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Posts Tagged ‘persistent pain’

You have a pesky headache, so you reach for the aspirin. You can ice a bruise to reduce swelling. When youve had surgery, painkillers are prescribed. The pain resulting from these situations may be acute but thankfully, its usually temporary. Chronic pain, though, lasts for days, months or even years, undermining quality of life. Chronic pain is common, yet managing it successfully can be elusive.

Chronic pain is a complex condition, involving the source and history of the pain how it has been treated, the perception of pain by the individual and the psychological toll it has taken. If youve experienced chronic pain, you may have suffered lethargy, fatigue, depression or anxiety. Dont ignore untreated, persistent pain; it could be symptomatic of a disease or injury that will only get worse without treatment.

How we address chronic pain

We first diagnose the source of chronic pain, and review its history, treatment, if any, and results. This may be difficult, because pain may have no discernable source, such as the widespread pain of fibromyalgia. Pain, with or without a known source is real, and should be taken seriously.

We find that a multidisciplinary treatment program is the best pain management approach, because it takes addresses the whole person, including physiological and psychological aspects of pain. Pain management is not all about medications. With appropriate medications, complementary therapies and lifestyle changes, patients engage in their recovery and gain a renewed sense of control of their lives. While a cure may not always be possible, managing pain should be.

Common causes of chronic pain i

These include headaches, back pain, arthritis, cancer pain, post-injury and post-operative pain, and neuropathic pain, which result from nerve injury. Treatment is specific to the individual. For example, someone with arthritis may need occasional over the counter medications, while another is prescribed regular aerobic exercise or physical therapy and prescription antiflammatory drugs.

Americans are conditioned to look for the quick fix, the magic pill. In some cases narcotic prescription drugs are appropriate, but the majority of chronic pain cases, theres a variety of effective and safer therapies, including some exciting new drugs. These therapies usually take more time to work, requiring more patience.

At Hanley Center, hanleycenter.org we treat many patients recovering from addictions to pain and other medications. Addiction is a brain disease with genetic components, so talk to your doctor about appropriate, non-narcotic pain medications if you have a family history of addiction, or if you are in recovery. Narcotics can also significantly change ones perception of pain, often making it intolerable. The impulse is to over-medicate. This dangerous and probably wont lesson pain in the long run.

Pain medications

Drugs traditionally used to treat chronic pain are acetaminophens, such as Tylenol, and nonsteroidal anti-inflammatory drugs (NSAIDs) such as aspirin, ibuprofen, and naproxen, such as Aleve (OTC) or Naprosyn (prescription). These drugs inhibit hormones that stimulate nerve cells the injury site, causing swelling and infection. Opioids such as morphine and codeine can be very effective for treating severe chronic pain. They block pain by locking onto opioid receptors in the brain. But they can be addictive and can cause lack of concentration, drowsiness, dizziness and constipation.

Newer drugs to treat pain have often been developed to treat other conditions such as seizures or depression. Duloxetine (Cymbalta) is an antidepressant, and is effective in treating diabetic neuropathy. Neurantin (brand Lyrica) affects chemicals and nerves in the body that cause seizures, and can treat some types of pain, as in herpes virus or shingles.

Managing pain with narcotics, other prescription medications and OTC drugs can cause serious side effects and interactions. Inform your doctor about all current medications.

The mind/body connection

Why do some people totally recover from injuries and others with similar injuries suffer for years? How a person physiologically responds to pain may determine the development of chronic pain. For example, after the initial trauma, the bodys neurological processes may cause the central nervous system to create a memory of the pain. And if the injured person relies solely on medication and doesnt carry through with prescribed physical therapy and exercise regime, chronic pain can become crippling.

There are many pain management methods. Some of these include:

• Acupuncture
• Expressive and creative therapies include art, music, movement, and journaling.
• Cognitive behavior therapy
• Massage
• Meditation
• Breathing exercises

Appropriate Exercise is important for almost anyone suffering from chronic pain. Weight bearing exercise is therapeutic for osteopina, the precursor of osteoarthritis. Try aqua-aerobics if walking is difficult. Yoga can be gentle, strenuous, or meditative. Many find Tai Chi and Jin Shin Jitsu healing.

Biofeedback: By using an electronic machine, the patient becomes aware of and gains control of muscle tension, heart rate and skin temperature, then learns to affect changes in her response to pain.

Attitude is key to successfully managing pain. Having a routine, a support system, paying attention to proper nutrition, getting adequate sleep, and not skipping exercise are all effective. Join a walking group, a gentle yoga class, the Y for aqua aerobics. Get moving and get involved.

Author: Barbara Krantz, D.O.
Article Source: EzineArticles.com
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The last few decades of research have brought to the fore the strong influence that psychological factors have on pain. It is known that different individuals differ greatly in the way that they describe their symptoms, in their propensity to consult a physician when they have symptoms and in their response to treatment(1). Also, certain data indicate that for 30 to 50% of the people who consult a doctor for pain-related symptoms, no diagnosis(2) can be determined and that for up to 80% of people suffering from back pain and headaches, there is no physical aspect enabling us to identify the reason for the pain(3).

Pain is a personal and subjective experience, modulated not only by the severity of the diagnosis, but also by the idea that the individual has of the immediate consequences of the pain on his life, the consequences to come, the estimated duration of the problem, the emotions that the pain arises within him and the strategies that he thinks are available to him to help him feel better. The intensity of the pain is therefore the consequence of a cascade of physical and psychological events that influence each other.

In short, the manner in which the individual interprets the sensorial information of pain, the long term implications as seen by the person and his perception of his capacity to face such demands(4) determine and direct “the experience” of pain. This inter-connexion between the physical and psychological aspects of pain sets out certain disadvantages but also some important advantages. Among the disadvantages, we must consider the fact that pain is disabling. We have often met people who have totally recovered physically but still feel intense pain. Another factor to consider is that pain can lead to psychological problems (depression, anxiety, somatization) and behavioural problems (drug or alcohol consumption). For people with persistent pain beyond the optimal re-adaptation period, long-term disability is almost inevitable. All of these elements give us an inkling of the usefulness of an effective structure of evaluation for people affected by pain, both on the human and financial levels, which will allow us to develop a specific (multidisciplinary) program for pain control adapted to the needs of the person.

Before being able to help a person to manage his pain, one first has to understand the nature of the pain, its impact, intensity, variations and influencing factors, the way the person interprets its consequences, and the individual’s available resources for facing the pain. Many elements play a role in the manner in which the pain is experienced. Now, when the time comes to take care of a person, we must first have a good idea of what the person is experiencing. Is it enough to ask the person to explain in clear and concrete terms what he is experiencing? Well, not really, because pain is known as being extremely difficult, if not impossible, to define with words(5). Our language and its words simply do not describe the whole meaning of pain and its impact on the person. In fact, most of the time people describe pain by using analogies: ” It’s like a knife eginning a pain management process implies asking an essential basic question: “What can be modified about the way that the pain is affecting the person and in the way the person perceives it?”. Pain is an information communicated by the body that indicates the eventual presence of physical damage. This information is not a simple electrical signal received by the brain, it is an electrical signal that takes on meaning for the person and leads to short and long-term implications. In this respect, many factors can be modified in order to diminish the pain felt. As soon as a person feels pain resulting from an accident or a disease, a series of psychological events is set in motion.

1. Does the pain involve a serious threat?

Whatever the severity of physical damage, as soon as the person perceives the situation as serious, the intensity of the pain and discomfort caused by it increase. Thus, the cause of pain, the nature of the pain, its potential duration and its consequences are all factors influencing the person when evaluating the threat that the pain represents.

2. How are the symptoms perceived?

In the short-term, symptoms generate fear, which constitutes an emotional experience which then modulates the intensity of the pain. When a person lives with pain, he or she necessarily questions the future consequences that will have to be endured. But these consequences are always perceived consequences that are more or less linked to the reality. But “what counts” for each person is his or her own reality and this reality influences his or her emotional state, which in turn… influences the pain experienced.

3. Are the strategies for facing pain too demanding and do they help to achieve concrete and effective results?

Many people in a pain situation use strategies that they think will reduce the pain but in fact which produce this paradoxical effect are: avoidance(6) (avoiding thinking about pain), inactivity (ceasing movement for fear of feeling pain) and maintaining “preventive”(7) muscular tension. Also, pain forces the person to adapt and to take action or make an effort (i.e. take part in a re-adaptation program) in order to improve the situation. In this context, if the person perceives the task as being too difficult or if he thinks he won’t benefit from his efforts, then the person becomes passive and the problem worsens.

4. And how are we doing psychologically?

Depression, fear, anxiety and passivity often become the fate of those suffering from chronic pain. A precarious psychological state does nothing to help the person get better. When this happens, the person sinks.

Each of the preceding questions has awakened our awareness that each person can “create” his or her own interpretation of pain, which then becomes the “reality” in which this person lives… with all of its consequences. The base of any pain management program must take these questions into consideration. Does the pain involve a serious threat? For the person who experienced shoulder pain for many years and who has consulted every health professionals she could, who has undergone every existing treatment offered by alternative medicine, who still doesn’t see any improvement and doesn’t foresee any improvement in the long run, the answer is “YES”. The reality for this person is that there is nothing left that can be done… until the day when we decide to adequately inquire about the nature of the shoulder pain and we realize that an instability of the stabilizing muscles of the shoulder blades are causing the shoulder pain. At this point, a specific physical therapy and muscular reinforcement program is implemented that returns the person’s condition to an optimal level… and the person’s reality changes.

The severity of the situation is no longer the same because now there is hope; an effective solution has been found, the threat disappears and leaves space for tangible results.

How are symptoms perceived? We must remember that for an individual, pain is linked to physical damage or to potential physical damage. So on the medical level, when there is nothing objective remaining to consider, we must evaluate the possibility that the person has adopted protective behaviour that is now causing him harm. This means proceeding to locomotor and behavioural re-adaptation (i.e. learning how to relax by repeating certain movements in order to avoid fear and exaggerated muscular contractions causing discomfort and pain) that will show the person that he can move without risk. On the other hand, when the cause of the pain can be objectively evaluated, it’s important to explain the impact of the disease (or the problem) to the individual and the potential for healing that he can hope for. We must never leave a chance for the person to falsely interpret what is happening.

Words which seem soothing for a health practitioner such as ” Your problem is due to wear and tear (degeneration)” can take on a very different meaning altogether in the person’s mind. All too often, what we say is very seldom what the other understands… Are the strategies for facing pain too demanding and do they lead to concrete and effective results? With regard to chronic pain, a person should never be left feeling alone. No one is really well equipped physically, physiologically, and psychologically to face pain by himself alone. The risk of developing badly adapted strategies is enormous and this can lead to disability over the long term. Education plays a key role. Teaching people how to psychologically manage pain and how to recognize behaviours harmful to the healing process constitutes an essential step for any pain management program. It’s not a matter of the person making exaggerated efforts, but rather one of adopting a new way of doing things that will produce observable results for the person.

It takes a lot of courage to face such a problem and adopt a new way of dealing with it, but in many cases the readjustment is necessary. And how are we doing psychologically? When pain affects someone to the point of suffering serious psychological repercussions, it becomes of paramount importance to treat both aspects of the problem (physical and psychological). It is then important to regularly evaluate the psychological state of the person throughout the progression of the pain treatment. The body has a difficult time healing when the mind isn’t doing well. Skimming over the nature of pain and the components of a pain management program aimed to relate the extent of possibilities (too often ignored) available to people suffering from chronic pain. It goes without saying that a pain management program does not produce miracles where all cases are able to be resolved instantaneously. However, a better capacity on the part of health professionals to analyze the problem, leading to the development of a structured and specific intervention plan, constitutes for many people the chance they were hoping for to rediscover an optimal quality of life.

Author: Denis Boucher
Article Source: EzineArticles.com
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Suffer From Chronic Pain

Each year tens of millions of Americans suffer from persistent pain known as chronic pain. Individuals with chronic pain are less able to function in daily life than those who do not suffer from chronic pain.

Chronic pain patients suffer from poor sleep quality and depressed mood rather than pain intensity, duration, or anxiety. Clinical Implications Chronic pain patients suffer from poorer quality of sleep than do healthy control subjects. Many people suffer chronic pain in the absence of any past injury or evidence of illness. Although more than one in five Americans live with chronic pain, women are more likely to suffer from chronic pain conditions than men. If you or a family member suffer from chronic pain, you know that the search for relief is an ongoing process. But some people suffer chronic pain in absence of any past injury or evidence of body damage. At least 25 percent of Americans suffer from back pain. One fourth of these individuals, back pain is chronic and unremitting.

Experience

If you’re grappling with chronic pain, one of the earliest and most wrenching emotions you experience is a deep sense of loss. In fact, a number of people with SCI experience chronic pain in areas that otherwise have no sensation. Lascelles’ experience, owners are usually more concerned about pain from surgery than pain associated with chronic conditions. The path to chronicity of pain is characterised by failed attempts to adjust and cope with an uncontrollable, frightening, and adverse experience.

Problem Of Chronic Pain

RSD or RSDS is a neurological problem and one of the symptoms is constant chronic burning pain. It is now appreciated that the phenomenon of wind-up is crucial to understanding the problem of chronic pain. Chronic pain in children is an important problem and more action is urgently required to overcome the embarrassing lack of data on childhood pain. Some believe that many factors work together to produce chronic pain, rather than a single disease or medical problem. The longer pain goes on the more susceptible it is to other influences and developing into a problem.

Source From Injury

Some people develop chronic pain out of the blue, with no injury or illness to trigger pain signals. Once chronic pain that has been caused by an injury or surgery is managed, patient recovery may be faster. an injury, and chronic pain with no identifiable pain generator (e.g. The injury transformed her into one of millions of Americans tormented by chronic pain. In stark contrast to acute pain, persists beyond the amount of time that is normal for an injury to heal. In some cases this may stem from an injury incurred during an accident or an assault.

Stress

Managing stress and managing chronic pain go hand in hand. Stress Ask most chronic pain patients what their most significant source of stress is, and they will usually tell you that it is pain. Physical, psychological, and emotional stress may worsen chronic pain. Predictors of posttraumatic stress disorder symptom severity level in chronic low back pain patients.

Prevalence

Statistical analysis The prevalence of recent pain, chronic pain, and severely disabling chronic pain were summarised as percentages of respondents with 95% confidence intervals. Croft et al [11] found the prevalence of chronic pain to be slightly lower in postal survey non-responders. A small number of previous studies have sought to collect data on the prevalence of chronic pain from non-responders. The prevalence of severely disabling chronic pain in this sample was 3.0%.

Depression

This pattern has to be changed if depression, stress, and chronic pain itself are to be conquered. This is because the consequences of chronic pain and the symptoms of depression look very similar. Depression Persons with a chronic pain problem often show decreases in meaningful and enjoyable activities. Depression is often associated with chronic pain and may need to be treated as a separate, but related, condition. Living with chronic pain can lead to loss of appetite, depression, and exhaustion. The consequences of unrelieved chronic pain in this population, similar to others, include depression, decreased socialization and sleep disturbance. Influence of chronic pain on mood and psychosocial function, utilizing age-specific scales (e.g., geriatric depression scale). Nelson and Diane…and depression in patients with chronic pain was investigated. Counselling may also be of some help in addressing the depression which so often accompanies chronic pain or illness.

Levels of anxiety, depression and self-rated health were described for respondents with severely disabling chronic pain and contrasted with respondents reporting no pain. Psychological therapy for anxiety and depression is helpful in managing the emotional consequences of chronic pain. This is not the case and if somebody has chronic pain and depression, ‘you have to treat both’, he says. Our research provides further evidence that chronic pain and depression are quite independent”, Dr Clauw said. There are many factors that affect the development of chronic pain such as age, level of disability, depression, or the presence of nerve damage. Schatzberg suspects that the presence of chronic pain should be added to this list as a symptom for assessing depression.

Please continue with Chronic Pain Syndrome And Chronic Pain Management And Treatment – Part II

Author: Richard Lim
Article Source: EzineArticles.com
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