The onset of pain is a symptom of illness or injury in the part of the body that is experiencing the pain. The sudden onset of pain is called chronic pain. Chronic pain is pain that persists over time (6 months or longer) and typically results from long-standing (chronic) medical conditions or damage to the body. Pain interrupts our work, our recreation, and our relationships with our families. Comfort is one of the goals if a person becomes sick, and treatment by a health care professional for an illness associated with chronic pain is another goal. Once the cause of the pain is found and proper treatment is started, the pain may serve the useful function of keeping the affected individual at rest so that the injury or illness can heal. But if the pain is from an illness that is incurable and will never heal, the pain loses its usefulness and becomes harmful. This type of pain keeps a person from normal activity, and inactivity decreases strength. Common sources of chronic pain include injuries, headaches, backaches, joint pains due to an arthritis condition, sinus pain, tendinitis, or overuse injuries such as carpal tunnel syndrome. Chronic pain is also a feature of many types of advanced cancers. A number of symptoms can accompany chronic pain and can even arise as a direct result of the pain. These can include insomnia or poor-quality sleep, irritability, depression, mood changes, anxiety, fatigue, and loss of interest in daily activities. Pain can trigger muscle spasms that may lead to soreness or stiffness.
Causes & Symptoms
Studies find the following signs may be associated with chronic pain, including:
- Fear – It is common to begin fearing increased pain when you experience a chronic pain condition; as a result, you may begin to avoid activity.
- Body stiffness – Stiffness may make you feel as if your body is less able to perform daily activities.
- Decondition – Not being able to move your body results in less tolerance when you want to become more active. If you are inactive for a long period of time, muscles weaken and shrink from not being used. This can also increase your risk of falling.
- Decreased circulation – Lack of activity decreases the circulation of much-needed blood to your cells. Tissues in your body may not get as much oxygen as they need. As a result, they may not be as healthy as they can be. This can cause you to feel fatigued, and lack of energy.
- Weight gain / worsening of other conditions – Decreased activity can lead to unwanted weight gain. Added pounds and inactivity can aggravate symptoms of other conditions such as diabetes and high blood pressure.
Chronic pain conditions are also commonly associated with feelings of anxiety or depression. Increased use of medications can also be a risk factor regarding to chronic pain since chronic pain patients can have the tendency to increase their medication over time to seek relief. Other individual behaviors linked to chronic pain include the following:
- Seeking out of many different doctors or health care providers and facilities to find relief.
- Difficulties within job performance; some people with chronic pain even seek work disability.
- Avoidance of social situations or family members.
When pain is ongoing, you may find you have feelings of bitterness, frustration, or depression. Some people report having thoughts of suicide when experiencing a severe level of chronic pain – if you are having any of these types of feelings, seek immediate medical attention straight away.
Who Gets Chronic Pain?
Research shows that some patients are more susceptible to chronic pain than others. Some of these factors include:
- Patients with chronic and painful conditions, such as arthritis.
- People who are depressed. Experts are not sure why this is a factor; however, one theory is that depression changes the way the brain receives and interrupts messages from the nervous systems.
- Individuals who are smokers have an increased risk of chronic pain. As of yet, there is no clear answer, but experts are exploring why smoking seems to worsen pain in patients living with arthritis, fibromyalgia, and other chronic pain disorders. Studies even show that smokers make up 50% of those who seek treatment for chronic pain relief!
- Patients who are obese may also have a chance of having chronic pain. Generally, 50% of individuals who seek treatment for obesity report mild to severe pain. Most doctors are not sure if this is because of the stress extra weight puts on the body, or if it is due to the complex way obesity associates with the body’s hormones and metabolism.
- Females are more at risk of having chronic pain than men. Women tend to have more sensitivity to pain, therefore, researchers theorize this can be due to hormones or differences in the density of female versus male nerve fibers.
- Elders who are older than 65 have a higher risk of experiencing this condition; as one person ages, he / she is more prone to all kinds of conditions that can produce chronic pain.
How Does It Affect You? How Serious Is It?
There is a wind-up phenomenon that causes untreated pain to become much worse. Nerve fibers transmitting the painful impulses to the brain become trained to deliver pain signals better. Just like muscles become stronger for sports with training, the nerves become more and more effective at sending pain signals to the brain. The intensity of the signals increases over and above what is needed to get the affected patient’s attention. To make matters worse, the brain becomes more sensitive to the pain. Therefore, the pain may feel much worse even if the injury is not worsening. At this point, pain may be termed ‘chronic pain’, and it is no longer helpful as a signal of illness. Unfortunately, many illnesses do not have known cures. The treatment of illnesses such as diabetes and high blood pressure is often lifelong. In these chronic illnesses, as in the treatment of chronic pain, the person’s only goal is to live as normal as possible. Sometimes medication is required for the rest of a person’s life in order to achieve that goal.
While chronic pain and fibromyalgia often coexist, they are two different disorders; chronic pain often has an identifiable trigger, such as arthritis or injury from a broken bone that does not heal much properly. To describe fibromyalgia, it is a disorder of the nervous system characterized by muscle pain, joint pain, and fatigue. It often arises without a known cause – therefore, if you looked at an X-ray, you would not find tissue or nerve damage with chronic pain, whereas fibromyalgia does. However, even when treated, the pain of fibromyalgia may still be ‘chronic’.
Recommended Treatment & Rehabilitation
A diagnosis of chronic pain begins with an in-depth medical history (when the pain started, any recent injury, type / severity and location of the pain; if any other condition makes the pain worsen, and if any specific treatment eases the pain). Depending on the nature and location of the pain, a detailed examination of the musculoskeletal, neurological, gastrointestinal, or reproductive systems will take place. Imaging tests, such as X-rays, CT scans, and MRI scans, are often ordered. Blood work may also be done to determine any underlying conditions.
Your physiotherapist will then work with you to educate you on chronic pain and find solutions to help improve your quality of life. He / she will be able to cooperate with you to improve movement, teach you pain management strategies, and, in many cases, reduce your pain. Not all chronic pain is the same; your therapist will evaluate your clinical examination and test results and design an individualized treatment plan that fits well for your best needs.
Strengthening and flexibility exercises help you move more efficiently with much less discomfort – your therapist will soon design a program of graded exercises for you with movements that are gradually increased according to your abilities. Graded exercises help you improve your coordination and movement, reducing the stress and strain on your body and decreasing your pain. Carefully introducing a graded exercise program will help train your brain to sense the problem area in your body without increasing its danger messages. Manual therapy, which consists of specific, gentle, hands-on techniques, can be used to manipulate, or mobilize tight joint structures and soft tissues. Manual therapy is used to increase movement (range of motion), improve the quality of the tissues, and reduce pain.
Posture awareness and body mechanics instruction help improve your posture and movement – this type of training enables you to use your body more efficiently while performing activities and even when you are resting. Your therapist will help you adjust your movement at work, or when performing chores or recreational activities, to reduce your pain and increase your ability to function. The use of ice packs, heat packs, or electrical stimulation has not been found to be helpful with chronic pain. Your therapist, however, will determine if any of these treatments could very well benefit your unique condition.
Generally, surgery is rarely used in chronic pain cases. If used, it is commonly the last resort. However, if you have serious neurological complications (such as bowel or bladder dysfunction), along with chronic pain, you may need immediate surgery. If you do not have neurological complications, it is typical to try several months of non-surgical treatments, such as physiotherapy and medications, before performing any surgery. It is also difficult to treat chronic pain with surgery because often, there is no identifiable cause of pain. The surgeon cannot operate without knowing what he or she must fix.
There are some remarkably simple exercises that have been proven to help with chronic pain symptoms – some of these exercise methods include the following:
Weightlifting – Exercises that help strengthen muscles can be helpful in managing certain kinds of chronic pain by building up the muscles around the affected joints, which can mitigate stress around those joints. Be sure to consult with a physiotherapist regarding how much weight you can handle when starting off, and what kinds of training you can perform.
Walking – Walking is a great, as is light exercise that provides oxygen to your muscles – boosting energy and reducing stiffness and pain. Low-impact aerobic exercises like walking are the most effective at improving chronic pain symptoms. Walking can also help with fibromyalgia symptoms.
Stretching – This exercise increases flexibility and helps loosen stiff muscles. People who stretch often also have a better range of motion. Stretching may help alleviate some of the muscle aches associated with chronic pain.
Alternative & Homeopathic Treatment
The following alternative medicine therapies have been shown to help relieve pain symptoms:
Acupuncture – This practice involves inserting hair-thin needles into various points on the skin to regulate movement within the body’s meridian system. Numerous studies have confirmed acupuncture’s effectiveness in treating pain.
Aromatherapy – This pain management therapy uses scents from essential plant oils that are either applied to the skin or inhaled. Studies have shown a decrease in pain symptoms in people with rheumatoid arthritis, headaches, and cancer who use aromatherapy.
Chiropractic – The main focus here is the spine; most chiropractic visits involve adjustments that are designed to realign the body to promote self-healing; it has been shown to be effective for a variety of chronic pain syndromes, including lower back pain, neck pain, carpal tunnel, headaches, and sports injuries.
Massage – Massage is one of the greatest recommendations for any pain symptoms. Through manipulation of the body’s soft tissues, massage therapy influences the muscles, circulation, and lymphatic and nervous systems – several clinical studies have shown massage to be an effective pain management therapy.