When Pain Becomes a Disease – Chronic Pain
Chronic pain is a problem for many people unfortunately in the world. Chronic pain can be anywhere in the body and you may have heard, for example, or you might be experiencing a chronic neck pain or chronic low back pain.
So what exactly is meant by chronic pain and why does chronic pain occur in our lower backs or necks? I came across a great video today from US paediatric anaesthetist, Dr Elliot Krane, on what chronic pain is in simple terms and diagrams and why pain can become the disease and not just the symptom of a say a neck injury.
Table of Contents
Chronic Pain – When Pain Becomes the Disease
The Chronic Pain Video I Promised You
First, before I talk about chronic pain, I would like you to watch the TED talk video by Elliot Krane in which he uses a patient with complex regional pain syndrome (a.k.a regional sympathetic dystrophy) as an example. Krane explains how her nerves developed abnormal pain signals (allodynia) beyond what seemed a simple wrist sprain injury.
Definition of Chronic Pain
It is important you know what chronic means first. The definition of chronic is an important term in medicine for giving the appropriate diagnoisis and treatment of a pain condition.
Chronic comes from the Greek chronos meaning time, lasting a long time. A chronic neck pain or chronic low back pain condition is one lasting 3 months or more, or the time beyond where a condition is expected to have healed.
Using Time vs Condition Based Definition
An example of a time based chronic pain could be a a simple low back pain, without a disc herniation, lasting more than 3 months.
An example of a condition based chronic pain could be a major ligament injury with surgical repair around a shoulder or knee with pain lasting more than 6 months to one year. Ligaments take longer to heal naturally so pain might be expected to last longer anyway than a muscle type injury before calling the pain a chronic pain experience.
I find the condition based definition of chronic pain interesting because I was originally taught the time frame based definition. Letting someone know it is normal for pain to last x amount of time for their specific condition so it is still classified as acute pain, I think, helps them feel they are progressing as they should.
When someone is told they are a chronic pain patient for their type of condition they could become depressed thinking their bodies aren’t healing themselves and they will be on pain killers or in pain for the rest of their lives. Especially if the google chronic pain and read various stories of other chronic pain patients around the world.
That is why defining your source of pain and acute vs chronic pain is important for your state of mind and your recovery from a condition.
Chronic Pain Conditions
Some common chronic pain conditions are:
- Chronic Neck Pain
- Chronic Low Back Pain
- Plantar Fasciitis
- Tennis Elbow
- Frozen Shoulder
So How to Treat Chronic Pain
As you heard from Dr Krane, that is a major research topic in the healthcare industry. Pharmaceutical companies would like to develop a chemical that will fix the condition not the chemical aftermath. This could help avoid surgeries. The World Health Organisation pain ladder shows even with cancer pain and neurogenic pain medications it a mix and match process for achieving symptom pain relief via medication at this point in time.
Physical conservative care therapists like chiropractors, physiotherapists or osteopaths would love to develop techniques or protocols that if used on any patient with a certain chronic nerve, muscle or bone condition would most of the time help resolve the condition without using chronic drugs or surgery. That is why I see so many different courses advertised promoting manual therapy techniques and products to help pain and dysfunction like kinesio tape.
So chronic pain typically needs a combination of treatment using the biopsychosocial model of health. Bio for your physical biological pain source, psycho for your personal psychological state of mind, and social for those that are around you or your environment that could be affecting your health.
I have meet chronic pain patients who have ended up in the hospitals pain clinic. These pain clinics are usually where after multiple investigations and treatment options people still have pain. Here a patient would be given psychological counselling and a repeat prescription of chronic pain medication. Using the the mind and the medication to manage the pain.
Yes, there are times when a pain can only be managed and not cured.
like believe in positive psychology for overall health and seeing that girl recover her ability to use her right wrist with a chronic pain like complex regional pain syndrome should be inspiration for others.
If you are reading this and you have been diagnosed with a chronic pain condition I hope you were inspired to keep looking and trying to help your bodies health.
I don’t like seeing people depressed and not happy cos they cant do what they used to do. I especially don’t like seeing people who were positive become depressed by pain. We all need moments of health motivation and I hope watching the video above clears up a little what is chronic pain and that a combination of active and passive treatments are needed chronic pain management.
If you are living with chronic pain what is your diagnosis and have you been given a combination of medication, psychological care and physical care? If so has it helped your pain levels or function? I’m sure others would love to hear your progress and experience below.