Sunday, January 19, 2014

Chronic Pain

Chronic Pain Chronic pain as the name suggests is the pain that is experienced long term more often for weeks, months and even years. Chronic pain is one that persists even after the injury or illness that has created it has healed. The pain signals in the brain/nervous system remains active for long-term. Chronic pain can cause several emotional problems such as anxiety, depression, and anger and sometimes fear. These factors can disturb the affected person to such an extent that it may take more than normal period for him/her to return to normalcy.


Chronic Pain .Vs. Acute Pain :


Acute pain is experienced suddenly and is felt as sharp staggering pain. Often acute pain is considered as a warning signal for the underlying disease that needs immediate medical treatment. Some of the examples of acute pain are broken bones or fracture, pain caused during or after dental procedures, pain felt after surgery and pain felt during labor. Acute pain does not lasts longer but chronic pain can be felt for weeks or even months together. Acute pain will disappear if the underlying medical cause or injury is treated or healed but chronic pain will not disappear even after the cause is treated. Some of the common types of chronic pain are arthritis pain, headache, low back pain and cancer pain.


For some people chronic pain would have originated after trauma or physical injury to the body part and it often continues as ongoing cause. But in some cases chronic pain can be felt without any apparent cause. Chronic pain can range from mild to sharp pain disrupting the daily routine of the affected person. It is common in both sexes and is more common in elderly adults. Chronic pain is a symptom of aging process and older adults would have more types of medical issues like diabetes or arthritis than normal adults.


Causes :


The exact cause of chronic pain is still not known. Many times, chronic pain will continue to exists even after the underlying medical problem is treated. Some parts of nerve signals continue to remain active sending pain signals continuously to the body. For some people, the underlying nerves can get damaged causing the chronic pain.


Symptoms :


Some of the common signals of chronic pain are shooting or burning pain in some parts of the body. Some people may feel it as electrical pain or staggering pain. It might cause discomfort for the affected person and there may be muscle stiffness or tightness in the concerned area of the body. Chronic pain will not go away after the injury or trauma is treated and healed.


Chronic pain often causes fatigue and impatience for the affected person. In many people with arthritis pain sleeplessness is the main problem. The pain will not allow them to sleep properly during the night. Other common symptoms of chronic pain are withdrawal from normal activity, lack of motivation, depression, anxiety, mood changes like hopelessness and irrational fear. Sometimes it can cause weakness in your immune system giving way for infection and frequent illness.


Chronic pain can affect any part of the body like the muscles, joints and bones. Osteoarthritis and rheumatoid arthritis are some common types of chronic pain affecting the bones, tendons and joints. It can affect the nervous system causing intense nerve pain and it happens when there is excess of pressure on the nerves thereby damaging them. Diabetes and shingles can cause such nerve pain. In some cases, chronic pain can affect the internal organs like stomach and intestine which is felt once the person is diagnosed with stomach ulcer or inflammatory bowel disease. In rare cases, chronic pain can affect more than one organ in the same person.


Who are at risk?


Chronic pain can occur at any age and is common for men and women. But elderly adults are more prone to get chronic pain due to underlying illness like diabetes or arthritis or weakened immunity. Certain health problems like shingles, fibromyalgia, depression, anxiety disorders and weak immune system can trigger chronic pain. People who have undergone previous surgery like back surgery, limb amputation etc are more prone to develop chronic pain.


Medical conditions like post-therapeutic neuralgia are very difficult to treat. People with sedentary lifestyle and those with smoking or drinking habit can develop chronic pain easily in old age. Women who are having stressful relations and those working in stressful atmosphere or facing constant sexual abuse can develop chronic pain.


Diagnoses :


Your doctor will examine the body by doing a physical exam at the doctor’s office. He may ask about your past illness/injury and the list of medications you are using at present. He may request for blood test, X-rays and test for diagnosing nervous problem. But in most of the cases, the test report will be negative indicating there is no underlying problem. Diagnostic tests like CT or MRI scan, angiogram test, electromyogram and nerve tests can be done to rule out any anomalies in nervous system.


He would check your mood changes and request for complete mental health assessment, if necessary. It is often difficult to diagnose the underlying cause for chronic pain. However the pain is very much real and affects the person’s health.


Treatment :


Over the counter medications like Ibuprofen, aspirin and acetaminophen may give you some relief from pain. Often chronic pain has no cure and the affected person has to manage to live with it. Eating healthy foods and practicing regular exercise will help you in reducing chronic pain. You can also try alternate therapies like acupuncture or yoga therapy. For some people mild chronic pain can be managed with OTC medications and mild exercises. But severe type of chronic pain gives great discomfort and disrupts one from carrying out daily activities. It would also cause great mental health problems like depression and anxiety. The person may not get quality sleep at night thereby causing irritation and fatigue. The entire outlook of life will change and it might disturb your relationships as well.


It is very much necessary for the person with chronic pain to take continuous treatment to prevent him/her from disability to work. Prolonged pain can interfere with your routine work causing disability. You have to get help from pain management clinic wherein you can find team of doctors like a neurologist, psychiatrist and anesthesiologist, treating you for managing the pain. It is certainly a challenging task for the doctor to treat anyone with chronic pain. He would have to consider several combinations of treatment for the same person to get real relief. Treatment will definitely improve the quality of your life if not give you complete relief from the pain.


The aim of the treatment is to decrease the intensity of your pain and improve your ability to function. Your doctor would give medications or therapies to get quality sleep and to reduce stress. Treatment varies with what kind of chronic pain you have and how severe it has affected your life. Many people get addicted with Non-steroidal anti-inflammatory drugs for managing chronic pain. But it is not advisable to take these drugs for long term without consulting your doctor.


Psychotherapy can bring relief and improve your emotional strength for managing chronic pain. You can get help from a counselor for overcoming depression/anxiety and addiction with alcohol. CBT (Cognitive Behavior Therapy) is very useful in handling many mental health problems. Some doctors use nerve block injections for giving relief from severe nerve pain. Surgery is the last choice for chronic pain and it depends on the individual’s health condition and intensity of the pain.


Intrathecal drug delivery is done using small tubing inserted into the spinal cord which would release small amounts of drug whenever the person feels pain in the area. Spinal cord stimulation is a process in which electrical current is used for treating chronic pain. Radiofrequency ablation is another procedure through which the pain causing nerves are numbed thereby giving relief from chronic pain.


Prevention :


You cannot prevent from getting chronic pain. But you can always try your best to stay in good health both physically and mentally. Eat balanced diet, sleep well and do exercise regularly.


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