About Chronic Pain
The Pathology and Management of Chronic Pain
Pain is an integral body process that serves a vital purpose -- it tells the body where and when an injury has taken place. It also plays an important part in healing; when pain diminishes, the body is healing. However, pain sometimes manifests in difficult-to-control or unexplained ways. In some cases, nagging injuries that never fully heal can cause ongoing struggles with lingering pain, which can be severe. In other cases, pain persists even when there seems to be no physical cause. These situations are known as chronic pain syndrome.f
What Is a Chronic Pain?
The clinical definition of chronic pain is pain that has persisted for a period of three to six months, regardless of whether or not its root cause can be identified or treated. Doctors have noted that the presence of chronic pain seems to trigger a reduction in the patient's pain threshold. As such, it is not uncommon for people suffering from chronic pain syndrome to develop more than one pain condition, regardless of whether or not a second injury has taken place. In some instances, localized pain confined to one particular area of the body gradually spreads, becoming generalized throughout the body.
Chronic pain can present in various ways, ranging from persistent, dull, aching pain to sudden, sharp pain which flares up for unexplained reasons. The exact causes of chronic pain syndrome are poorly understood, but research has shown that patients who seek treatment within six months have a better prognosis than those who delay it.
Managing Chronic Pain
Because doctors and researchers have struggled to identify the mechanisms of action of chronic pain syndrome, management can be difficult. In most cases, a number of therapies, or different combinations of therapies must be tried in order to find the approach that works best for that particular patient. Individuals suffering from chronic pain syndrome tend to respond very differently to treatment.
With that in mind, there are several mainstays used in the treatment of chronic pain. These include:
- Medications. A wide range of medications have shown promise in the management of chronic pain. Interestingly, painkillers don't generally have a strong effect when used to treat chronic pain syndrome; dual-action drugs, which combine analgesia with psychopharmacological agents such as NMDA antagonists, SNRIs, and SSRIs generally achieve much more beneficial effects. Antidepressants and relaxants may also be prescribed, either to treat the pain or to address comorbid conditions or complications.
- Lifestyle modifications. If the patient's conditions allow it, doctors generally encourage regular, vigorous physical exercise. Cardiovascular activity triggers the production of the body's natural painkillers, and exercise is considered one of the very best non-pharmaceutical treatments for chronic pain.
- Psychotherapy. Many researchers believe that chronic pain syndrome has a psychological component, namely that patients begin to perceive pain when pain may not actually be present because their brains have become so accustomed to feeling it. It is also common for people with chronic pain syndrome to become depressed and socially withdrawn. Psychotherapy can help patients maintain a positive outlook and keep up their mental health while chronic pain syndrome is in the process of resolving.
- Surgery. In cases where the chronic pain is caused by an injury that has not fully healed, surgery may be used to correct the underlying problem. However, this is considered a last-line treatment, as surgery is invasive and poses an inherent risk of complications.
- Holistic treatments. A number of alternative treatments and holistic therapies are used by chronic pain sufferers for relief. Some possible approaches include massage therapy, acupuncture, meditation, and hypnosis. However, keep in mind that evidence of the effectiveness of these treatments is largely anecdotal and has not been proven or reproduced by scientific research.
Approximately 50 million people in the United States are living with some form of chronic pain, so if you're also suffering from it, you're not alone. Take advantage of resources in your local health network and be proactive about managing the condition. With a positive outlook, you can find real and lasting relief from chronic pain syndrome.