What is chronic pain?

Chronic pain is often defined as any pain lasting more than 12 weeks, and can range in intensity from mild to severe. Most types of pain resolve after the physical injury heals. However, chronic pain can last for months and even years after the physical injury heals. In fact, chronic pain can even occur when there’s no known trigger for the pain. Chronic pain has reached epidemic proportions in Canada and US, with millions of people suffering from it on a daily basis. Since chronic pain is psychologically difficult to endure, it can often trigger anxiety and depression. This debilitating condition is often associated with other health problems, including fatigue; sleep disturbance, decreased appetite, and mood changes.

What are the causes of chronic pain?

Chronic pain can be caused by a variety of conditions. Chronic pain may arise from physical injury, such as a back sprain, or by an ongoing illness. Sometimes, there is no clear cause which can be found. Chronic pain can change the way neurons (nerve cells in the brain and spinal cord) transmit and process sensory information, and become hypersensitive to pain messages.

Chronic pain is often associated with conditions which cause long-lasting pain. These include the following:

Osteoarthritis

This is the most common form of arthritis, affecting millions of individuals worldwide. In osteoarthritis, the protective cartilage on the ends of bones wears down due to “wear and tear.” This causes increased friction, and pain and inflammation at joints. Although osteoarthritis can damage any joint in your body, the disorder most commonly affects joints in your hands, knees, hips and spine.

Accidental injury

Often, the source of chronic pain comes from accidental injury, for example from falling down or being involved in a car accident. The pain from an accidental injury can persist for years after the actual physical injury is healed.

Rheumatoid arthritis

This is an autoimmune disease, which causes the cells of the immune system to attack the body’s joints. It results in pain, redness, stiffness and inflammation and often causes chronic pain.

Fibromyalgia

This is a neurological condition that causes widespread pain and tenderness all over the body. Fibromyalgia affects the muscles and soft tissue, and often involves increased sensitivity to pain, fatigue (extreme tiredness) and muscle stiffness.

Cancer

Cancer pain is often chronic in nature. It is often caused by the tumour pressing on bones, nerves or other organs in the body. Sometimes, this type of pain comes from nerve changes due to cancer pressing on nerves or chemicals produced by a tumour. It can also be caused by nerve changes due to cancer treatment.

Back pain

Chronic pain often arises from back pain. The pain may come from back muscle strain, spinal nerve compression, or spinal stenosis (arthritis of the spine).

What are the treatments options for chronic pain?

The goal of chronic pain treatment is to reduce pain and improve function, so the individual can resume daily activities. There are many treatment options for chronic pain treatments, and they typically depend on the cause of pain. They include the following:

Pain medication

Pain medication used to treat chronic pain include non-steroidal anti-inflammatory drugs (NSAIDs), steroids, muscle relaxants, antidepressants with pain-relieving qualities and, in severe cases, opioids. Opioids are powerful painkillers, and include drugs such as oxycodone, codeine, fentanyl, and morphine. These drugs provide effective pain relief, but are often used as a last resort in chronic pain treatment, since they are associated with side effects such as dependence and addiction.

Nerve block

A nerve block is an injection used to decrease inflammation or “interrupt” a pain signal along a specific nerve or bundle of nerves. Essentially, this is a method of producing anesthesia, and produces a loss of feeling to prevent or control pain sensation. Nerve blocks can be performed on various nerves in many parts of the body, depending on the cause of chronic pain.

Steroid injection

This treatment (also called corticosteroid injections) involves the injection of anti-inflammatory medication to treat inflammation and pain. When nerve inflammation is the cause of chronic pain, steroid injections can be delivered directly to the nerves. Steroid injections can also be injected directly into joints to treat conditions such as rheumatoid arthritis and other inflammatory diseases.

Adhesiolysis

This is a procedure used to treat chronic pain caused by scar tissue (or “adhesion”) on or near a nerve, which causes nerve irritation or inflammation. In adhesiolysis, the scar tissue is first located using imaging techniques. Then, a needle and catheter is inserted near the adhesion to inject the medication used to reduce pain and inflammation and/or dissolve the adhesion. This procedure is often performed to treat chronic back and neck pain.

Radiofrequency ablation

This technique is a minimally invasive procedure which destroys the nerve fibers carrying pain signals to the brain. The first step of radiofrequency ablation involves the insertion of a needle-like probe to access the targeted nerve tissue. Then an electrical current produced by a radio wave is used to heat up a small area of nerve tissue, decreasing pain signals from that specific nerve. Radiofrequency ablation is used in cases of severe chronic pain, and is considered to be relatively safe.

Acupuncture

Acupuncture is an ancient medical practice based on traditional Chinese medicine, and is widely used around the world to treat a variety of medical conditions. It is considered to be a complementary medicine practice, and involves the insertion of fine needles through the skin at specific points of the body. One of the main benefits of acupuncture is that it can provide effective results without causing the side effects associated with prescription medication. The effects of acupuncture can also be long-lasting (for up to 6 months). Numerous scientific research studies have demonstrated that acupuncture can help to alleviate pain, including chronic low-back pain, neck pain, as well as osteoarthritis and knee pain. In addition, studies have also shown that acupuncture can be used to decrease the frequency and even prevent tension headaches and migraines.

Conclusion

Chronic pain is defined as any pain lasting more than 3 months. Chronic pain can vary in intensity from mild to severe, and can arise from different causes and illnesses, such as physical injury or chronic conditions such as arthritis. It can also affect different parts of the body, including the spine, joints and tissues. There are many available treatments for chronic pain, and they typically selected depending on the underlying condition or cause of pain.