In order to
effectively treat chronic pain you must first distinguish it from
acute pain. Acute pain is caused by tissue damage, and its source is
usually obvious such as a burn or even possibly a bee sting. Although
acute pain may be intense it usually is very short lived. Acute pain
is usually repaired through the natural healing powers of the body and
the pain eventually fades away. Sometimes individuals will take some
type of pain killer for interpreting time until the body has a chance
to repair the tissue damage.
In contrast to
acute pain, chronic pain is persistent and the nervous system
continues to transmit pain impulses for months or even years.
Musculoskeletal injury and inflammation usually lie at the root of
some forms of chronic pain. Other forms of chronic pain may include
rheumatoid arthritis, cancer, or coronary artery disease. In many
cases the original cause, such as a herniated disc or tumor may be
successfully treated, yet the pain will remain and sometimes even get
worse. This type of chronic pain, which is often out of proportion to
the original injury, arises from nerve damage and is term neuropathic
pain.
Neuropathic pain
can occur whenever nerves have been damaged. Until recently,
neuropathic pain has usually referred to specific pain syndromes such
as postherpetic neuralgia, the intense pain that frequently follows
shingles; tic douloureux (trigeminal neuralgia), a condition marked by
searing jolts of facial pain; and diabetic peripheral neuropathy, a
form of nerve damage that leads to numbness and pain in the hands,
feet and legs. It is becoming increasingly clear that a larger array
of conditions may fall under the category of neuropathic pain. Pain
syndromes that are associated with amputations, spinal cord injury,
migraines, multiple sclerosis, mastectomy, and Parkinson's disease are
now also believed to be examples of neuropathic pain. Also, doctors
are now starting to believe that some forms of lower back pain may
have a neuropathic component.
Regardless of the
source of the chronic pain, it is believed that cortisol is triggered
and other hormones that can have a significant effect on an
individual's immune system and mental health. Also, research has
continued to identify some of the changes underlying chronic
neuropathic pain. It is believed that our nervous systems are very
flexible; the nerve circuits that transmit pain impulses can become
"rewired" after nerve injury and consequently lead to persistent
pain. If the pain remains untreated, these wiring changes can then
become permanent, resulting in progressive as well as more severe and
widespread chronic pain.
Chronic pain is
believed to affect 50 million Americans. Over time, chronic pain may
cause a destructive physiologic response characterized by fatigue,
mood disorders, brain hormone abnormalities, muscle pain, and other
physical as well as mental impairments. Chronic pain may set off a
vicious cycle of stress and disability that eventually raises a
person's sensitivity to pain. Uncontrolled, chronic pain can disrupt
an individual's family life, work life and income, it may lead to
depression, isolation and anxiety. The key to breaking this damaging
cycle is to treat chronic pain early and effectively.