Chronic Pain

Chronic Pain

Alternate Names

  • pain
  • pain management

Definition

Chronic pain can be described as pain that lasts long enough, or is intense enough, to affect a person's normal activities and well-being. It may continue over a long period of time, or it may come and go. Any area of the body can be affected.

What is the information for this topic?

Pain is the number one reason why people see their healthcare professionals. Roughly one in 10 people reports having chronic pain. This pain can occur anywhere in the body and may vary throughout the day, month, and seasons. Chronic pain affects not only the person who has it, but also his or her family.
Treating it means paying attention to the emotional, psychological, physical, social, and spiritual needs of the person in pain. The first step in managing chronic pain is finding its cause. This will help determine treatment options.
A healthcare professional must learn:
  • about the person's general health
  • whether the person has had health problems, injuries or surgeries that may have contributed to the pain
  • whether any treatments have been tried for the pain
Once these questions have been answered, a plan for managing the pain can be developed. There is no single way to deal with chronic pain. This is true even for people whose pain is caused by the same disease or condition. Every person has a unique response to pain and pain management. That is why it is important to evaluate the person's needs as well as the physical pain.
The person in pain plays an integral role in any treatment plan. He or she needs to understand the reasons for the pain, as well as the ways to manage it. A Patient's Bill of Rights has been established for people dealing with chronic pain. It stresses that each person has the right to:
  • be treated considerately and respectfully
  • know everything about his or her diagnosis and prognosis
  • know about all the available treatments
  • accept or refuse any recommended treatment
Most plans for handling chronic pain are multi-disciplined. People may see a variety of healthcare professionals, including:
  • doctors
  • psychologists
  • physical therapists
  • anesthesiologists
  • acupuncturists
  • other complementary healthcare providers
Pain treatment teams usually meet to share information so that care is coordinated and monitored over time. Treatment options can include:
  • nonsteroidal anti-inflammatory drugs or NSAIDs long term,(daily use of such drugs can cause kidney failure).
  • sympathetic blockades, or nerve blocks
  • corticosteroid injections
  • neurostimulation therapy. These therapies include transcutaneous electrical nerve stimulation or TENS, spinal cord stimulation or SCS, and peripheral nerve stimulation or PNS. The stimulation of nerves, usually through a low electrical current, has been shown to relieve chronic pain.
  • surgery
  • antidepressant drugs
  • opioid or narcotic drugs
  • physical therapy
  • occupational therapy
  • psychotherapy
  • biofeedback
  • relaxation training
  • acupuncture
These therapies can be overseen by physicians or by other healthcare professionals practicing either from a conventional medicine or a complementary medicine (such as chiropractic) model.

New options in conventional and complementary medicine arise all the time. This can be both helpful and confusing to the person in pain. That is why managing chronic pain usually involves a team of specialists that understand the variety of options available. It takes patience and time to figure out which treatment or combination of treatments works best.
A person's needs for pain control may also change over time. Careful monitoring of pain and pain relief is essential. The person who has chronic pain plays a key role in pain management. He or she must work with the healthcare professionals to decide on treatment, then monitor and report on how treatments are working.
A person with chronic pain can do other things to help, including:
  • exercise to keep muscles toned. Toned bodies feel less pain.
  • recognize emotions and stress. Stress makes pain worse. Stress management tools improve pain control.
  • focus on personal priorities outside of the pain. It helps to set and meet goals. Successful pain management means learning to make pain part of life, rather than the whole life.
  • understand each patient's rights. A person should settle for nothing less than respectful care and being listened to by all healthcare professionals.
Finally, many people with chronic pain find it valuable to speak with others who suffer from it. Many self-help groups allow people to share ideas, strategies, struggles, and successes. Talking with others can offer more help to the person with chronic pain and give him or her a chance to help others.

Sources

American Chronic Pain Association, The Ten Steps For Moving From Patient To Person, PO Box 850, Rocklin, California 95667. [hyperLink url="http://www.atheacpn.org/" linkTitle="www.atheacpn.org"]www.atheacpn.org[/hyperLink]

Goldman B., Chronic Pan and the Search for Alternative Treatment, Journal of the Canadian Medical Association 145[5]: 508-513, 1991

Clark, AJM, Chronic pain- is anything new? Canadian Journal of Anesthesiology 42[5] Part ll: R55-R61 1995

Quality Improvement Guidelines for the Treatment of Acute Pain and Cancer Pain, Consensus Statement, American Pain Society quality of Care Committee JAMA December 20, 1995 Vol. 274, No.23

Practice Guidelines for Chronic Pain Management, A Report by the American Society of Anesthesiologists Task Force on Pain Management, Chronic Pain Section Anesthesiology 1997; 86-995-1004 [c] American Society of Anesthesiologists, Inc. Lippincott-Raven Publishers.

American Academy of Pain Management, Patient Bill of Rights.13947 Mono Way #A Sonora, California 95370. Email: [hyperLink url="mailto:aapm@aapainmanage.org" linkTitle="aapm@aapainmanage.org"]aapm@aapainmanage.org[/hyperLink]

« Back