Pain Awareness Month

 

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