Chronic Pain: A Painful Truth

Chronic Pain Syndrome
It is now believed that about 100 million Americans suffer from chronic pain and chronic pain syndrome. It is has become a ‘silent epidemic’ over the past years. It is defined as pain lasting from approximately 12 weeks or 6 months. While acute pain is a ‘normal’ sensation that alerts us of an injury, chronic pain is very different and something else entirely that persists often for months or longer. Imagine the physical pain and emotional damage that individuals have to deal with every single time and the fact that things will ‘not be better’ in time. Not only does this greatly take a toll on the afflicted but to the immediate family members and loved ones as well; knowing that someone you deeply care for is in pain and there isn’t much you can do for them.

Causes of Chronic Pain
The pain itself can be mild to excruciating, episodic or continuous, merely a nuisance or totally incapacitating. With chronic pain, signals of pain remain active in the nervous system for months or even years. This takes a great toll on the body and mind of the afflicted and to those around them. Chronic pain may spring from an initial injury, such as a back sprain, or there may be an ongoing cause, such as an illness. The most common causes of chronic pain vary from headache, joint pain, and pain from injury. Others may include tendinitis, sinus pain, carpal tunnel syndrome, pain affecting certain parts of the body such as shoulders, pelvic and neck. Your common muscle or nerve pain may develop into a chronic condition. However, there may also be no clear cause. With all the physical pain felt and suffered by the patient, there are also other health problems that often accompany chronic pain. These include and may not be limited to; fatigue, sleep disturbance, decrease appetite and mood changes. This not only inflicts pain unto the person but also triggers a second gun that takes its effect on the individual’s emotional and over-all disposition. Because of this, chronic pain may limit the person’s movements, which in effect can reduce flexibility, strength and stamina. This difficulty in carrying out seemingly simple yet important and enjoyable tasks leads to frustration, anxiety and despair.

Pain History
While pain is a relative and personal therefore subjective kind of experience, there is no test that and locate and measure pain with precision. Doctors and health workers heavily rely on the individuals’ own description of the type, timing, location of the pain. Word cues like sharp or dull, constant or on-and-off, burning or aching may better help your attending physician the best clues to the cause of the pain. These descriptions are readily asked as part of what is called a “pain history,” undergone usually at the start of the evaluation of pain. Since chronic pain can occur and does occur in a variety of locations, patients and their respective health professionals need to work together to identify the causes and symptoms of that pain and how sufferers can be relieved. Technology can greatly help and improve professional diagnosis. Due to the fact that pain is relative to each person, the best treatment plan is tailored to suit the individual with inputs from different healthcare team members with different training background and experience. The person in pain and his or her family should also actively participate in this as this also affects them.

Chronic Pain Treatment
With chronic pain treatment, the goal is reduce pain and improve function so that the person afflicted can resume day-to-day activities and become more productive and redeem self-esteem and motivation. Patients and their healthcare providers have an array of options for treatment of pain and medical plan. Just like pain is relative to the individual concerned, some treatments are more effective than others. Whatever the treatment plan you agreed, it is crucial to remember that chronic pain usually cannot be cured but it can be managed. As your medical health provider, the focus is to manage pain so you and those who are affected can be functional and can work as independent as possible. The best pain control can be achieved by targeting the underlying problem and minimize pain with different medications and non-pharmaceutical treatments, also called natural pain relief. These include less invasive psychotherapy, relaxation therapies, biofeedback and behavior modification may also be used to treat chronic pain. Just as stated above, these methods have proven to be strong and effective in some people. You and your health care provider need to discover what will suit you best. When talking about chronic pain treatment, many people find the treatment more effective by adding complementary or alternative medicine (CAM) in their approaches to provide maximum relief. This may include but not limited to tai chi, acupuncture, meditation, massage therapies and similar treatments. Self-management approach also holds great promise as a treatment approach. In this program, the individual patient becomes an active participant in his or her treatment. Although self-management varies from case to case, they have a common feature. The rationale of this approach is to help the person living with pain learning to think, feel and do better despite the presence of pain. Some medication options may include:

Acetaminophen (Tylenol) – Is used to treat pain. Unlike some medications for pain, Tylenol does not have anti-inflammatory effects therefore; Tylenol may be an appropriate treatment choice. It is safe when used appropriately but can be dangerous when used excessively. Always discuss medication options with your physician.

Non-Steroidal Anti-Inflammatory Medicine (NSAIDs) – Such as Ibuprofen, Motrin, Aleve, etc. are most beneficial in cases of acute pain or flare-ups with patients with chronic pain. In general NSAID use is limited for patients with chronic pain because of complications. While the newer, so-called COX-2 inhibitors, such as Celebrex, were designed to avoid this complication, caution should still be used when using these medications for long periods of time.

Corticosteroids – They have the same effect and precautions as NSAIDs.

Anti-Convulsants – Anti-convulsant medications are the category of medications that work to relieve nerve pain. These medications alter the function of the nerve and the signals that are sent to the brain. The most commonly prescribed anticonvulsant medication for nerve pain is called Neurontin (Gabapentin), another more recent, specifically for the treatment of fibromyalgia called Lyrica (Pregabalin).

Local Anesthetics – They can provide temporary pain relief to an area. When used in the setting of chronic pain, local anesthetics are often applied as a topical patch to the area of pain such as Lidoderm.

The bottom line is that the fact that chronic pain is a problem that does not resolve quickly and with one specific treatment or medication. The best way is still to actively work with your attending physician and discuss different types of treatment and medication to attack the pain. Dr. Unger’s expertise in treating patients with chronic disease states, especially chronic pain, is an ideal treatment for your chronic pain. Have us give you a call today.