Millions of people suffer from acute or chronic pain each year, and the cost to our society in healthcare, lost wages, reduced productivity, and a diminished quality of life have doctors and scientists scrambling to learn more about chronic pain and how we can manage and prevent it.
What is Chronic Pain?
While acute pain is a normal sensation triggered in the nervous system to alert you to possible injury and the need to take care of
yourself, chronic pain is different. Chronic pain persists. Pain signals keep firing in the nervous system for weeks, months, even years. There may have been an initial mishap, like a sprained back, serious infection, or there may be an ongoing cause of pain — arthritis, cancer, ear infection, but some people suffer chronic pain in the absence of any past injury or evidence of body damage. Many chronic pain conditions affect older adults. Common chronic pain complaints include headache, low back pain, cancer pain, arthritis pain, neurogenic pain (pain resulting from damage to the peripheral nerves or to the central nervous system itself).
A recent market research report indicates that more than 1.5 billion people worldwide suffer from chronic pain and that approximately 3- 4.5% of the global population suffers from neuropathic pain, with incidence rate increasing in complementary to age. [Source: http://www.painmed.org/patientcenter/facts_on_pain.aspx]
Causes of chronic pain
Chronic pain can be caused by many different factors. The natural act of aging may affect bones and joints in a way that causes persistent pain. Other common causes are old injuries that never healed properly, like a poorly set broken bone, or nerve damage from an accident.
Back pain can be caused by any number of factors, including bad posture, improper lifting of heavy objects, being overweight, spine curvature, wearing high heels or a bad mattress. Disease can also cause chronic pain. Rheumatoid arthritis and fibromyalgia are well-known culprits of persistent pain.
Pinning down a single cause and treatment can be tricky and take quite a long time to diagnose properly.
Coping with Chronic Pain Through Medication
The use of analgesics (pain relievers) and other medications is the most common method of chronic pain treatment. Pain medications can be helpful for some patients in chronic pain, but they are not universally effective. In fact, in some individuals, pain medications may actually worsen their symptoms over time or cause unwanted or dangerous side effects.
In particular, the overuse, misuse and abuse of opioid (narcotic) pain medications has now become a national issue. Deaths due to overdoses of opioid prescription drugs have risen sharply, and now outnumber all other causes of accidental death.
Therefore, each person with chronic pain should be medically managed individually, and medication use should be determined by weighing benefit compared to other alternatives, cost, potential side effects, and the person’s other medical problems.
A realistic goal for pain relief medications is partial rather than full relief of symptoms.
Over the Counter (OTC) pain relievers like asprin, naproxen and ibuprofen are commonly used to help ease the discomfort of chronic pain, without the worry of narcotic dependence.
Even though they are considered safe enough to be dispensed without a prescription, remember they are real medicines. There is often a mistaken belief that because the medication can be obtained without a prescription, that they are safe and without potential for harm. Nothing could be further from the truth.
For instance, acetaminophen is the medication most involved in overdoses which can be fatal but it is important to recognize the relative risk when compared to taking NSAIDs for chronic pain. When the labeled dosing of acetaminophen is not followed (overdose), serious liver damage may occur. In contrast, GI bleeds, injury and death from NSAIDs has been known to occur at labeled doses, especially in cases where it is used chronically.
Going through the extensive list of medication options with a medical professional is of the utmost importance if you are using anything, even OTC medications, for pain relief. The American Chronic Pain Association (ACPA) has a series of videos published regarding treatment of chronic pain with medication, which can be found here: http://www.theacpa.org/medsup/default.aspx
Chronic Pain in the Workplace
Many people who suffer from chronic pain wonder what disclosure is needed at work. Do you have to tell your boss about it? What are your rights when you suffer from a chronic condition? Health.com expert Jennifer Jaff outlines your obligations and rights: http://www.health.com/health/condition-article/0,,20198797,00.html
Treatment of Chronic Pain
Exercise has come to be a prescribed part of some doctors’ treatment regimens for patients with pain. Because there is a known link between many types of chronic pain and tense, weak muscles, exercise — even light to moderate exercise such as walking or swimming — can contribute to an overall sense of well-being by improving blood and oxygen flow to muscles. Just as we know that stress contributes to pain, we also know that exercise, sleep, and relaxation can all help reduce stress, thereby helping to alleviate pain. Exercise has been proven to help many people with low back pain. It is important, however, that patients carefully follow the routine laid out by their physicians.
Magnets are increasingly popular with athletes who swear by their effectiveness for the control of sports-related pain and other painful conditions. Usually worn as a collar or wristwatch, the use of magnets as a treatment dates back to the ancient Egyptians and Greeks. While it is often dismissed as quackery and pseudoscience by skeptics, proponents offer the theory that magnets may effect changes in cells or body chemistry, thus producing pain relief.
Physical therapy and rehabilitation date back to the ancient practice of using physical techniques and methods, such as heat, cold, exercise, massage, and manipulation, in the treatment of certain conditions. These may be applied to increase function, control pain, and speed the patient toward full recovery.
R.I.C.E. — Rest, Ice, Compression, and Elevation — are four components prescribed by many orthopedists, coaches, trainers, nurses, and other professionals for temporary muscle or joint conditions, such as sprains or strains. While many common orthopedic problems can be controlled with these four simple steps, especially when combined with over-the-counter pain relievers, more serious conditions may require surgery or physical therapy, including exercise, joint movement or manipulation, and stimulation of muscles.
Chiropractic care may ease back pain, neck pain, headaches, and musculoskeletal conditions. It involves “hands-on” therapy designed to adjust the relationship between the body’s structure (mainly the spine) and its functioning. Chiropractic spinal manipulation includes the adjustment and manipulation of the joints and adjacent tissues. Such care may also involve therapeutic and rehabilitative exercises.
Biofeedback is used for the treatment of many common pain problems, most notably headache and back pain. Using a special electronic machine, the patient is trained to become aware of, to follow, and to gain control over certain bodily functions, including muscle tension, heart rate, and skin temperature. The individual can then learn to effect a change in his or her responses to pain, for example, by using relaxation techniques. Biofeedback is often used in combination with other treatment methods, generally without side effects. Similarly, the use of relaxation techniques in the treatment of pain can increase the patient’s feeling of well-being.
There are no easy answers to treating chronic pain. The reduction of quality of life from the constant pain can lead to further psychological problems. Anyone suffering from pain that lasts more than a few weeks should get to the root of the problem with a trusted medical expert.
If you have tried the “traditional” treatments without much benefit, please visit Our Approach page to learn about our diagnosis and treatment plans.