Chronic pain – Characteristics and Management
It is estimated that about 20% of the population suffer from chronic pain, and it is particularly common among the elderly. Doctors emphasize that the treatment of chronic pain is one of the great challenges faced by medicine – it should be multidirectional, include various types of therapies and psychological support. In this article, we present the causes and methods of treating chronic pain.
Table of Contents
Chronic Pain – definition
There is actually no single definition of chronic pain . The most common chronic pain is unpleasant sensation that lasts for at least 3 months. However, more and more specialists also include chronic pain that occurs periodically and accompanies chronic diseases, such as cancer, fibromyalgia or rheumatic diseases.
Chronic and Acute pain differ mainly in:
duration (acute – up to about a month and until injuries heal, chronic – minimum 3 months and may continue after the tissues have healed);
intensity ( acute pain has a high intensity, while chronic usually smaller, but that does not mean that low, an example of which can be chronic migraine, the pain of the head with the highest intensity);
cause ( acute pain is most often a reaction to an injury or disease, and chronic pain is often the result of an injury or disease, or its cause remains unknown to medicine);
reception and conduction ( acute pain is primarily receptor pain , i.e. it is caused by irritation of the sensory nerve receptors, e.g. by inflammation; chronic pain is more often non-receptor, it may result e.g. from pressure or damage to the structures of the nervous system; moreover, these two types of pain are conducted by other routes).
There are many changes in the body of a chronic pain sufferer , and they involve both physical and mental aspects.
The perceptible reaction is increased muscle tension in the area of pain . In the case of chronic pain in the loin, over time, it may even lead to curvature of the spine, which is the result of excessive muscle tension. We write about the methods of treating pain in this area in the article: Lower back pain – causes and treatment of pain in the lumbar region .
Chronic pain also affects the structures and functions of the brain . People suffering from this type of pain quite often experience memory and concentration disorders, have problems falling asleep, and may be accompanied by insomnia .
When it comes to the psychological aspects of chronic pain, unfortunately it is very often associated with depression . In addition, sick people experience many negative emotions : ranging from fear to irritation to anger. Such emotions are most understandable in a situation where someone suffers, does not know the cause of the pain, and subsequent visits to a specialist and the implemented treatment does not bring relief (or only temporary). Unfortunately, they can be destructive for both the patient and his family, which is why psychological help is so important in the case of chronic pain .
Common causes of chronic (chronic) pain
It is estimated that about 20% of the population may suffer from chronic pain , with the greatest number of people complaining of chronic headache , backache , joint pain and neck pain . By origin , chronic pain can be divided into:
- osteoarticular pain accompanying e.g. osteoporosis or rheumatic diseases,
- muscle pain , often associated with fibromyalgia , but may be the result of other diseases, e.g. Lyme disease (muscle and joint pain ),
- pain of “nervous” origin , especially spinal pain (when the structures of the spine press on the nerves), neuralgia, neuropathy (diabetic, after shingles),
- pain, headache original, spontaneous way, for example. migraine or tension headaches headache and pain secondary, caused by different kinds of diseases – in the case of spontaneous headache its origin is usually difficult to determine
- pain , cancer ,
- non-specific pain , the causes of which remain unknown.
Chronic pain may be a consequence of an injury, degenerative changes, it may accompany various diseases, but unfortunately it also happens that for many years its cause cannot be found or its origin is complex (it results from many different factors). In such situations, it is most difficult to treat, but it is worth trying various diagnostic and therapeutic methods available.
Chronic Pain – A Multidirectional Approach
When we experience pain, we usually turn to over-the-counter painkillers almost automatically. While they can deal with acute pain fairly well, they are much less effective or even ineffective in chronic pain (if they cannot “find the source of the pain”, they do not bring relief). In addition, any of these measures should not be taken for longer than 2 weeks.
We always advise against using painkillers on your own – if pharmacology is to be part of the treatment of chronic pain, it should only be done under the supervision of the attending physician . We write about the possible negative effects of taking generally available painkillers, among others in the article: Alternative Pain Management .
It is virtually impossible to present a chronic pain treatment regimen , as the methods should be selected individually. In addition, the treatment of chronic pain is multidirectional or even holistic, and includes many different therapies , often used in combination. These include:
- pharmacotherapy,
- physiotherapy and physical therapy (physical treatments, such as electrotherapy, heat or cold treatment, vibrotherapy ),
- therapeutic blocks (peripheral nerves and sympathetic nervous system),
- surgical treatment, used most often when some structures put pressure on the nerves,
- psychological treatment, mainly cognitive behavioral therapy.
If the cause of chronic pain is known , the first step is to try to heal the condition . It is not always possible, for many diseases it is only possible to inhibit their development. This applies, for example, to rheumatoid arthritis or degenerative diseases. If the causes of the pain remain unknown, the doctor will focus on treating the pain and improving the patient’s quality of life.