly unable to live independently. A veteran living on disability who has lost any sense of mission or way to contribute. A young adult whose pain condition limits opportunities for work, isolates them from others, and undermines their belief in a worthwhile future.

Characteristic thinking: "What's the point?" "Why go on this way?" "I feel like giving up."

Solutions: Based on the person's own values and lived experiences, explore flexible ways to reconnect them with their sources of meaning. Retirees may volunteer or consult in an area of interest. Former athletes may coach. Veterans may engage with military organizations and causes. Parents may become involved with youth activities. And, due to the staggering advances in technology that enable online and virtual participation, developing meaning-oriented lifestyles with chronic pain has never been more practical or lower cost.

2. Suffering in Solitude

No relationship is 100 percent safe from the corrosive effects of chronic pain. Chronic pain can ruin once-strong marriages, corrupt lifelong friendships, and erode the parent-child bond. Even as the person with chronic pain may need more social support in light of their condition, they frequently experience less in both quantity and quality.

Scenarios. There are two classic versions of this scenario. In the first, other people pull away or drift apart over time. In the second, the person living with chronic pain themselves retreats from others, usually because they feel like a burden or that they are holding other people back.

Characteristic thinking: "I'm useless this way." "I'm no good to anybody like this." "They would be better off without me."

Solutions: Consider all options for rebuilding a healthy social network. Although in-person activities may be best, virtual options—phone calls, text messaging, even multiplayer virtual reality or video games—may be good starting points. Aim, where possible, for relationship settings and activities where the person is an active contributor and teammate, where they can give as much or more than they receive. 

Because men often struggle more with forming new relationships, explore options where an activity of interest is the centerpiece, while in a setting where social interactions can spontaneously occur.

3. Loss of Self

Chronic pain can not only steal purpose and corrode personal relationships, it can even threaten personhood and self-image. What are the psychological consequences when chronic pain leaves a person adrift from the core values and ways of living that enable their sense of self?

Scenarios: A person whose pain took away a career that previously gave them a sense of worth and identity. A middle-aged parent struggling with chronic pain and whose grown children have left home. A veteran who spent their military career serving the greater good, who now has nothing but memories. A young adult whose pain condition took away the plan and future they envisioned for themselves.

Characteristic thinking: "I don't know who I am anymore." "I feel lost." "I'm just a disability now."

Solutions: Help people grieve the self they've lost while building a new one. Post-traumatic growth examples through stories, movies, and relatable people can be powerful mental seeds to help people see themselves as a human phoenix—capable of rising from the ashes in a new form—instead of as a person permanently broken by pain and loss. 

As in every hero's journey, people need not just examples but also guides and mentors to construct a new sense of self. A sense of self where their chronic pain helps them help others, view themselves as a survivor and not a victim, recognize hidden personal strengths, and find healthy ways to live their highest values.

Thomas Rutledge, PhD, is a Professor of Psychiatry at UC San Diego and a staff psychologist at the VA San Diego Healthcare System.

This post originally appeared in Psychology Today and is republished with permission from the author.

If you lost a loved to suicide after a change in their prescription pain medication, please consider participating in a survey to help researchers learn more about these tragic situations. Click here or on the banner below for more information.

How Chronic Pain Steals Your Time

By Crystal Lindell

Chronic pain is a thief. It steals your health, relationships, money, motivation, and time.

This week, so far, it has taken one full day away from me. My Tuesday was stolen.

That’s when my fiancé and I were supposed to go visit his relatives, who live about 2 hours away. But as soon as I woke up, I knew we weren’t going to make it. 

It was a bad pain day. Gray, dull, and full of inflammation.

The intercostal neuralgia in my ribs was flaring up, and I was having a hard time sitting upright. It was all I could do to keep myself out of bed long enough to brush my teeth.

Still, I tried to resist.

I told myself I just needed time to let my morning meds kick in. That, maybe, the weather would ease, and so would my pain.

But by 10:30 a.m. I knew I was going to have to tell my fiancé the verdict: there was no way I was going to be able to make that trip.

Thankfully, he didn’t hesitate. Just a quick and comforting “Okay.” And then he called his relatives to tell them we needed to reschedule for later in the week.

But I couldn’t help but feel disappointed and a little guilty. I hate having to cancel plans, and I hate worrying about what others will think when I do.

I was also frustrated with the realization that everything else I had planned for the week was now going to be squashed together or canceled.

Because having a bad pain day doesn’t suddenly mean that I have less to do. It just means I have less time to do it.

There were points in my life when my pain was so poorly managed that it would steal a lot more than one day of the week from me. Sometimes, it would take all seven.

And when those weeks happened, it was all too easy to blame myself. I should have pushed through it, been tougher, gotten it done.

It doesn’t help when other people make you feel guilty. After all, it is a lot easier to call someone “lazy” than it is to sympathize with their health struggles. 

A saying I often repeat to myself in those times is something my mom would always say to me when I was growing up: “All you can do is all you can do.”

I say it a lot because I still don’t always believe it. I have to constantly remind myself that my limits are actually my limits.

Beyond the guilt though, there’s also the sadness that comes when chronic pain steals your time. How many days do I have left on this earth, and how many of them will chronic pain take? How many holidays? How many more Tuesdays?

And how much time have I already lost to my pain?

It’s not fair. I want my time to be mine. I want to use it how I want to use it. 

The right pain medications give me a lot of my time back, and that’s why I treasure them so much. It’s why I work so hard to advocate for pain patients to have access to them. Because we all deserve to keep as much of our time as possible. 

In the end, all we can do is all we can do. But that doesn’t mean we shouldn’t get as much help doing it as possible. 

Moderate Cannabis Use Linked to Better Cognition in Older Adults

By Pat Anson

As cannabis use grows among older adults, researchers are beginning to focus on the effects – good and bad — on aging brains.

A recent study found that 18.5% of Americans adults aged 50 to 64, and 5.9% of adults over the age of 65 reported using cannabis products in the past year. About one in four used cannabis for medical purposes.

“More older adults are using cannabis. It's more widely available and is being used for different reasons than in younger folks – such as for sleep and chronic pain,” said Anika Guha, PhD, a clinical psychologist and researcher at the University of Colorado Anschutz Medical Campus. 

“Plus, people are living longer. We have to be asking, ‘What are the long-term effects of cannabis use as we continue to age?’” 

Guha is the lead author of a study, recently published in the Journal of Studies on Alcohol and Drugs, that analyzed the brain scans and cognitive test results of over 26,000 UK adults between the ages of 40 and 77. 

Researchers found larger brain volumes and better cognitive function among middle aged and older adults who used cannabis, especially those who used it moderately. .

“We did see that for many of our outcome measures, moderation seemed to be best. For the brain regions and cognitive tests that demonstrated an effect, the moderate-use group generally had larger brain volumes and better cognitive performance,” Guha explained.  

Moderate use of cannabis was associated with better performance in learning, processing speed, short-term memory, and cognition than non-users. 

Guha was surprised by the extent of the positive findings, but also cautious about interpreting them. Cannabis research is difficult due to the wide range in potency and different forms of ingestion for cannabis products.

Guha and her team are particularly interested in brain regions that have more cannabinoid receptors – called CB1s – which are more likely to be impacted by cannabis use. 

“Some studies will just say there was an impact of cannabis on overall gray (brain) matter. However, we wanted to take a more nuanced approach by looking at effects on specific brain regions, especially those with high CB1 receptor density, as well as on cognitive processes like memory, which is, of course, very relevant to aging,” Guha explained.

“For example, the hippocampus was one of the regions we looked at since it contains many CB1 receptors and plays an important role in memory, especially as we age, and is also implicated in dementia.”

Brain volume has a tendency to shrink as we age, due to atrophy and neurodegeneration. The decrease is often associated with reduced cognitive function and increased dementia risk. 

Cannabis use was associated with reduced volume in only one part of the brain – the posterior cingulate – which helps process memory, learning, and emotion. 

“I think the main takeaway is that the story is nuanced. It’s not a case of cannabis being all good or all bad. I think sometimes people have seen my poster on this project or they see the headline and they say, "Great, I'll just use more cannabis." But it’s more complicated than that,” Guha said. “There’s so much more to explore.”  

Most medical organizations still take a dim view of cannabis. The American College of Physicians (ACP) released a new guideline last year that recommends against the use of medical cannabis.

The ACP said physicians should warn patients that the harms of cannabis outweigh its potential benefits. Medical cannabis may produce small improvements in pain, function and disability, but the ACP warns it could lead to addiction and cognitive issues, as well as cardiovascular, gastrointestinal and pulmonary problems.

Can Fentanyl Be ‘Rewired’ to Make It Safer?

By Pat Anson

Scientists at Scripps Research have found a way to change fentanyl’s molecular structure to reduce the risk of overdosing, while at the same time preserving its pain-relieving properties. 

The findings, published in the ACS Medicinal Chemistry Letters, suggest that next-generation synthetic opioids could have less risk of addiction, respiratory depression, and death. 

Fentanyl has been used safely and effectively for over 50 years as a surgical analgesic, and by patients with severe pain from cancer and other intractable pain conditions. Only in the past decade has illicit fentanyl emerged as a potent and deadly street drug that fueled the U.S. overdose crisis.

That has given fentanyl a bad name – and led to efforts to “rewire” fentanyl and other opioids to make them safer, but still effective as pain relievers.

“For decades, the pharmaceutical industry has been constrained by the assumption that major structural changes to opioids would eliminate their analgesic properties,” says senior author Kim Janda, PhD, Professor of Chemistry at the Skaggs Institute For Chemical Biology. 

“Our research has identified a different possibility—that fundamental structural redesign can preserve pain relief while improving safety.”

Janda and his colleagues used a medicinal chemistry strategy known as “bioisosteric replacement,” a method used to redesign molecules to have different effects than the original molecules. 

To engineer the change in fentanyl, scientists replaced the central ring structure of fentanyl molecules with an entirely different one called “2-azaspiro[3.3]heptane.” The new compound doesn’t bind as much to nerve receptors in the brain that regulate breathing. 

When the redesigned fentanyl was tested on laboratory mice, the team arrived at a dose that remained effective as an analgesic, while the mice “appeared normal with no indication of distress or signs of acute toxicity.” 

Slowed breathing in the mice occurred only at very high doses and was temporary, with breathing returning to normal within 25-30 minutes. The new analog has a short half-life of about 27 minutes – the amount of time it takes for the liver to metabolize and break down the drug. Other medicines have a long half-life of several hours or even days — which makes them potentially more toxic.

“Finding ways to preserve the analgesic properties of the synthetic opioids without encumbering the perils of respiratory depression could help derisk the toxicity associated with synthetic opioid use while providing a new conduit for pain management,” says Janda.

The research appears promising and may someday benefit pain patients, but it overlooks the fact that illicit fentanyl is involved in most overdoses. The drug cartels and street dealers that sell it will have little interest in changing the chemical structure of illicit fentanyl to make it safer.

Food: The Daily Challenge for People With Chronic Pain

By Crystal Lindell

One of the biggest hurdles many people with chronic pain face is finding something to eat. It’s literally a daily challenge that has to be solved.

Personally, it’s something I struggled with even before I started having chronic pain in my right ribs.

Finding food three times a day just isn’t easy. Anyone who tells you it’s easy probably has someone else who cooks for them, and does all the shopping and clean-up.

The temptation is to eat out, but that gets expensive fast – especially if you use delivery apps like DoorDash. So, over the years I have become an expert at feeding myself, even when I feel like crap and have no money.

In fact, these days I’m even a vegan, living in a small town in the Midwest, so the option to eat out most days doesn’t even exist.

Below are some realistic tips for feeding yourself even when you’re sick, broke, and a bad cook.  

Level 1: Heat-and-Eat Meals

The first goal in feeding yourself is to avoid fast food and food delivery apps. Almost everything you get at the grocery store is going to be healthier and cheaper.

To avoid the strain of food preparation and cooking, look for anything that just needs to be opened and heated. This can include frozen meals and pizzas; canned meals like beef stew and ravioli; and refrigerated meals from grocery store deli sections.

When I first made it my goal to avoid eating out, I would literally stock my freezer with 14 frozen dinners each week. One of my friends commented that my refrigerator looked like an ad for Lean Cuisine. They aren’t cheap, but they are easy and they can offer a lot of variety.    

Frozen and prepared foods tend to be more expensive than fresh food at the grocery store, but they are all significantly cheaper than DoorDash. 

Level 2: Easy Cooking

When I say easy cooking, I mean easyyyyy cooking. So easy, you can do it on bad pain days.

If you can master this category, meals are also exponentially cheaper than prepared grocery food.

In this level I would include easy to prepare meals like spaghetti noodles with a jar of sauce, quesadillas, and cereal with a side of toast (warm toast really elevates the experience from sad and cold to warm and comforting). This level also includes sandwiches, whether it’s peanut butter and jelly or lunch meat.

There are weeks when I go days at a time living on vegan cheese quesadillas. For these, I simply put a non-stick pan on the stove, heat up a plain tortilla, add cheese, fold it over and eat. I dip it in vegan sour cream, hot sauce, or even add some microwaved vegan steak if I have any on hand. Voilà! A perfectly satisfying meal.

The trick to this category is to find meals you can make that don’t require you to chop a single thing. However, they may require you to pull out a pan. 

If you have the energy to chop something, even better!  Tomatoes and onions tend to make most things taste better.

For these meals, the microwave is still your best ally. There are a lot of foods usually cooked on the stove that can be cooked faster and easier in the microwave. So, if I’m adding some vegetables to my pasta, I will put the steam-in-the-bag version in the microwave first so they don’t have to be cooked on the stove top. Or if I’m adding vegan meatballs to sauce, I’ll heat them in the microwave first.

I firmly believe that a mix of Level 1 and Level 2 cooking can get most people through most days of the month when needed.  

Level 3: Meal Prep

That brings us to the most difficult level of chronic pain cooking: Meal Prep.

For this category, you will probably need to chop things, and you may need to dirty multiple pots and pans.

The shopping, cooking, and the clean-up are both more extensive, but if you can pull it off, the rewards can last for weeks.

When I have a good pain day, I try to use some of my time in the morning to make a large dish, whether that’s a soup, chili, or a casserole. There’s no rule that says you have to cook dinner at dinnertime. 

And I always triple the recipe so that I can eat leftovers for days. I’ll even make enough to freeze portions of it, essentially making my own frozen dinners.

Midwest cooking has a lot to offer for this category because our winters often make it hard to go to the grocery store more than once a week.

For example, chili is an especially great recipe in this category because you can do the whole thing with cans of beans and cans of tomatoes mixed with a chili seasoning packet in the crockpot. I add dried lentils to mine to give it a meaty texture, but you can also add something like cooked ground beef if you have the energy to make that on the stove top

I also love making vegan pot pie (I use chickpeas instead of chicken), potato soup, or a large batch of enchiladas.

I also have a bread machine, so when I have the energy, I like to throw the ingredients in there so I can have fresh, homemade bread for a few days. When I don’t want to deal with that, a loaf of $2 French bread from the grocery store bakery also hits the spot.

Eating three meals a day takes a lot of effort, and it’s understandable that a lot of people with chronic pain don’t have the physical or mental energy needed for cooking. But that doesn’t mean you have to eat out for every meal. Or starve yourself.

The trick is to forgive yourself for taking kitchen shortcuts, start off easy, and to find just a couple go-to homemade meals that you can make on autopilot. That’s more than enough. Then it’s just a matter of bon appétit! 

Microcurrent Therapy: The Healing Electrical Stimulation You’ve Never Heard Of

By Madora Pennington

If you suffer from chronic muscle or soft tissue pain, a physical therapist or doctor may have recommended you get a TENS unit.

A traditional TENS (Transcutaneous Electrical Nerve Stimulation) device sends a low-voltage current through an injured area of the body, attempting to disrupt pain signals and stimulate endorphins, the body’s natural painkillers. The reviews of TENS are mixed. Some people experience relief from TENS, but many do not. 

There is another kind of TENS that few patients and providers know about called microcurrent therapy (MCT). These devices deliver an electric current so small, the user might not feel anything. That’s because the current approximates the body’s own energy flows. The goal of MCT therapy is not to block pain sensation, but to encourage actual healing.

The human body itself is a complex electrochemical machine. Your cells generate low levels of electricity through chemical reactions called “biocurrents” -- which power bodily functions, regulate nerve signaling, boost cellular growth and energy, reduce inflammation, and so on. When body tissue is damaged, it produces an altered current that doesn’t work as well. 

Stimulating the body with an external microcurrent accelerates tissue repair, wound healing, and muscle recovery. In short, it speeds healing by assisting with energy at the cellular level. The current from a traditional TENS, while low, is still much higher than the electrical currents the body runs on, so it does not improve the electrical functioning of cells. 

For me, I never felt much benefit from a traditional TENS. So when I read articles about microcurrent therapy, I wanted to try it. I asked my physical therapist, and she had never heard of anything but a traditional TENS current, even though she is a recent graduate of a doctoral program, and an excellent PT. 

I checked the various TENS units I already own, and none had the capacity to produce a microcurrent.

John Hubacher, President and CEO of Pantheon Research, a biomedical instrument manufacturing company, thinks microcurrent therapy may have gotten left behind because it was unclear why it worked so well. Without a clear mechanism for physiological action, it’s hard to get studies done. But now research is emerging that shows that MCT has the potential to change a cell's physiological processes.

Microcurrents have been shown to improve skin ulcers, varicose veins, and wound healing. It is also being used for cosmetic purposes as a “natural facelift” to tighten and tone skin, stimulate facial muscles, and boost collagen and elastin production. There are practically no side-effects, and it can be safely used in elderly populations.

Combining microcurrent therapy with exercise can be very helpful. Microcurrent used before and after a workout improves fat breakdown and reduces muscle soreness. Mice with atrophied muscles experienced muscle regrowth from the application of microcurrent therapy.

A 2025 paper remarked that this low-risk, powerfully therapeutic and inexpensive technology is grossly underutilized due to lack of awareness, even though studies support that it improves pain and function in many musculoskeletal conditions.

“Despite a growing body of evidence highlighting its therapeutic potential, MIC (MTC) therapy remains underutilized across many areas of medicine. Its subsensory, low-intensity electrical currents offers a non-invasive, pain-free alternative to traditional electrotherapies like TENS, without triggering muscle contraction or discomfort,” wrote lead author Sarahrose Jonik, MD, a Resident of Internal Medicine at Penn State College of Medicine.

“MIC therapy shows promise as an adjunctive modality capable of supporting tissue repair, reducing inflammation, and modulating pain, particularly in complex, chronic, or refractory conditions.” .

After an internet search, I bought the InTENSity 12 made by Compass Health. It looks and operates like a typical TENS and costs about the same, but produces a microcurrent. Like a TENS device, it has sticky pads that you attach to the skin near the area you want to work on. 

I first used the InTENSity 12 on an area around my hip that is constantly tight. There, my muscles overwork to compensate for an old knee injury. It is an area I always have to work on and have had much physical therapy for.

The microcurrent absolutely melted the tension like no stretching, heat, massage, or trigger point release ever came close to doing. I did some stretching afterwards. The area released even more deeply and completely. My formerly hyperactive muscles stayed soft and easy to stretch for days. 

Using the microcurrent TENS on other painful areas caused by other old injuries and a neuropathy flare, I felt relief that lasted for days. It left me wondering if this extra power, when delivered at the same level at which my cells operate, caused healing that my body was not doing on its own. 

You Might Have Chronic Pain If…

By Crystal Lindell

Back in the 90s, comedian Jeff Foxworthy had this whole bit about, “You might be a redneck if…”  

He’d start off with a funny description and then make the obvious conclusion, like: “If you ever cut your grass and found a car… you might be a redneck.”

It was an in-joke among people who proudly saw themselves as rednecks. Foxworthy wasn’t laughing at them, he was laughing with them — because he portrayed himself as one of them.

Whether or not a rich comedian was ever authentically a redneck is a debate for another day. But regardless, I very much am a member of the chronic pain community, and as such, I think there’s a few of these I could share.

So without further ado:

• If your favorite breakfast is coffee and pain pills… you might have chronic pain.

• If you have ever wanted to argue with a pharmacist… you might have chronic pain.

• If you need at least 24 hours notice to leave the house… you might have chronic pain.

• If you know exactly how long you can go without showering… you might have chronic pain.

• If your favorite outfit is pajamas… you might have chronic pain.

• If you think your “Dr. Google” search results are more valuable than your doctor’s degree… you might have chronic pain.

• If the words “Have you tried yoga?” trigger your PTSD… you might have chronic pain.

• If you have ever slept for 24 hours and then woken up and needed a nap… you might have chronic pain.

• If your medical bills are higher than the GDP of a small country… you might have chronic pain.

• If your “desk” is just your bed with a pillow propped up behind you… you might have chronic pain.

• If you have ever had to diagnose yourself… you might have chronic pain

• If you currently have a 500-count bottle of ibuprofen at home — and another one in the car… you might have chronic pain.

• If your idea of a perfect date night is sitting at home under a heated blanket while watching Lord of the Rings … you might have chronic pain.

• If your favorite food is THC gummies… you might have chronic pain.

• If you ever used up all of your sick days in the month of January… you might have chronic pain.

• If you use more dry shampoo than regular shampoo… you might have chronic pain.

• If you ever hoped that a test actually showed you had cancer, so that then you’d at least have an explanation… you might have chronic pain.

• If your most worn accessory is some sort of medical brace… you might have chronic pain.

• If all your shoes have arch support… you might have chronic pain.

• If your entire social media feed is posts about surviving chronic pain… you might have chronic pain.

• If you have ever worn the same outfit for 5 days in a row… you might have chronic pain.

If you can relate to any of these… you might have chronic pain.

Here’s hoping today is one of your good pain days. 

And if you have any “You might have chronic pain if…” examples that you’d like to share, we’d love to read them in the comments.