Chronic Pain: Won’t it just go away?
Chronic pain is believed to affect 50 million Americans. Over time, chronic pain may cause a destructive physiologic response characterized by fatigue, mood disorders, brain hormone abnormalities, muscle pain, and other physical as well as mental impairments. Chronic pain may set off a vicious cycle of stress and disability that eventually raises a person’s sensitivity to pain. Uncontrolled, chronic pain can disrupt an individual’s family life, work life and income, it may lead to depression, isolation and anxiety. The key to breaking this damaging cycle is to treat chronic pain early and effectively.
Types of pain: Acute and chronic pain
In order to effectively treat chronic pain you must first distinguish it from acute pain. Acute pain is caused by tissue damage, and its source is usually obvious such as a burn or even possibly a bee sting. Although acute pain may be intense it usually is very short lived. Acute pain is usually repaired through the natural healing powers of the body and the pain eventually fades away. Sometimes individuals will take some type of pain killer for interpreting time until the body has a chance to repair the tissue damage.
In contrast to acute pain, chronic pain is persistent and the nervous system continues to transmit pain impulses for months or even years. Musculoskeletal injury and inflammation usually lie at the root of some forms of chronic pain. Other forms of chronic pain may include rheumatoid arthritis, cancer, or coronary artery disease. In many cases the original cause, such as a herniated disc or tumor may be successfully treated, yet the pain will remain and sometimes even get worse. This type of chronic pain, which is often out of proportion to the original injury, arises from nerve damage and is term neuropathic pain.
Neuropathic pain can occur whenever nerves have been damaged. Until recently, neuropathic pain has usually referred to specific pain syndromes such as postherpetic neuralgia, the intense pain that frequently follows shingles; tic douloureux (trigeminal neuralgia), a condition marked by searing jolts of facial pain; and diabetic peripheral neuropathy, a form of nerve damage that leads to numbness and pain in the hands, feet and legs. It is becoming increasingly clear that a larger array of conditions may fall under the category of neuropathic pain. Pain syndromes that are associated with amputations, spinal cord injury, migraines, multiple sclerosis, mastectomy, and Parkinson’s disease are now also believed to be examples of neuropathic pain. Also, doctors are now starting to believe that some forms of lower back pain may have a neuropathic component.
Regardless of the source of the chronic pain, it is believed that cortisol is triggered and other hormones that can have a significant effect on an individual’s immune system and mental health. Also, research has continued to identify some of the changes underlying chronic neuropathic pain. It is believed that our nervous systems are very flexible; the nerve circuits that transmit pain impulses can become “rewired” after nerve injury and consequently lead to persistent pain. If the pain remains untreated, these wiring changes can then become permanent, resulting in progressive as well as more severe and widespread chronic pain.
Some Information adapted from The Johns Hopkins Medical Guide to Health After 50
Additional Information and webpage by Paul Susic Ph.D. Licensed Psychologist