Chronic Pain Issues

[ButterflyLady]

I know I atleast suffer from chronic pain issues. There are many different types and some are pain syndromes that some people suffer from so I decided it might be a good idea to have a pain thread too.

What Is Chronic Pain?

About 100 million Americans suffer from chronic pain, defined as pain that lasts longer than six months. Chronic pain can be mild or excruciating, episodic or continuous, merely inconvenient or totally incapacitating.

With chronic pain, signals of pain remain active in the nervous system for months or even years. This can take both a physical and emotional toll on a person.

The most common sources of pain stem from headaches, joint pain, pain from injury, and backaches. Other kinds of chronic pain include tendinitis, sinus pain, carpal tunnel syndrome, and pain affecting specific parts of the body, such as the shoulders, pelvis, and neck. Generalized muscle or nerve pain can also develop into a chronic condition.

Chronic pain may originate with an initial trauma/injury or infection, or there may be an ongoing cause of pain. Some people suffer chronic pain in the absence of any past injury or evidence of body damage.

The emotional toll of chronic pain also can make pain worse. Anxiety, stress, depression, anger, and fatigue interact in complex ways with chronic pain and may decrease the body's production of natural painkillers; moreover, such negative feelings may increase the level of substances that amplify sensations of pain, causing a vicious cycle of pain for the person. Even the body's most basic defenses may be compromised: There is considerable evidence that unrelenting pain can suppress the immune system.

Because of the mind-body links associated with chronic pain, effective treatment requires addressing psychological as well as physical aspects of the condition.


What Are the Symptoms of Chronic Pain?

The symptoms of chronic pain include:

Mild to severe pain that does not go away
Pain that may be described as shooting, burning, aching, or electrical
Feeling of discomfort, soreness, tightness, or stiffness
Pain is not a symptom that exists alone. Other problems associated with pain can include:

Fatigue
Sleeplessness
Withdrawal from activity and increased need to rest
Weakened immune system
Changes in mood including hopelessness, fear, depression, irritability, anxiety, and stress
Disability

Chronic Pain: New Research, New Treatments

As recently as 20 years ago, people with chronic pain were too often dismissively told that their problem was "in their heads" or that they were hypochondriacs. But in the last decade, a handful of dedicated researchers learned that chronic pain is not simply a symptom of something else -- such as anxiety, depression, or a need for attention -- but a disease in its own right, one that can alter a person's emotional, professional, and family life in profound and debilitating ways. Today, doctors have yet to fully apply this knowledge.

Some 50 million Americans have chronic pain and nearly half have trouble finding adequate relief. But the outlook is good: Ongoing research is revealing the promise of novel treatments, including new medications, devices and injections, alternative therapies such as biofeedback and acupuncture, and an all-encompassing mind/body approach. The point? If patients' whole lives are affected by pain, the treatment must address their whole lives.

I sat down with Scott M. Fishman, MD, to find out what's new in pain management -- and what doctors still need to learn to help their patients. Fishman is the president and chairman of the American Pain Foundation; he is also the chief of the division of pain medicine and professor of anesthesiology at the University of California, Davis. He wrote The War on Pain: How Breakthroughs in the New Field of Pain Medicine Are Turning the Tide Against Suffering. A University of Massachusetts Medical School graduate, he is board-certified in internal medicine, psychiatry, and pain and palliative medicine.

Q: About chronic pain: have researchers learned anything new about the origins of chronic pain that might lead to better diagnosis or treatment?

A: Absolutely -- we know exponentially more today than we knew even 10 years ago and much more than we knew 50 years ago. For one, we've learned a great deal about how pain is produced and transmitted and perceived. Fifty years ago, when someone hurt, we thought it was just a symptom of something else. But we now know the symptom of pain can become a disease in and of itself, and that disease is similar to other chronic conditions that can damage all aspects of someone's life.

[ButterflyLady]

Chronic neuropathic pain: issues in patient education.

Chronic neuropathic pain is difficult to diagnose and treat. For the patient, multiple aspects of his or her life may be altered, including physical, emotional, and spiritual health, as well as the ability to work, and family and social relationships. Successful treatment plans require more than just pharmacotherapy. Patients often need to receive a lot of information about complex regimens related to both pharmacologic and nonpharmacologic strategies. Additionally, patients with neuropathic pain need nursing support and guidance to help them master the self-management and coping skills required to minimize pain flares, while optimizing mood and functioning. A number of specific strategies are available based on the cognitive-behavioral model. These include the ability to interpret changes in pain in a helpful way, engagement in health promoting behaviors (including diet and exercise), and the development of an action plan for coping with pain exacerbations. A central element in this approach is to help patients become experts in understanding and managing their pain, then addressing the toll it has taken on their emotions, daily activities, and important relationships. Self-initiated techniques, such as relaxation, imagery, and hypnosis, can also be used to alter the subjective experience of pain. This article presents an overview of patient education approaches useful in the management of chronic pain.