Browsing: Chronic Pain

Little pain is a healthy reaction to a threat in an environment, enabling a person to change their behavior or response immediately. It’s like bumping your foot on the corner of furniture in a dark room, and the pain lets you mind your way next time you enter. When pain lingers long enough after the incident or danger has passed, it becomes chronic.

For most people, chronic pain is a physical symptom. However, it can also affect emotions, relationships, and the mind. 

What is chronic pain?

Any pain lasting longer than six months after the injury or illness that caused it and healed medically, is a chronic one. It’s mostly in the form of frequent headaches, joint pains, nerve damage pain, low back pain, arthritis pain, and fibromyalgia pain.

It is one of the most common types of health problems among U.S. adults. According to statistics from the CDC (Center for Disease Control),  chronic pain affects 1 in 5 adults in the U.S.

The Psychology of Chronic Pain

In contrast to the common psychology of chronic pain being physical, it adversely affects a person’s life. For example, chronic back pain is not just a medical condition; it can even derail employment and relationships. 

Considering only the medical factor might make a person over-rely on medical treatments such as pain medicines and surgeries. It might give some relief, but the risks of surgical complications or addictions to pain medicines still looms. 

More accurately, chronic pain is both a medical condition and a psychological condition. It negatively affects the social, emotional, and quality of life of the person.

For instance, one person suffering from chronic back pain can continue working with pain medications, but another might struggle and be unemployed or socially isolated. Studies even show chronic pain can clinically cause elevated levels of depression or anxiety in a person.

In a nutshell, apart from physical pain, chronic pain can have socio-psychological implications too like

• Depression
• Sleep problems
• Social Isolation
• Overuse and Addiction to Pain Medications

Causes of Chronic Pain

An initial injury, a muscle pull, or sprain, lights up the pain sensors sending messages through electrical signals to the brain. An ordinary pain like headaches can go away with aspirin. But in chronic pain, the brain continues to receive pain signals long after the injury has healed, raising the need for some pain management techniques.

A general injury pain can go away within three months. It all depends upon the extremity of the injury and the medical healing process. However, nerve damage pain can be more intense and long-lasting with a more extended recovery period. 

A pain that lingers on indefinitely from any such injury becomes chronic pain. 

Other Conditions Causing Chronic Pain

• Arthritis and other joint problems
• Back pain
• Headaches
• Muscle strains and sprains
• Repetitive stress injuries as a result of pressure over a body part on its movement 
• Fibromyalgia – It’s an ailment of muscle pain all over the body
• Nerve damage
• Lyme disease
• Broken bones
• Cancer
• Acid reflux or ulcers
• Inflammatory bowel disease (IBD)
• Irritable bowel syndrome (IBS)
• Endometriosis
• Surgery

Symptoms of Chronic Pain

1.  Physical Symptoms
   • A dull ache to throbbing pain in the previously injured area
   • Poor sleep 
   • Exhaustion
   • Daytime fatigue
2. Cognitive Symptoms
   • Anxiety
   • Depression
   • Irritability or Mood swings
   • Guilt feelings
   • Loss of interest in sex
   • Suicidal thoughts
3. Other Social Symptoms
   • Drug or alcohol abuse
   • Marriage or family relationship problems
   • Job loss

Who is at risk for developing chronic pain?

Anyone can suffer from chronic pain, but females are more susceptible to it. The other people at risk of developing a chronic pain 

• Those over 65 years of age
• Overweight
• Depressed
• Those with a history of smoking

Getting a Diagnosis

When you approach a doctor to get your chronic pain diagnosed, they may ask various questions about it to prepare their prognosis. Some of them are like 

• When did the pain originate?
• Where does the pain occur in your body?
• What degree of pain do you feel? 
  • throbbing
  • pounding 
  • shooting
  • sharp
  • pinching
  • stinging
  • burning
  • Or anything else
• What is the severity of the pain on a scale of 1 to 10?
• What do you think sets it off or makes it worse?
• Did any treatment relieve you from it?

Additionally, a doctor can ask you to get some tests done to recognize the cause of pain

CT Scan –  A powerful X-ray that gets detailed images inside your body

Magnetic Resonance Imaging(MRI) – A technique of getting images of organs and structures inside you using magnets and radio waves. 

X-ray – A technique of getting images of the structure of your body using low doses of radiation.

Treatment

Initially considered as a physical problem, today, experts address pain on psychological and social levels too. A doctor can prescribe medications to treat chronic pain, such as 

• Nonsteroidal anti-inflammatory drugs (NSAIDs)

These medications reduce inflammation and pain, but it may cause issues with the stomach and the cardiovascular system in some people. 

• Antidepressants 

In lower doses, these medications can treat pain in cases like diabetic neuropathy and fibromyalgia. It can take two to four weeks to feel its effects. They also have side effects like dizziness, dry mouth, fatigue, and headaches. 

• Opioids

They help in the treatment of moderate-to-severe pain, but it only works for a short period. Moreover, they can be highly addictive. As per the CDC, only opt for it when the benefits outweigh the risks. Further, there is no substantial evidence to show how effectively these works for chronic pain cases. 

• Beta-Blockers

It slows down the heart and restricts hormones, like adrenaline, from working. It’s mostly used for treating migraines, and in low doses, it can momentarily improve chronic pain in females with fibromyalgia and temporomandibular syndrome. However, it’s better to consult a doctor before taking these medications.

• Medicinal cannabis and cannabidiol (CBD)

Medicinal CBDs can relieve neuropathic pain, but it cannot treat chronic pain due to fibromyalgia, headaches, or rheumatoid arthritis. Furthermore, it’s not legal everywhere and if, taken in higher doses, can cause side effects like addictions. Therefore, it’s best to consult a doctor before taking CBD to treat chronic pain. 

Additionally, depending upon the severity of pain, a doctor can also recommend procedures like  

• Transcutaneous electrical nerve stimulation (TENS) 
• Braces
• Spinal cord stimulation
• Nerve blocks
• Or surgery to treat the root cause of the pain 

Apart from medications and surgery, there are also various ways to manage pain.

Pain Management Techniques

There are various ways of pain management. These are techniques to reduce and control the degree of pain a person experiences over the course of time.

Physical Techniques

Hot and cold therapy

It’s one of the most traditional and safe techniques to manage chronic pain. 

Heat therapy or thermotherapy involves using hot water bottles or heated pads (electrical or heat warps) to relieve pain. The heat applied to the inflamed area causes blood vessels to dilate and promote better blood flow. It also helps sore and tightened muscles to relax and promote healing after an injury. 

Cold therapy or cryotherapy involves using cold water, or a chemical cold pad or an ice pack to reduce inflammation in the injured area. It numbs sore tissues like a local anesthetic and reduces pain signals transmitted to the brain. It’s even helpful for treating swollen or inflamed muscles and joints. It’s one of the most effective treatments for an injury within 48 hours.

Heat therapy can help treat chronic muscle pain or sore joints due to arthritis. Similarly, cold therapy can help with migraine pains.

Massage

When used with other forms of chronic pain treatment, massages or soft-tissue manipulations can give patients relief. Studies have found it helpful, particularly in providing relief from lower back pains. The other benefits of massage include

• Deep relaxation
• Increased flexibility
• Reduced inflammation
• Improved posture
• Improved blood circulation
• Reduced stiffness

Physical therapy

It involves therapeutic techniques to strengthen and develop the muscles and joints. The long term impact of therapeutic exercises on chronic pain and help people cope with it. These techniques include

• massages
• exercise plans 
• Red light therapy – A procedure of exposing the body to a low wavelength of red laser light. 

Acupuncture

It’s a technique that involves applying thin needles piercing through the skin at precise points in the body. Trained practitioners can safely perform it using sterile needles. It can provide short-term relief in chronic pains related to the lower back, neck, knee, and osteoarthritis.

There is no substantial evidence for long-term relief from chronic pain through acupuncture. But it does benefit patients 

• Relieving pain
• Reducing inflammation
• Proving relaxation
• Reducing muscle spasms

Psychological Techniques

Cognitive behavior therapy

CBT, a form of psychotherapy that aims to reduce the negative impact of chronic pain on a person mentally, like reducing anxiety around the pain. It’s used mostly as a coping mechanism to manage the psychological impact of chronic pain.

According to studies, CBT has been found effective in reducing pain immediately after treatment. However, there is no evidence that CBT can reduce long term pains. 

Yoga

The procedure of relaxing, strengthening, and making the body flexible through various poses is known as yoga. In these modern times, it’s a popular type of physical exercise. It combines physical postures, breathing techniques, and meditation or relaxation to help a person cope with chronic pain that affects everyday life. 

People have found yoga effective in reducing their pain, but it does not decrease their chronic pain altogether.

Tai chi

This non-competitive martial art of self-defense also has health advantages. As an exercise therapy, Tai chi helps in pain management. It improves a person’s strength and body stability through slow, continuous, fluid body movements and breathing or relaxation techniques. It also improves balance control, fitness, and flexibility in people.

Tai chi is also helpful for senior people in managing their pain as it has lesser risks of falling while exercising. Several studies indicate Tai chi can impact chronic pain experienced by people due to osteoarthritis of the knee and fibromyalgia. It showed that over a 12-week course of Tai chi, it improves its physical condition and stiffness issues. 

Currently, many people have adopted Tai chi to experience improvements in chronic pain from 

• rheumatoid arthritis
• lower back pain
• osteoporosis

It’s also associated with mindfulness and the psychological well being of a person. Studies found it useful in dealing with stress and anxiety related to chronic pain. 

Relaxation Techniques

The discomfort from the pain can cause stress leading to muscle tensions and lack of proper sleep. The various relaxation techniques help in releasing endorphins in the body like natural pain killers. It reduces stress easing, muscle tension, muscle spasms, aches, and pains that further promote better sleep.

Some of the relaxation techniques include

Deep breathing methods

It’s a slow and relaxed method of breathing like box breathing. In it, a person slowly breaths-in for 4-seconds filling up the lungs, holds it inside for 4-seconds, and slowly breaths-out for 4-seconds. Repeating the exercise for 4-minutes relaxes the stress levels in a person. 

Progressive muscle relaxation

It’s a technique of focusing on breathing while tensing and relaxing for 10-seconds, each muscle in the body. The goal is to relax while breathing and avoiding muscles that feel painful.

Calming Exercises

It’s a technique of thinking of a calming view like green trees, mountains with waterfalls, birdsongs in the forest, sunrise or sunset in nature, etc., for 5-minutes. 

Calming Activities

It’s about taking some time off from routine life and engaging in relaxing activities like having a warm bath, reading a book, or listening to a piece of soothing, soft music. 

How does chronic pain affect the mental wellbeing of a person?

Chronic pain can contribute to mental health issues like depression and anxiety. It can disrupt a person’s routine life. 

Such patients can benefit from seeing a therapist or a clinician specialized in treating the negative emotions triggered by chronic pain. It’s also best to openly discuss it with a doctor before taking any pain medications.

Further, if a person wants to start pain management techniques, like acupuncture, physical therapy, and yoga, do it with a  professional therapist or practitioner for safe practice.