Tens of millions of Americans suffer from chronic pain. In fact, one in every three people is dealing with chronic pain as I write this report. Chronic pain can be mild or excruciating, episodic or continuous, merely inconvenient or totally incapacitating. With chronic pain, signals of pain remain active in the nervous system for weeks, months, or even years. This can take both a physical and emotional toll on a person.
What causes chronic pain? Chronic pain is often caused by more than one problem. For example, an injury to the spinal area may eventually become arthritic. Prolonged exposure to this chronic pain might then produce fibromyalgia symptoms to complicate the area’s entire pain picture and treatment possibilities.
One Sun City resident’s son, who has had these pain complaints since 2000, which resulted in job disability, tells us that he has visited seven pain management physicians in that time period to no avail. Because the 41-year-old is on psychiatric medicine, the stronger pain medicines cannot be used due to dangerous side-effects.
“I take Ibuprofen and Tylenol daily to slightly lessen the pain,” he said. “I swim at least 11-and-a-half miles about three times weekly to strengthen my back muscles and relieve myself of tension that the pain produces.”
Pain problems may also include damage to the nerves or tissues, such as skin, muscles, and organs. Long-term diseases, hormonal changes, physical injuries caused by surgeries or accidents, and problems with the body’s chemicals that send pain messages to and from the brain may cause or trigger chronic pain. In some cases, there may be no clear or exact cause of chronic pain.
The emotional toll of chronic pain can make pain feel worse. Anxiety, stress, depression, anger, and fatigue interact in complex ways with chronic pain; they may decrease the body’s production of natural painkillers. Such negative feelings may then increase the level of substances that amplify sensations of pain. This causes a vicious cycle of pain for the person. The body’s most basic defenses may be compromised, for there is considerable evidence that unrelenting pain can suppress the immune system.
To substantiate the individual’s unique role in feeling the pain response is the belief of a leading pain researcher stating that pain is a variable personal experience. Roger B. Fillingim, Ph.D, Professor of University of Florida College of Dentistry, told his audience at the American Pain Society’s Annual Scientific Conference in May 2009 that pain is a variable personal experience that is influenced by genetics but also involves multiple interactive biopsychosocial processes. This opinion helps us to understand why two patients undergoing the same surgical procedure by the same physician may express completely different levels of post-operative pain.
Indeed, besides genetics coming into play here, age, sex, race, ethnicity, and personality have all been associated with pain responses. As stated above, situational variables like mood, stress, and cognitive processes also are “at play.” Fillingim suggests to pain clinicians that knowing the social and psychological situations of their patients can be helpful in gauging responses to pain and to morphine and other medications.
Next Week: Part 2: Treatment for pain relief
