Managing & Coping with Chronic Pain

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Category: Chronic Pain Articles Published on Thursday, 07 February 2013 Written by Yong Tsai, MD
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Do you or someone you love suffer from relentless pain? Have you become frustrated with your poor response to different treatment? Maxine was, until she decided to take control of her situation.

Her first course of action was to become educated about her pain. And in doing so, she learned that our natural protective response system, known as “pain”, alerts us when injuries such as tissue damage occur by creating an unpleasant sensation. Located within nerve endings throughout our body, pain receptors are able to detect tissue damage when injury, inflammation, or disease occurs, sending signals to our brain, which in turn processes these signals and interprets pain.

Acute pain occurs as a response to injury or inflammation to protect the affected area from further damage and resolves itself as the healing process takes place. On the other hand, chronic pain is a harmful state that is of no benefit to an individual, which is caused by improper processing and interpretation of pain signals by our central nervous system. Even though the original injury appears to be healed, its associated pain remains and evolves into chronic pain, most commonly influenced by past experience, memory, social or cultural ties.

Different conditions can cause chronic pain: chronic arthritis and spinal stenosis, which create irreversible structural changes, neurogenic pain such as postherpetic neuralgia and reflex sympathetic dystrophy (RSD), which damage nerves, and certain instances of fibromyalgia, which shows no indication of injury. In Maxine’ case, chronic pain was due to osteoarthritis and fibromyalgia.

“Having pain all the time” can greatly affect you and your family’s life because of its associated depression, insomnia, anxiety, anger, abnormal behavior and poor physical conditioning creating a vicious cycle of “pain-depression-insomnia-pain”. Maxine found herself miserable, and unable to focus on anything but her pain, not even her family.

Finally, Maxine found the ideal chronic pain management strategy with the help of a multidisciplinary treatment regimen, which has been effectively applied at large medical centers, that incorporates the expertise of a rheumatologist, physical therapist, invasive pain specialist, psychologist, and psychiatrist as opposed to treatment for pain relief with the use of analgesics alone. Specific treatment options such as medications (non-steroidal anti-inflammatory drugs, analgesics, anti-depressants, muscle relaxants), injections (trigger point, joint, spinal cord), or other invasive procedures (acupuncture, spinal cord stimulation, nerve block, morphine pump, surgery), are appropriately coordinated.

Despite the fact that chronic pain is difficult to cure, the key to success largely relies on the patient’s understanding of their condition, as well as their willingness and determination to be pro-active in managing their pain. Maxine did it, and so can you!

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