Chronic pain is lasting and persistent pain. Pain signals keep firing in the nervous system for weeks, months, even years. There may have been an initial trigger of the pain, such as a sprained back, or serious infection. There may also be an ongoing cause of pain, such as arthritis, or cancer. However, some people suffer chronic pain in the absence of any continuing source of injury. Common chronic pain complaints include headache, low back pain, cancer pain, arthritis pain, neurogenic pain (pain resulting from damage to the peripheral nerves or to the central nervous system itself), psychogenic pain (pain not due to past disease or injury or any visible sign of damage inside or outside the nervous system). Analgesics, acupuncture, local electrical stimulation, and brain stimulation, as well as surgery, are some treatments for chronic pain. Psychotherapy, relaxation and medication therapies, biofeedback, and behavior modification may also be employed to treat chronic pain.
There has been much discussion in the medical community as to what is chronic pain. Some believe that chronic pain is centrally generated pain produced by abnormalities within the mind/brain system. In many cases, the pain may have begun as a result of some peripheral injury; however, the persistence of pain after the injury has healed is likely the result of psychological factors. Chronic pain, in the sense of persistent or recurring pain, can also involve peripheral factors. For some these may play a significant role, whereas for others peripheral nociception may be entirely absent.
Medical treatment approaches to chronic pain can be divided into two broad categories depending on the goal of treatment. These can be referred to as curative and symptom-focused approaches. The first category includes repetitive efforts to resolve, repair, or eliminate the underlying physical mechanism presumed to be responsible for the pain. The second category consists of treatment approaches aimed at alleviating the pain symptom. Some of these approaches, such as medication, are aimed at temporarily alleviating the pain itself or other associated symptomatic consequences of chronic pain such as depression, anxiety, sleep disturbances, and muscle spasm. Others, primarily neurosurgical procedures attempt to eradicate the pain primarily by destroying nerve mechanisms presumed to transmit pain impulses.
When one experiences chronic pain, it has a direct relationship on one’s emotional reactions. Chronic pain often causes anxiety, fear, depression, frustration, irritability, impatience and anger. Unfortunately the emotional responses triggered by chronic pain acts as a Catch 22 that only exacerbates the sensation of pain.
Chronic pain also interferes with one’s cognitive activities including memory, judgment and problem solving capabilities. These cognitive problems only become worse with increased medication use.
When one suffers from chronic pain the person often becomes deconditioned. When one experiences chronic pain, one generally stops engaging in the activities that increase the sensation of pain. By ceasing physical activity, one’s body becomes deconditioned. There is decreased muscle tone and increased joint stiffening and bone demineralization. There is also a loss aerobic fitness and many people experience unwanted weight gain. Deconditioning, just like adverse emotional responses, plays a role in the vicious cycle of people with chronic pain.
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