Recall the pain you experienced when you had an intermediate degree headache or the back pain that haunted you for a few hours or the pain of accidentally hitting your elbow joint against the wall. These types of pain that we experience are classified as “acute pain” and they don’t last long. Now imagine experiencing this pain over long periods of time like a few months. This then becomes “chronic pain”. Chronic pain can be caused by an old or current injury or infection or sometimes, there may not even be any body damage or injury. An untreated acute pain may lead to chronic pain.
Pain is subjective and cannot be quantified. Chronic pain varies in the range from “I can bear this” to “even death is a preferable to this torture”. The pain is a mere inconvenience in the former case and incapacitating in the latter. A chronic pain can occur in any part of our body or in one of the many muscles. It can be sporadic or continuous. Because of this chronic pain, pain signals will be active in the nervous system for a long time, sometimes for years. Therefore, it may persist even if the underlying cause is cured.
Understanding Chronic Pain:
In addition to the physical pain, there is the emotional or psychological effect of chronic pain on the patient. Because of the constant pain, the patient may experience feelings of anger and anxiety, which may lead to stress and depression. It can, therefore, interfere with the production of certain chemicals in the body which can act as natural painkillers. Adding to that, the negative feelings the patient may experience can cause the production of chemicals that increase the sensation of pain. There is substantial evidence that chronic pain can even suppress the immune system.
As mentioned earlier, pain is subjective i.e. it varies with the person. For example, two persons who suffered similar injuries might experience varying amounts of pain. There is no instrument that can measure pain. Doctors rely on patient’s description of pain like whether it is dull or sharp, sporadic or continuous and other details to estimate the strength of the pain and prescribe medicines. Because of this characteristic of pain, chronic pain is not yet fully understood. A quick visit to some of the online chronic pain support groups will reveal just how differently everyone describes their pain. An effective treatment for chronic pain is ‘Pain Management’. Pain management can be done through many ways, of which a few are discussed below.
These drugs are used to treat or cure the underlying cause of the pain (if any). These include pills for a headache or other symptoms which may be the cause of the pain. These are prescribed by the doctors after intense scrutiny and analysis of the situation. While using these drugs, one has to be aware of the side effects of these drugs and their compatibility with the patient depending upon his/her medical history.
The psychotropic drugs are used to alter the mental condition. These are used to treat the mental or emotional effects of chronic pain, like stress, anxiety, and depression among others. Apart from that, some of them also relax the muscles and on some occasions, can relieve the pain. But doctors prefer them less and only use them after they have tried the painkillers mentioned earlier.
Many people don’t know the relation between exercise and pain relief. Some are confused when their physicians prescribe routine physical exercise for back pain or knee pain. Regular exercise, even a moderate one like walking, can improve the blood flow to muscles, thereby increasing the oxygen flow. Exercise also causes the production of endorphins in the brain which blocks the pain signals and helps in controlling our emotions like fear or stress. But we have to be careful to follow the prescribed exercise regimen and not overdo it.
This concept is very simple. The pain from any area is relayed to the brain in the form of electrical and chemical signals through nerves and the nervous system. So, in this method, the signals are blocked or the nerves are numbed, thereby preventing the transfer of information about the pain. This can be achieved through the use of chemical agents (like anesthetics) or through surgery (like neurectomy). Different parts of the body require different types of nerve blocks. Although enough care is taken by the physician in prescribing this method, one has to be wary of the side effects of this process which may vary from itching, rashes and weight gain to bleeding, the rise in blood sugar or even death in very rare cases.
This a mysterious practice and to some extent, controversial. A placebo is an inactive substance (e.g. sugar pills) or an innocuous procedure (e.g. administering saline) used to augment the effect of active treatments. Some argue that the effect of placebo is psychological while others say that it reduces the pain by stimulating the release of natural painkillers in the body. Still, others believe that this works by reducing the negative feelings of the user like stress or anxiety, halting the release of chemicals that contribute to the pain. Placebos don’t have any direct side effects. But one has to remember that this is an ‘expectation effect’, which means the patient experiences what he/she expects. So, depending upon the perception of the user, some unpleasant symptoms like a headache or nausea may be observed. This is called ‘nocebo effect’.
On the whole, chronic pain is a difficult situation, but not an impossible one to deal with. Both, the patient and the family should be aware of this condition and different pain management regimens and make living with chronic pain easier. Throughout history, many chronic pain patients were mistaken for hypochondriacs or attention seekers and suffered a lot due to the negligence of the family or the doctors. Even today, this is the situation in places with no awareness of this condition. That has to change; the seriousness of this condition, which can ruin lives if not properly treated, should be made aptly clear for everyone.