Spring 2021

In This Issue:

  • Facing the COVID "15" by Penney Cowan
  • The Anti-Inflammatory Diet for Spondylitis
  • Living Life in Full with Chronic Pain
  • Welcome MAC Members
  • Improve Your Health With These Actionable Tips for a Better Night's Sleep
  • Living Systematic Review on Cannabis and Other Plant-Based Treatments for Chronic Pain
  • What Role Could virtual Reality Play in Managing Chronic Pain?
  • Walk with a Doc
Facing the COVID "15"
Penney Cowan 
“A healthy outside starts from the inside”
---Unknown
Wiser words were never spoken. During the pandemic many of us stayed at home, worked from home, and limited most of our activities. When we spend more time at home, the refrigerator seems to have some type of magnet that pulls us in. The pantry, filled with wonderful salty and sweet snacks, calls out to us as we try our best to concentrate on the work we are doing, the book we are reading, or during those annoying television commercials. 
The idea of enjoying one last snack, one more serving of mashed potatoes or pasta haunts us as we try to convince ourself that we should not indulge. But that little voice says, why not, one more will not hurt. And so, we follow our “food desires” and enjoy. That is until suddenly our pants are a bit snugger, the shirt seems tighter than it used to be. Perhaps the washer was set on hot water and shrunk it. We try to tell ourselves it could not have been those midday snacks, extra servings at mealtime, or late-night bowl of ice cream. 

The pandemic seemed to have the same effect on many people when it came to their daily diet. With so much stress and anxiety about COVID, indulging in tasty morsels gave us some enjoyment, even if only momentarily. For some it was boredom or their way of coping with the daily tension. 
 
When it comes to a person living with pain, diet is even more important.  Extra weight can lead to: 
·      Increased risk of cancers   
·      A risk factor for type 2 diabetes
·      High cholesterol
·      Osteoporosis
·      Increased risk of cardiovascular disease
·      High blood pressure
·      Sleep apnea
·      Increased risk of acid reflux/heartburn
·      Depression
·      Lower life expectancy

Many of us is that we know we need to eat better, and we tell ourselves tomorrow we will start our diet . . . right after you finish that bowl of ice cream.

An adequate diet will provide all the necessary nutrients to meet what you need in a day. But with so much diet hype out there, how do we know what to eat? Let’s take a closer look at the six classes of nutrients that can provide you with a balanced diet. Keep in mind that most food contain more than one of these so, no single food would supply all the essential nutrients that you would need. 
Carbohydrates provide approximately 50% to 60% of the total calories in a well-balanced diet. Each gram of carbohydrate supplies about four calories, and carbohydrates are the body's chief source of energy.
 
Simple carbohydrates are easily digested and provide quick energy. Food sources for simple carbohydrates include cane sugar and honey.
 
Complex carbohydrates are digested with varying degrees of completeness and provide energy more slowly than simple carbohydrates. Some food sources are cereal, grains, peas, and beans.
Protein is present in each body cell.  The main function of protein is to supply antibodies to fight off infections, to build and repair body tissues, and to provide energy. Each gram of protein supplies about four calories. Protein will supply energy when the carbohydrates and fat content of the diet are insufficient to meet the body's needs. Some food sources are meat, poultry, fish, eggs, dairy products, dried beans, and peas.
Fat supplies the most concentrated form of energy in food. Fat protects the body against low temperatures and damage to vital organs. Each gram of fat supplies about nine calories and carries fat-soluble vitamins (A, D, E, and K). In addition, fat is the source of essential fatty acids. Some food sources are oil, butter, lard, margarine, shortening, salad dressing, and bacon. Too much dietary fat provides excessive calories and is stored as adipose tissue, causing increased body weight. Chronic over-ingestion can lead to obesity which is associated with hypertension, diabetes mellitus, and heart disease. Too much dietary saturated fat also is associated with atherosclerosis, which contributes to heart attacks and strokes.
Minerals are inorganic elements and fulfill a variety of metabolic functions. About 4% of body weight consists of mineral elements. There are two groups of minerals:
Major minerals present in the human body in large amounts are calcium, phosphorus, sodium, potassium, chloride, sulfur, and magnesium. They make up 60% to 80% of all inorganic minerals in the body.
 
Trace minerals present in the body in minute quantities include fluoride, iron, zinc, iodine, and copper. They make up about 1% of all inorganic minerals in the body.
Vitamins are organic, noncaloric substances necessary for growth and the maintenance of life. Vitamins are carried in the blood stream to all parts of the body but must be provided by the diet since we are not able to manufacture them internally. Vitamins may be fat or water soluble, and their solubility affects absorption and transportation to target tissues. Extra amounts of fat-soluble vitamins (A,D, E, and K) are stored in body tissue and may eventually be toxic, especially vitamins A and D. Excessive amounts of the water-soluble vitamins are not used metabolically and are readily excreted in the urine.
Water makes up 50% to 60% of the weight and is present in all body cells and fluids. Water is essential for nutrient transport and transfer to cells, for blood circulation, control of body temperature, excretion of body wastes, and for maintenance of electrolyte balance.
 
The question is how to have a well-balanced diet that will suit your needs. First know that you must include all four food groups into your daily diet.   The four food groups are Milk, Meat, Fruits and Vegetables, and Grains. Include two servings of the milk groups such as plain yogurt or cheese and two servings of meat (but make sure the beef is lean, fish, poultry, eggs, and beans.) It can be easy to include the four servings of fruits and vegetables into your daily diet by using things like apples and bananas as snacks while having raw or cooked vegetables with your meals. Four servings of gains can be incorporated into each meal with one serving of cereal, pasta, or rice. 
“When you grow your own garden, it grows you.”
― T.F. Hodge
To get your diet back on track, think about planting a garden. You do not need a large lot to grow a few vegetables. Even if you live in an apartment, you can still have a tomato plant in a container. There are even elevated garden boxes for those who cannot bend down to garden. Fruit trees come in dwarf sizes to be grown in larger pots on the patio. To spice up your cooking, you can plant a small herb garden in a planter box with things like basil, sage, rosemary, and parsley.  

Farmers markets are available across the country and are filled with fresh vegetable and fruit offerings. They have great values in local produce that can be incorporated into your weekly menus. You can even find a wide variety of honeys to use instead of sugar.
Instead of going to the salty snack, think about some carrots or celery sticks or perhaps even an apple or pear. Try keeping a jar of unsalted nuts at your desk or next to the television controls. Popcorn is a great snack if you do not use a lot of salt or cover it with chocolate drizzle. Make a point to drink water instead of sodas. Protein helps you stay fuller longer and may help you consume fewer calories during the day. Protein also can help you ward off the cravings you get in between meals. Vegetables and fruits make a great snack. You can cut them up, put them in a little lemon juice and water and they will stay fresh in the refrigerator for your snacking pleasure.  It might help to keep a food diary for a few days just to see how many times you find yourself nibbling between meals. 

 “Eating healthy is not so much about what you eat, but what you don’t eat.”
― Clifford Cohen
Exercise is not difficult and can be fun. When your intake of calories exceeds what you burn, that is a problem, and the pounds build up. Did you know that you can burn calories doing simple things?
For all the effort you put into taking care of yourself by exercising, eating right and getting the right amount of sleep your body and mind will be forever grateful. And you may live a longer, healthier, and happier life. 

If you don’t make time for your wellness, you will be forced to make time for your illness. 
Unknown
The Anti-Inflammatory Diet for Spondylitis
 
There is no conclusive research that a specific diet can prevent, cure, or improve the symptoms of spondylitis, an inflammatory form of arthritis that causes joint pain — most commonly in the lower back. However, eating an anti-inflammatory diet or avoiding certain foods associated with inflammation may help.

What Is an Anti-inflammatory Diet?
An anti-inflammatory diet is any diet that reduces inflammation in the body. Inflammation is an immune system response that occurs when white blood cells and chemical messengers are activated by the presence of injury or infection. In the case of an autoimmune disease like spondylitis, the body mistakenly attacks the joints.
While scientific evidence on an anti-inflammatory diet for spondylitis is scarce, an anti-inflammatory diet can reduce inflammation in the body, which may help with symptoms of spondylitis. Popular anti-inflammatory diets include the Mediterranean diet, a high-fiber diet, and a vegan diet.

Mediterranean Diet
A Mediterranean diet is rich in omega-3 fatty acids, whole grains, and antioxidants. The diet contains high amounts of olive oil, fish, legumes, fruits, vegetables, nuts, and seeds and limits red meat and refined grains. The Mediterranean diet is linked with reduced rates of vascular inflammation and several chronic diseases, such as diabetes and heart disease.
High-Fiber Diet
Diets rich in high-fiber foods may help lower body weight, nourish beneficial bacteria in the intestines, and lower levels of inflammation markers in the blood. Foods with abundant fiber include most fresh fruit and vegetables, whole grains, beans, and many nuts.

Vegan Diet
Those following a completely vegan diet avoid all foods that come from animals, including dairy, meat, fish, eggs, and honey. Some studies indicate that a vegan or vegetarian diet may help reduce inflammation, but more research is needed.

Anti-Inflammatory Foods and Nutrients for Spondylitis
There are key nutrients in the Mediterranean diet that may specifically improve spondylitis symptoms.
Olive Oil
Studies have suggested that olive oil can reduce the risk or progression of rheumatoid arthritis, another form of inflammatory arthritis. Extra virgin olive oil has been linked to reduced levels of cartilage damage and joint damage.

Dietary Fiber
Dietary fiber is important for the prevention and management of inflammation, as well as blood sugar control and cholesterol management. Some studies have found relationships between dietary fiber intake and inflammatory biomarkers, but other studies have been contradictory.

Antioxidants
Antioxidants are substances that prevent or delay cell damage. Eating a variety of fresh fruits and vegetables and whole grains is an easy way to ensure you are getting enough antioxidants. Turmeric, ginger, black pepper, and green tea are other foods high in antioxidants.
Omega-3 Fatty Acids
Omega-3 fatty acids can be found in chia seeds, flaxseed, soybeans, and fatty fish (such as sardines, mackerel, or tuna).

Studies have found that people with rheumatoid arthritis who take omega-3 supplements may require less pain relief medication. Remember to always consult your physician before starting a new supplement to ensure it does not interact with any other medications.

Inflammatory Foods to Avoid
Several foods can contribute to inflammation, including:
●     Refined grains
●     Sugar
●     Sodium
●     Saturated fat
●     Trans fats (often found in packaged goods)

Rather than trying to completely cut out favorite foods that might contribute to inflammation, focus on reducing your consumption.

Identifying Your Trigger Foods
While some foods are more common triggers for inflammation, there is no way to know what yours are without paying close attention to the association between what you eat and how you feel. Keeping a food diary on paper or using an app can help you identify foods that trigger your spondylitis symptoms. Watch for patterns of worsening pain after eating certain foods. If you suspect a food is associated with a spondylitis flare, try eliminating it and track results in your journal.
 
You can also try an elimination diet. This strategy helps you eliminate all common inflammatory foods, then slowly add them back in while monitoring how your symptoms change.               
Starting Anti-inflammatory Diet
Here are some staples to include on your grocery list to follow an anti-inflammatory diet:

●     Whole grains like brown rice and rolled oats
●     Nuts and seeds
●     Nut butters like almond or peanut butter
●     Beans and legumes
●     Fatty fish like tuna, salmon, or mackerel
●     Lean meat like turkey or chicken
●     Fresh or frozen fruits and vegetables
 
Planning and Cooking Meals
Planning ahead can help you stick with an anti-inflammatory diet. Try focusing on one meal per week to get started. There are many cookbooks and websites where you can find recipes that align with an anti-inflammatory diet.
It can be a learning curve as you try new recipes and methods of cooking to adapt your diet. Be patient with yourself as you learn.

References
Living Life in Full with Chronic Pain
 
Dr Melissa A. Day1,2 and Prof Mark P. Jensen2
1School of Psychology, University of Queensland, Brisbane, Australia
2Department of Rehabilitation Medicine, University of Washington, Seattle, USA
 
Chronic pain is a common and highly debilitating problem affecting millions of Americans. It also costs the economy billions of dollars every year. Perhaps the most widely used treatment approach for chronic pain continues to be opioid analgesic medication. While this might be helpful for managing chronic pain for a small portion of individuals, when used over long periods there is a substantial risk for tolerance effects (i.e., needing a higher dose of opioid medication over time to have the same amount of pain reduction), sedation, and other negative side effects, including overdose mortality. Current treatment guidelines put forth by the US Center for Disease Control state that non-opioid therapy be offered as first-line treatment for chronic pain.

In order too understand which non-opioid approach(es) to use for chronic pain, it is helpful for us to understand how the brain and body work together to create the experience of pain. It is now widely understood that chronic pain is the result of complex patterns of activity in the brain. We know, for example, that the same amount of stimulation is felt in very different ways by different people. Pain is real. But how it feels is strongly influenced by the brain.

Research conducted over the past few years has shown that when we are in pain, many different areas of the brain are involved. These areas include, of course, the areas that process information the brain receives from the body. But other areas include those associated with the creation of our thoughts, what we are paying attention to, our emotions, and our motivations (to name a few!). This means that changes in any one of these factors – the sensory experience, our thoughts, what we pay attention to, our emotions, or our goals
can and does change the way pain is processed in the brain. Treatments that change any of these factors can therefore change our experience of pain. All pain is real, all pain is created by the brain, and all pain is influenced by many factors.

With this understanding, we can now see how different non-opioid treatments have the ability to change pain. We also now know that several evidence-based psychological treatments are effective in changing important brain pain processing pathways. Three of the most widely used treatments include Cognitive Therapy (targeting changes in a person’s thoughts related to pain – what we think), Behavioral Activation (targeting changes in a person’s behavioral responses to pain – what we do), and Mindfulness Meditation (targeting changes in attentional aspects related to pain – how we think). A large amount of research has shown that these treatments can result in significant improvements in pain. More good news is that the “side effects” of these treatments are also positive for many people, improving not just pain, but also increasing the amount of activities they can do, reducing their disability, improving their mood, and helping them get better sleep. Unfortunately, however, millions of Americans who have chronic pain do not always have easy access to trained professionals to receive one of these evidence-based treatments.

Research currently being conducted by Drs. Mark Jensen and Melissa Day, in the Department of Rehabilitation Medicine at the University of Washington, Seattle, is looking at novel ways to make these treatments more accessible for more people. One study* that is currently recruiting patients is evaluating a telehealth delivered version of these psychological treatments – Cognitive Therapy, Behavioral Activation and Mindfulness Meditation – for improving chronic pain outcomes. Arguably the most useful elements of all three of these treatments – as well as other psychosocial approaches – is that they train individuals in pain management skills that the individuals themselves can use to manage pain independently. Thus, these programs place the individual with pain firmly in the driver’s seat, equipping them with skills needed to take an active role in moving their life in the valued direction of their choosing (rather than the pain “choosing” – or dictating in many cases – the direction for the individual). This research has the capacity to greatly improve treatment efficiency and cost-effectiveness in meeting the challenge of chronic pain.

Historically, chronic pain has been underdiagnosed and undertreated. Advancing our understanding of how and for whom various evidence-based non-opioid treatment options are of benefit informs the most efficient and effective use of such approaches as a complement or alternative approach to pain medications. The high rates and incalculable costs of chronic pain to society, the individual and their loved ones demands urgent action be taken to advance precision health care and to overcome the challenge of pain and to live life in full despite the pain.
            
*Note: The study being conducted by Drs. Jensen and Day is funded by the National Institutes of Health. Participants receive the free, 8-session treatment (2 sessions per week) from the comfort of their own home via video-conference, with treatment delivered via a trained professional in a group setting (typically 8-12 individuals are enrolled in each group).

For more information and/or to see if you are eligible for the study, see the study website for more details:
https://sites.uw.edu/lifestudy/. Interested individuals may also contact study staff by calling 206-221-7224 or toll-free 1-800-570-5576, or by email at [email protected]. All interested participants will need to complete a phone screening to determine eligibility for this study.
Welcome MAC Members!
It gives me great pleasure to share this article with you. I hove known many of this group for many years and have the utmost respect for them. They have been dedicated to the American Chronic Pain Association and been your voice in many areas of policy and research. I could not be prouder of each one of them and thank them for all they do!  Penney Cowan

ACPA Member Advisory Committee 
By Patti Mehaffie

The ACPA is committed to ensuring all Facilitators are nurtured, empowered, and have the tools they need to be successful with their local support groups. A new Member Advisory Committee (MAC) has been established with that purpose in mind. The MAC is made up of experienced Facilitators who will develop responsibilities, coordinate efforts, and provide support for all Facilitators and Facilitator Committees. Please take a few moments to look over the profile of each member of the new ACPA Member Advisory Committee.
Ernie Merritt, Saco, Maine
Ernie has been an ACPA Facilitator with his local group for 14 years. He has been an ACPA Regional Director and has served on the previous Member Advisory Committee. He believes in positive thinking and using alternative treatment to deal with chronic pain. He works with the University of New England by having some of their medical students interact with his group members. Whether groups meet in-person or virtually, Ernie wants to stay focused on supporting Facilitators and providing whatever resources they need to keep their groups going. Ernie enjoys wood working and has crafted many beautiful canes and decorative items.
Catherine Cartwright, Vallejo, CA
Catherine has been involved with the ACPA since 2007 when she started a local group in Vallejo, CA. In 2010, she became an ACPA Regional Director for the Northern Bay Area in California. Her responsibilities included coordinating area groups, being available to Facilitators for problem solving, promoting group cohesiveness, participating in events, and making sure support groups use and follow ACPA principals. Catherine has also served on the ACPA Member Advisory Committee in the past. She has continued to be on panels, write articles and take part in various public speaking opportunities to promote effective ways to cope with chronic pain.
Mariann Farrell, Pittsburgh, PA
In 1984, Mariann was involved in two car accidents that ended her career and disrupted her entire life. She attended an ACPA meeting and learned that she could live through this terrible experience and function again. It was the start of her getting her life back. Mariann moved to Armstrong County, PA, and facilitated an ACPA support group there for thirteen years. Upon moving back to Pittsburgh, PA, 18 years ago, she took over as Facilitator for an existing group and considers them to be her second family. Mariann feels that, in addition to helping others learn how to function better and have good lives, her support group has helped her learn to cope with her own pain experience. Mariann has been an ACPA Regional Director and served on the previous Member Advisory Committee. She has been a Facilitator speaking on behalf of the ACPA at various conferences and meetings. Mariann has appeared in the documentary, Pain Matters, about daily life with chronic pain and in a video about Fibromyalgia.  
Patti Mehaffie, Fort Myers, FL
Patti has facilitated an ACPA support group in Fort Myers, FL, for the past 7 years. She is also Co-Administrator of the new ACPA Facilitator Connection Facebook page where Facilitators have an opportunity to share information and ideas or ask questions of each other. As part of her former career, Patti trained Facilitators and group members how to work more effectively together in a team environment. She educated groups on topics such as data analysis, team leadership, member responsibilities, and valuing individual differences. Patti enjoys supporting and educating individuals with chronic pain so they can discover better coping techniques and have hope for the future. She is excited about the opportunity to work with other Facilitators to further the ACPA Mission and to help local support groups be as effective as possible.
Tom Norris, Los Angeles, CA
Tom is a happily married, 26-year veteran ACPA Facilitator who currently has two groups. His “Los Angeles Branch of the ACPA” group has been in place for more than 10 years. He advertises on Meetup and has more than 300 people interested in joining this weekly group. Due to the popularity of the group, he is now utilizing Zoom Breakout Rooms to encourage small group discussions. His “Living with Chronic Pain” part of Front Porch (formerly known as Well Connected), is designed for the homebound elderly and meets telephonically on a weekly basis. He is currently a Patient Partner on several studies on chronic pain treatment and management at Cedars-Sinai. Tom has been an ACPA Regional Director and served on the previous Member Advisory Committee. He also advises the American Psychological Association (APA) Advisory Panel on the development of Guidelines for Dealing with Musculoskeletal Pain. Tom is also a participant with the Department of Defense’s Peer Reviewed Medical Research Program (PRMRP) of proposed research studies. Tom is an active advocate for people living with chronic pain and has participated in numerous recorded and live interviews, both national and international.
Improve Your Health With These Actionable Tips for a Better Night's Sleep
Photo credit: Unsplash.com
A good night's sleep leaves you feeling refreshed, invigorated, and ready to tackle the day. Sufficient rest is also important for your health. According to research published in The Journal of Pain, poor sleep can exacerbate conditions like chronic pain. It further increases the risk of mental health issues like depression.
 
The American Chronic Pain Association provides resources to help people with chronic pain live fulfilling, enjoyable lives. The below guide provides tips for better sleep.
 
Make exercise part of your daily routine
 
The average adult should get at least 150 minutes of physical activity every week, according to the Centers for Disease Control and Prevention. This could just be half an hour a day, five days a week. Regular exercise helps to maintain muscle tone, improve cardiovascular health, and enhance immune function. It can also help you sleep better.
 
Hopkins Medicine reveals that getting at least 30 minutes of aerobic exercise per day can improve sleep quality at night. If you live with chronic pain, exercise can also help improve mobility and decrease inflammation. Healthline reports that low-impact activities like walking, swimming, stretching, and water aerobics are ideal for individuals with chronic pain.
 
Invest in technology to make your bedroom sleep-friendly
 
If you're still tossing and turning, your bedroom may be to blame. Ideally, your sleeping area will be free of external lights or sounds, which can interfere with deep sleep. The Sleep Foundation explains that light hinders the part of the brain that produces melatonin, the "sleep hormone" that makes you drowsy. You can install black-out curtains to keep light out.
 
To block out noise, invest in a white noise machine or get earbuds that you can comfortably wear in bed. Verizon offers a variety of wireless Bluetooth headphones to choose from. You can also try using a scent diffuser in your bedroom to help you drift off. According to VeryWellMind, scents like lavender promote relaxation and improve sleep.
 
Create a stress-busting pre-bedtime routine
 
If you're wracked by worries when you lie in bed at night, you're sure to have problems falling asleep. Stress can negatively impact sleep, making it tough to get the Z's you need. Stress can also exacerbate chronic pain, so it's important to get a handle on it if you are dealing with this health condition.
 
According to the American Psychological Association, stress harms many bodily systems, including the endocrine, nervous, reproductive, cardiovascular, and respiratory systems. Combat stress before bed with practices like yoga, meditation, and deep breathing. These activities force you to slow down and turn your focus inwards, blocking external worries.
  
Getting a good night's sleep shouldn't be a struggle. Implement the above tips so that you can fall asleep quickly — and stay that way throughout the night.
 
For more helpful content like this, check out the ACPA website. Discover diverse resources designed to help people with chronic pain, from relaxation audio to alleviate stress to DIY pain management tips. 
Living Systematic Review on
Cannabis and Other Plant-Based
Treatments for Chronic Pain
 
SYSTEMATIC REVIEW DRAFT
May 18, 2021

Click below to make comments
This draft report is available in electronic format only (Draft Report, [PDF, 880.3 MB]; Draft Appendixes [PDF, 1.2 MB]; Draft Appendix Study Details Evidence Tables [XLSX, 93.9 KB]; Draft Appendix Cohort Studies Evidence Tables [XLSX, 13.8 KB]; Draft Appendix Rate of Bias Evidence Tables [XLSX, 15.3 KB]). For additional assistance, please contact us.

Main Points
In patients with chronic (mainly neuropathic) pain with short-term treatment (4 weeks to <6 months):
  • Studies of cannabis-related products were grouped based on their tetrahydrocannabinol (THC) to cannabidiol (CBD) ratio using the following categories: high-THC to CBD, comparable THC to CBD, and low-THC to CBD.
  • Comparable THC to CBD ratio oral spray is probably associated with small improvements in pain severity and may be associated with small improvements in function. There was no effect in pain interference or serious adverse events. There may be a large increased risk of dizziness and sedation and a moderate increased risk of nausea.
  • Synthetic THC (high-THC to CBD) may be associated with moderate improvement in pain severity and increased risk of sedation, and large increased risk of nausea. Synthetic THC is probably associated with a large increased risk of dizziness.
  • Extracted whole-plant high-THC to CBD ratio products may be associated with large increases in risk of withdrawal due to adverse events and dizziness.
  • Evidence on whole-plant cannabis, low-THC to CBD ratio products (topical CBD), other cannabinoids (cannabidivarin), and comparisons with other active interventions was insufficient to draw conclusions.
  • Other key adverse event outcomes (psychosis, cannabis use disorder, cognitive deficits) and outcomes on the impact on opioid use were not reported.
  • No evidence on other plant-based compounds such as kratom met criteria for this review.
What Role Could Virtual Reality Play In
Managing Chronic Pain?

Laura Garcia, PhD
Research and Development, Manager
AppliedVR                                                                         
For the 100 million Americans affected by chronic pain, managing their care can be very taxing. They may struggle with balancing the costs and risks of common pain treatments. If treatments fail to relieve the pain, individuals may face frustration and even greater pain. Behavioral therapies can provide information and skills to manage chronic pain. These skills can also help individuals cope with any setbacks or life challenges. Unfortunately, there are still many barriers to these low-risk treatments. Thus, there is a great need for effective and accessible behavioral therapy for chronic pain. 
 
Virtual reality (VR) is a technology that can provide easy access to pain management skills. VR headsets display 3D images and sounds to make people feel as if they are immersed in a different place. VR experiences can be very distracting and entertaining. In particular, AppliedVR’s recent national study showed that a skills-based VR program can relieve chronic low back pain. The best part: pain relief was possible in the comfort of an individual's home. 
Our study evaluated an 8-week self-administered VR therapeutic program. We tested whether this program could reduce pain intensity and any related outcomes. We analyzed data from 179 individuals with chronic low back pain. Participants were randomly assigned to one of two VR programs:
  
  • EaseVRx: An immersive VR program with interactive pain education and skills training for relaxation.
  • Sham VR: A non-immersive VR program displaying 2D nature content delivered in a VR headset (like a TV display). 

Our study showed that EaseVRx was superior to Sham VR in its ability to reduce:

·      Pain Intensity (42% EaseVRx vs. 25% Sham VR)
·      Pain Interference with Activity (51% EaseVRx vs. 32% Sham VR)
·      Pain Interference with Mood (55% EaseVRx vs. 40% Sham VR) 
·      Pain interference with Stress (59% EaseVRx vs. 38% Sham VR)
 
EaseVRx was also superior at reducing general sleep disturbance and improving physical function. Furthermore, 65% of participants with the EaseVRx program reported a meaningful pain reduction (≥30%). But this was the case for only 40% of participants with the Sham VR program. Participants with EaseVRx also reported greater satisfaction and were more likely to recommend the program to others. Similarly, 85% of participants who used EaseVRx reported that they would "definitely continue to use" it if they could.
This is the first study to show that skills-based VR is superior to a VR sham in reducing chronic pain. Most importantly, our study showed high participant engagement and many other benefits of using VR therapy. Further research and development with VR could continue to improve the wellbeing of many individuals with chronic pain. 
 
You can read the full press release on the AppliedVR website.
You can watch our Patient Testimonial video.
Inspiring Communities through Movement and Conversation
With an aim to make hope and health accessible to all, our doctor-led walking groups are a safe, fun, and FREE place to get some steps, learn about health, and meet new friends. Join us by attending a Walk near you or let us help you start a healthcare provider-led Walk of your own. https://walkwithadoc.org/

100 Reasons to Walk
Walking is one of the best things you can do for your health. Many diseases, conditions, and ailments can be prevented or even healed by participating in regular physical activity. Fortunately, even moderate-intensity aerobic activity such as walking can provide these health benefits. See 100 reasons to walk below!
  1. Lowers “Bad” Cholesterol (LDL)  
  2. Increase “Good” Cholesterol (HDL)
  3. Prevents and Reduces High Blood Pressure  
  4. Reduces heart attacks by 86% (combined with healthy lifestyle choices)
  5. Reduces risk of stroke by up to 50%
  6. Lowers resting heart rate to make your heart more efficient!
  7. Improves cardiovascular endurance and performance
  8. Improves Circulation
  9. Keeps your lungs healthy!
  10. Strengthens breathing muscles
  11. Safe, even for those with asthma
  12. Lets one eat more with less weight gain
  13. Burns calories
  14. Causes weight loss!
  15. Increases metabolism
  16. Decreases Fat Tissue
  17. Reduces BMI
  18. Prevents Obesity
  19. Curbs Metabolic Syndrome
  20. Improves glycogen storage and allows better fat burning
  21. Stimulates digestion
  22. May reduce acid reflux severity and frequency
  23. Improves functioning of organs
  24. Beneficial for those with chronic kidney conditions
  25. Decreases risk of fatty liver disease
  26. Can act as an appetite suppressant
  27. Prevents or manages type 2 diabetes
  28. Helps insulin work better, lowering blood sugar
  29. Helps to regulate hormones.
  30. Improves chance of healthy pregnancy
  31. Alleviates menstrual cramps
  32. Increases testosterone in men
  33.  Reduces chances for breast, endometrial, and colon cancer
  34. Can reduce the urge to smoke!
  35. Allows one to stay independent as they get older
  36. Helps to avoid falls
  37. Reduces pain and disability
  38. Can add years to one’s life
  39. Enhances quality of life
  40. Increases blood flow to the brain
  41. Stimulates growth of nerve cells in the memory center of the brain
  42. May help reduce the risk of dementia
  43. Can stimulate you mentally
  44. Improves cognition.
  45. Reduces anxiety
  46. Increases overall sense of well being
  47. Improves psychological sense of wellbeing
  48. Opposes the effect of stress on the brain.
  49. Helps with relaxation and stress relief.
  50. Improves mood
  51. Increases sense of excitement
  52. Keeps unnecessary worry at bay.
  53. Improves self-esteem and self-confidence since body and mind are improved and strengthened
  54. Increases sense of self-control
  55. Healthy stress reliever
  56. Avoid stress eating!
  57. Curbs junk food craving
  58. Improves body image
  59. Improves bone density and prevents osteoporosis
  60. Strengthens and develops muscles
  61. Loosens up stiff joints
  62. Helps maintain cartilage health in the joints
  63. Reduces joint discomfort
  64. Improves balance
  65. Allows you to overcome illness or injury more quickly
  66. Boosts immune system functioning
  67. Promotes clean pores and healthier skin
  68. Stimulates circulation to improve skin, delay wrinkles, and promote hair growth.
  69. Helps to manage arthritis
  70. Improves stiffness from rheumatoid arthritis
  71. Eases muscular tension
  72. Reduces inflammation
  73. Increases resistance to pain
  74. Can prevent migraine headaches
  75. Alleviates back problems
  76. Helps to alleviate varicose vein pain
  77. Improves pain from fibromyalgia
  78. Increases creative ability
  79. Boosts work performance
  80. Improves mood at work
  81. Increases productivity at work
  82. Increases Productivity in general
  83. Boosts energy
  84. Fights fatigue
  85. Linked to increased income
  86. Provides source of pleasure and fun
  87. Improves sexual function and satisfaction
  88. Can prevent erectile dysfunction
  89. Can replace medications for better sex and sounder sleep
  90. Improves sleep quality and reduces daytime sleepiness
  91. Keeps health care insurance premiums lower
  92. Can lessen medical bills
  93. Affordable form of exercise
  94. Better for the environment
  95. “Walking is a Man’s Best Medicine”–Lowers death rate.
  96. Walking improves relationships Makes for a great date night!
  97. Healthy way to spend time with friends
  98. Great for you…AND your pet!
  99. Read about other pet friendly activities here. 
  100. The Surgeon General calls us to Step It Up!
Reprinted with permission from Walk With the Doc 
ACPA Support Groups are going to Zoom Virtual Meetings. Here is where they are located. You can email the National Office for contact information.

New Zoom Meetings:

Rochester, NY
Savannah, GA
*******

Falls Church VA
Hampton VA Veterans only
Union/Essex Cty NJ
Newton NJ
Ocean Park ME
Minneapolis MN
Ft Wayne IN
Chicago IL
Cincinnati OH Veterans only
Cincinnati OH
Pittsburg PA
Ft Myers FL
Austin TX
Fremont CA
Danville CA
North Hollywood CA
La Mesa CA
Beaverton/Tigard OR
South Salem NY
Rocky River OH
Englewood CO

We are also offering a conference call group:

Vallejo, CA
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These groups will continue to also do face to face meetings when the shelter in place opens up. Please email the National Office at [email protected]
Gifts given to the ACPA
In Loving memory:

Armando Chilelli

Given by
Bob & Tina Pringle

Julia Bailey

Given by
Bob & Virginia Colgan

Brian P Quinn

Given by
NY State Tax Department - audit Group 2

Damian Alexander

Given by
Annette DeVito Dabbs
Heidi Donovan
Jonna Morris
Grace Campbell
ATC
Elizabeth Katrancha
Kristine Poloyac
Kyle Hartley
Heeyoung Lee
Peggy & Michael Rosenzany

Terri Alcorn

Given By
Diane Pessagno
Fall 2020 Combined Federal Campaign (CFC)

Consider directing your donation to the American Chronic Pain Association this year.

CFC Code number is:
10549 
ACPA Corporate Members
 You shop. 
Amazon gives.

Shopping on line helps the American Chronic Pain Association 
 
If you use Amazon for your on-line shopping, you can now support the ACPA. It is simple just go to AmazonSmile and select American Chronic Pain Association as your charity from the drop down menu.  
  • Amazon donates 0.5% of the same price of your eligible AmazonSmile purchases to the charitable organization of your choice.
  • AmazonSmile is the same Amazon you know. Same products, same prices, same service.
  • Support American Chronic Pain Association by starting your shopping at smile.amazon.com