Living With Chronic Pain

Defining Chronic Pain

According to multiple studies, it’s estimated that between 20-30% of people in this country suffer from what the CDC terms “high-impact chronic pain,” which is pain severe enough that it frequently limits life or work activities. But chronic pain syndrome (CPS) is a common problem that presents a major challenge to health-care providers because of its complex natural history, unclear etiology, and poor response to therapy. CPS is a poorly defined condition. Most authors consider ongoing pain lasting longer than 6 months as diagnostic, and others have used 3 months as the minimum criterion.

Some authors suggest that any pain persisting longer than the reasonably expected healing time for the involved tissues should be considered chronic pain. Under this guideline, its believed that the actual number of chronic pain suffers is closer to 35%, and approximately 50 million Americans are partially or totally disabled due to it. That means if you don’t suffer from it, in all likelihood someone you care about or know at work, does.

Pain is one of the most common reason people seek out medical care. Chronic pain is very different from acute pain. Acute pain is what you experience when you get hurt—say, when you break a bone or burn your hand—or when something goes wrong in your body, such as indigestion, appendicitis, or a passing kidney stone. Acute pain is like an alarm system. It tells you your body is being or has recently been damaged so that you can do something about it.  Chronic pain is like an alarm that’s malfunctioning or goes off when it doesn’t need to, like a smoke alarm with a dying battery. We’ve all had that neighbor whose car alarm goes off any time a cat walks by or the wind blows, waking you up in the middle of the night. Everyone on the street knows they don’t need to call 911 or come flying up out of bed to chase off a thief, and yet that alarm still has an impact on your life.

Acute pain can turn into chronic pain. Years ago, medical science didn’t understand why pain lingered after something was healed. Often, they’d say the pain was “all in your head.” More recently, though, researchers have discovered that acute pain sometimes changes how our brains are wired. When you sense pain, your nerves are detecting a problem and sends this information to the brain. It in turn then sends signals out to the body aimed at removing danger and directing the healing process. When signals are constantly going back and forth, it’s like your nervous system gets in the habit of sending them, and sometimes, it just doesn’t stop, even when it should. The physical structures that carry those signals have changed, similarly to how pathways in your brain change when you learn a new skill. It becomes a never ending loop.

Chronic pain can limit quality of life and lead to additional, serious health problems. Finding effective treatment is important — as is balancing pain relief with safety. Treatments are available to help you to live with pain. There is no cure. I think that’s the hardest message for patients to hear- it’s a life-long issue. But no different in that respect to living with any other long term medical issue such as high blood pressure, diabetes, high cholesterol, or obesity. I write these posts not just to help those with chronic pain but those who’s lives are impacted by anyone who suffers from this condition. Their lives are impacted as well.

I recently traveled over the holiday and how I traveled was significantly affected by my pain. In many ways it chose my destination- close enough to afford a short flight with no lay overs i.e. Los Angeles. I required extra pillows and blankets to make the bed tolerable. I interrupted another’s sleep repeatedly by having to move frequently during the night or take a bath to relieve the pain. Our daily plans were altered to suit my needs and concerns. This is the rule, not the exception, for those living in pain and their loved ones.

Chronic pain is a serious health condition. Like any long-term health problem, the condition often leads to complications beyond your physical symptoms, such as new or worsened depression, anxiety and difficulty sleeping. Chronic pain can make it more difficult to keep up at work, manage tasks at home and attend social gatherings, leading to problems in your relationships and financial instability. Some research suggests that the more severe your pain, the more serious these problems.

Finding effective treatment is imperative. Unfortunately, this process is complex and uniquely personal. What works for one person’s chronic low back pain may not offer any relief for another’s osteoarthritis. Your diagnosis, biology and personal history all play a role, and finding pain therapies that bring you adequate relief can be a lengthy endeavor. Working in partnership with your provider can identify treatments that allow you to live an enjoyable, fulfilling life. The approach you choose should include more than just medications, including weight loss if necessary, exercise, and a healthy diet. It’s a path that may need constant tweaking to improve the benefits. Tell your provider what helps, what doesn’t. Don’t give up. In this day and age there are alternatives that can work for you.

I’m living proof of that.

dsc_0323    –Dr. Courtney

-mayoclinic.org/chronic-pain-medication-decisions/art-20360371

-medlineplus.gov/magazine/issues/spring11/articles/spring11pg5-6.html

-verywellhealth.com/what-is-chronic-pain-4134684

-emedicine.medscape.com/article/310834-overview

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