Chronic pain: symptoms, causes, treatment

Chronic pain is a type of disease that causes tissue damage that can last for months to years. The most common conditions are osteoarthritis, rheumatoid arthritis, migraine, and tendinitis carpel tunnel syndrome. Chronic is different from acute pain. Acute pain is a short-term sensation that alerts us to injury.

Chronic pain is pain that lasts more than 3 months. Your nervous system receives constant pain and aching signals from your body for months and even years. Sometimes, pain affects lifestyle habits, leading to insomnia or poor sleep quality, irritability, depression, mood swings, anxiety, fatigue, and loss of interest in daily activities. Because the mind and body are intertwined, treatment for pain involves controlling both the physical side of the disease and the psychological aspects of the condition.

How to measure the level of pain?

The World Health Organization (WHO) has defined "pain levels" of pain based on three levels: mild, moderate and severe.

• Mild pain: Mild pain may go away with or without drug therapy. Although you can use mild pain relievers to heal quickly.
• Moderate pain: moderate pain is worse than mild pain. This can affect the ability to carry out daily activities. Pain is difficult to ignore and may take strong medication to treat the pain. However it will disappear after a while and does not come back after being treated.
• Severe pain: severe pain is defined as pain that interferes with all activities of daily living. The person may only be able to lie down or sit all day because of the severity of the pain. Often, it doesn't go away, and treatment has to be continuous for days, weeks, months, or years.

Causes & Risk Factors

What are the causes of chronic pain?

Chronic pain has many causes. Pain naturally comes with age. As you get older, your cells start to break down. Often times this damage occurs first to bones and joints. Nerve cells can also be damaged and possibly cause chronic pain.

Some types of chronic pain result from an unhealthy lifestyle. Poor posture, frequent lifting of heavy weights, being overweight, or being injured can all cause pain.

Disease can also be an underlying cause of chronic pain, for example, rheumatoid arthritis, osteoarthritis and fibromyalgia. Long-term pain may also result from cancer, multiple sclerosis, heartburn, and gallbladder disease.

In many cases, the sources of chronic pain can be very complex. Even though it may start with an injury or illness, ongoing pain can develop a psychological dimension after the physical problem has healed. This makes it difficult to find effective treatments for pain.

Risk factors

Who is at risk for chronic pain?

There are several factors that can affect your risk of developing chronic pain:

• Chronic pain develops in the elderly due to degenerative diseases and disorders.

• Genetic factors can make you more sensitive to pain. Some conditions such as migraines are linked to gene problems.

• African and Hispanic descent appear to be at greater risk for chronic pain.

• Obese people often have poor health and are more prone to chronic pain.

• Injury or trauma that occurs as a child often causes chronic pain.

• Certain mental illnesses that affect the brain's perception of pain, such as depression or anxiety.

• Abnormal brain structures with too many pain receptors can decrease pain tolerance.

• Injuries related to work or certain aspects of work, such as jobs that require lifting weights, can increase the risk of chronic pain.

• Chronic pain has been linked to chronic stress and post-traumatic stress disorder.

• Smoking increases the risk of conditions that cause pain. Smoking also causes your body to respond poorly to pain management therapy.

Signs & Symptoms

What are the signs and symptoms of chronic pain?

Chronic pain is often defined as pain that lasts more than 12 weeks. The pain can be described as:

• Mild or severe pain.
• Burning, aching, or painful feeling in part or all of the body.
• Pain that causes discomfort, soreness, tightness, or stiffness.

How will pain affect my life?

Pain will interfere with your daily life, limit your movement, and reduce flexibility, strength, and stamina. An estimated 20% of American adults (42 million people) report that pain or physical discomfort interferes with their sleep several nights a week or more. This can lead to other psychological problems such as depression or insomnia.

Although therapies are available to reduce pain for those dying of cancer, more than half of all hospitalized patients experience pain in the last days of their lives. Research shows that 50-75% of patients die from moderate to severe pain.

Complications

What are the complications of chronic pain?

Long-term pain can lead to several complications. These complications can include:

• Anxiety

• Depression

• Avoiding things / activities that cause pain

• Trauma is linked to the cause of pain

• Dependence on painkillers

• Difficulty finding work

• Stress with finances due to unemployment or unpaid medical bills

• Lack of sleep

• Poor concentration and short term memory

• Health problems related to stress, such as headaches, indigestion, diarrhea, increased blood pressure

• People either ignore or don't believe that you are sick

• Decreased participation in the family because of illness or because it will cause pain

• Not being able to help and others not understanding

• Lack of regular daily schedule & feeling aimless

• The feeling of being lost in life, having no direction.

If your pain is caused by any of the complications above, please contact your doctor for medical assistance. Your doctor can help you find effective treatment options to help manage pain and prevent further complications.

Medicines & Medicines

How is chronic pain diagnosed?

Chronic pain is often caused by pain from the internal organs. Pain from the internal organs is more difficult to diagnose than pain from the external body. Furthermore, each person's pain tolerance makes the diagnosis very personal and subjective. The doctor will depend on each pain description of the pain, level of pain, duration of occurrence and place of occurrence.

This description will help your doctor evaluate your pain and find out the best treatment. Treating pain requires a team of healthcare professionals and you need to communicate with this team throughout the treatment for the best results. Family and friends are part of the treatment too.

You can share with your doctor whether it is possible for you to go to work, go shopping, exercise or sleep.

Sometimes, the only measure of treatment effectiveness is that the patient can do certain things that were not possible before treatment was started. This is what doctors need to know in order to make decisions about patient care.

Your doctor will also do a physical exam, and may order blood tests or X-rays. Tests used to diagnose the cause of pain can include:

• CT or CAT scan
• MRI
• Discography
• Myelograms
• EMG
• Bone scan
• Ultrasound imaging

Treatment

How is chronic pain treated?

The goal of treatment is to reduce pain and improve function, so that the person can continue with daily activities. The following treatments are one of the most common ways to manage pain.

• Medicines such as pain relievers and medicationnonsteroidal anti-inflammatory (NSAIDs), paracetamol, corticosteroids, and anticonvulsants.
• Acupuncture, electrical stimulation, nerve blocks, or surgery.
• Psychotherapy, relaxation therapy, and behavior modification.
• Complementary or alternative medicine /complementary or alternative medicine (CAM) along with tai chi, acupuncture, meditation, massage therapy, and similar treatments.
• Practice good self-care such as meditation, get enough sleep, stay active and engage in family activities. Some of the patients who participated in the self-management program had significantly improved their ability to manage pain.

How can I manage my chronic pain?

Even if you can't cure chronic pain, you can have ways to control the pain. It is often said that positive thinking can make pain less.

• Eat and exercise to achieve a healthy weight and be physically fit.
• Quit smoking.
• Manage your stress by exercising, meditating, or doing other stress-relieving things.
• Seek help if you have depression or anxiety.
• Take safety precautions to limit the risk of injury in the workplace.

It is not always great for chronic pain relief. The patient's goal may be simply to be able to carry out more normal activities in daily life as before.