Definition & Overview

Chronic pain is pain that affects any part of the body and lasts longer than six months. In some cases, the pain signals in the nervous system stay active for years. This typically leads to physical, psychological, and emotional effects, depending on the intensity of the pain. While some people experience mild and inconvenient discomfort, some can also suffer debilitating and excruciating pain. The length and frequency of attacks may also differ: while some may experience episodes of pain or flare-ups, some may have to deal with continuous pain.

According to studies, chronic pain currently affects up to 50 million people in the United States alone. Although research is continuously done to improve medical information on this condition, it is still hard to control up to the present time. Despite the existence of pain medications, they have been shown to help only around 58% of people suffering from chronic pain. Understanding how the body identifies pain sheds some light on the condition. Since pain occurs due to nerve impulses that transmit signals to the brain, it can be caused not only by actual tissue damage, but also by social and psychological factors.

Studies also found that while it is important to treat the underlying cause of the pain, actual cases show that this does not always relieve 100% of the pain, which becomes a chronic condition of its own.

Cause of Condition

Chronic pain can be caused by:

  • An injury
  • An infection
  • Ongoing condition, such as diabetes or arthritis
  • Improper posture
  • Improper manner of lifting or carrying heavy objects
  • Obesity or being overweight
  • Congenital condition
  • Sleeping on the wrong mattress
  • Degenerative conditions
  • Nerve damage
  • Diseases, such as fibromyalgia, shingles, multiple sclerosis, and rheumatoid arthritis

Pain caused by an injury, trauma, or infection may linger even when there is no longer any physical evidence of the said injury. It is also possible for chronic pain to occur even in the absence of any known cause.

Chronic pain is also often worsened by its negative emotional effects on an individual. A person who experiences a painful condition may be prone to negative emotions such as anxiety and stress, and this may, in turn, inhibit the production of the body’s natural painkillers while increasing the production of substances that make pain sensations more pronounced.

The pain can also originate from many different parts of the body. Some common sources are the:

  • Head
  • Joints, tendons, and ligaments
  • Muscles
  • Back
  • Sinuses
  • Nerves, such as the median nerve that cause carpal tunnel syndrome
  • Shoulders and neck
  • Pelvis

Chronic pain tends to be more common among the elderly, but it is not considered as a normal part of aging. The higher risk faced by older individuals is caused by their susceptibility to conditions that may cause pain.

Key Symptoms

To determine whether the painful sensation that you are experiencing already qualifies as a chronic condition, here is a checklist of symptoms to watch for:

  • Pain of any intensity, whether mild or severe
  • Pain that does not go away after six months
  • Aching or burning pain
  • Stiffness or soreness

The pain itself may bring about other symptoms, such as:

  • Fatigue
  • Compromised immune system
  • Frequent need to rest
  • Sleeplessness
  • Fear
  • Depression
  • Anxiety
  • Stress
  • Irritability
  • Inability to work

Who to See & Types of Treatments Available

If you think you are suffering from chronic pain, it is important to seek treatment. Doing so will help you regain a normal life despite your condition. For medical help in relieving chronic pain, you can go to your family doctor, primary care physician or an internist. They may also refer you to other health care professionals, if necessary. Since there is evidence of a mind-body connection when it comes to causing or aggravating pain, you may need to seek psychological treatment alongside primary pain management.

If you are being treated for chronic pain, your doctor will conduct an analysis of your physical exam, the current state of health, and your medical history. Any past injury or illness will be taken into consideration to try and determine the cause of the pain.

Once diagnosed with chronic pain, you can discuss treatment options with your doctor. The most common treatment prescribed by doctors is the oral intake of medications designed to relieve pain. These include:

  • Pain medications such as acetaminophen, ibuprofen, or aspirin; these drugs have to be taken carefully because, although they have been proven safe, incorrect usage may cause negative effects on the body such as liver damage

  • Antidepressants such as amitriptyline, imipramine, clomipramine, desipramine, doxepin, and nortriptyline

  • SNRIs or serotonin and norepinephrine reuptake inhibitors, including medications for fibromyalgia such as venlafaxine and duloxetine; these have been proven to be especially helpful for relieving nerve-related pain although side effects such as dry mouth and urinary retention have been reported

  • Anticonvulsants such as carbamazepine and phenytoin, which are primarily used to treat epilepsy; if these first-generation drugs cause side effects, second-generation options such as garbapentin, pregabalin, and lamotrigine may be considered

  • Opioids, such as codeine, morphine, and oxycodone, which are available in pills, injections, implants, and skin patches; take note, however, that these are narcotic pain medications with the tendency to become addictive and are therefore not prescribed for patients with history or tendency to become addicted

Aside from medications, procedures and techniques used to treat chronic pain include:

  • Home treatment such as natural relaxation techniques, periodic rests, and getting adequate sleep
  • Mild exercise such as stretching, walking, swimming, and bicycling
  • Physical therapy
  • Massage therapy
  • Yoga or meditation therapy
  • Chiropractic therapy
  • Intravenous pain medications
  • Acupuncture
  • Nerve stimulation
  • Biofeedback
  • Psychotherapy such as cognitive-behavioral therapy
  • Surgery

For assistance in coping with the emotional and psychological effects of the pain, patients may also seek counseling.

The main goal of treatment is to relieve the pain, or at least lessen its intensity enough so that the patient will be able to lead a normal life. It is normal for patients to continuously deal with some amount of pain, as long as it does not get in the way of normal performance of daily tasks.

Different treatment options may be combined to form a single treatment plan, which should be discussed carefully by patient and attending physician. The plan should also be followed carefully for the treatment to become effective. If the pain does not go away or if it somehow gets worse, the plan may be adjusted accordingly.

References:

  • American Academy of Pain Medicine: “AAPM Facts and Figures on Pain.”
  • American Pain Society: “Biofeedback as an Adjunctive Treatment Modality in Pain Management.”
  • American Pain Foundation: “Treatment Options: A Guide for People Living with Pain.”
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