What is chronic pain? Pain is considered chronic or long-term if it lasts longer than three to six months or beyond the normal healing period for an injury. It may be mild all the way up to severe and does not go away even though the pain may not always be present. Chronic pain can take a psychological toll and cause problems like depression, stress, anger, withdrawal and anxiety. It can take a physical toll on health with fatigue and sleeplessness and can also suppress the immune system. Almost 100 million Americans suffer from chronic pain.
Chronic pain is most often due to a health condition with
some of the most common sources being:
- Back pain
- Pain from injury or trauma
- Infection
- Disease
- Headaches
- Joint pain
- Muscle or nerve pain
- Tendonitis
- Shoulder, neck, pelvic pain
Current evidence-based care includes non-pharmacologic
treatments and non-opioid medications which show improvements in pain, function
or both and are the preferred treatment for chronic pain. Treatments need to
address the physical as well as psychological. Patient education, discussion
and shared-decision making are important. If any complementary health
approaches are decided upon by the patient, a safety discussion should be had
with the health care provider. Personal health and special circumstances can
affect the safety of the treatment.
Analgesics are pain killers and treat pain by reducing
inflammation or by changing the way the brain understands the pain. They can be
used after surgery, for an acute injury and for painful chronic conditions such
as back pain or cancer. These can include anti-inflammatories and opioids. Anti-inflammatory
drugs reduce inflammation or swelling at the site of the pain. Opioids work by
changing the way the brain perceives the pain; opioids can cause physical
dependence and are prone to abuse. All of these medications can cause side
effects and complications and should not be used long-term.
Possible treatments for chronic pain besides medication and
surgery include:
- Physical therapy
- Relaxation, stress reduction, distraction techniques, guided imagery
- Exercise therapies such as aerobic, aquatic, resistance
- Spinal manipulation
- Mindfulness meditation
- Acupuncture
- Massage
- Behavioral therapy
- Hypnosis
- Music therapy
- Cannabis
- Tai chi, qigong, yoga, Pilates
- Healthy eating
- Getting plenty of sleep
- Lifestyle modifications such as weight loss and physical activity
- Positive thinking
- Dietary supplements may interact with prescription and non-prescription drugs and may cause other problems; discuss with your health care provider
Health inequities unfortunately exist for many patients
including older patients, less educated people, women, and racial and ethnic
minorities usually due to inadequate pain management. Patients may also believe
that nothing except pain medication will help their pain.
Chronic pain can be a barrier to self-management as it can
increase the risk of anxiety and mood disorders, physical and emotional
disability and other poor health outcomes. There are no easy answers for pain
sufferers. Research is constantly being done to find the causes and treatments
of different types of pain. During this Pain Awareness Month, it is important
to be sensitive to the problems connected to chronic pain that others
experience.
https://www.cdc.gov/mmwr/volumes/67/wr/mm6736a2.htm
https://www.webmd.com/pain-management/default.htm
