Chronic Pain

John Zajaros asked:




Chronic back pain is a condition that affects millions of Americans every year. Chronic pain of any kind leads to depression in as high as 85% of all individuals diagnosed with the disorder. Chronic back pain may result from any number of factors and is in fact one of the least understood conditions affecting millions of back pain and sciatica sufferers worldwide. The often insidious and frequently misunderstood complex of chronic back pain and depression leads to its own set of conditions and consequences. The combination of depression and chronic pain often leads to total disability, with little hope of a real solution or cure.

Back pain, in fact pain in general, often falls into one of two categories. The two types of pain are nociceptive pain and neuropathy or neuropathic pain. Nociceptive pain is sensed by what are called nociceptor sensory fibers. Neuropathic pain or neuropathy is a term used to describe damage to a nerve or nerve tissue. With nociceptive pain, messages are sent to the brain signaling an injury to the skin, muscles, connective tissue such as ligaments and tendons, bones and joints or other vital organs. Nociceptive pain may be described in terms of trauma or a specific injury that often heals with time and treatment. Examples of this type of pain include the pain after spine surgery, the pain due to a fall or an accident, stubbing your toe, and arthritis pain, just to name a few. Neuropathy or neuropathic pain is generally a deep sensation, whether aching, throbbing or soreness. Neuropathy is generally associated with back pain and sciatica but may also indicate damage in other areas, such as pain in the neck extending into the shoulders, arms, hands, and fingers. It is believed that in cases where the nociceptive pain is prolonged, with no clear resolution or outcome, it may evolve or progress into neuropathic pain. It is not uncommon for a patient to have a constellation of conditions in which both categories, both classifications of pain are present.

Within the context of nociceptive pain and neuropathy, there are gradations ranging from mild to acute and from short term or abrupt manifestations to a chronic, long term state. While pain is a subjective state and classification next to impossible, we will define it as falling into one of two basic expressions, acute and chronic. Acute pain and chronic pain are very different, not only in terms of the actual sensation or expression, but in terms what the sensation or sensations are “telling” us, as well. Acute pain generally reflects the degree of damage at a specific location on or in the body. In cases of acute pain, there is a positive correlation, a relationship, between the sensation and the amount of actual damage. As a result, pain is considered a protective mechanism, an adaptive response allowing us to remove the cause or cease the behavior, thus interrupting the pain and minimizing the damage. Thus, acute pain is an expression of nociceptive pain. Chronic pain, on the other hand, does not send the same message acute pain does. Nor is chronic pain protective or adaptive, it serves no real biological function either. In fact, you could almost say that the signal is a mistake. The reason? Chronic pain, or neuropathic pain, continues to send impulses to the brain long after the event is over and there is no longer tissue damage to report.

It is chronic back pain, with no clear causality, pathology or otherwise, that is so difficult to treat and leads so many of its sufferers into depression, debilitation, and disability. Depression and chronic back pain are inextricably linked and treatment is difficult, if not impossible. The typical chronic pain sufferer with depression also experiences a loss of appetite, insomnia, irritability, anxiety, and a myriad of other mental and physical maladies, all linked back to chronic back pain. Unfortunately, it is at this point the pain management practitioner usually steps in and medicates the patient with an amazing array of narcotics, exacerbating the situation further. Now we have an individual suffering from chronic back pain and depression, probably disabled and unable to work; and, if he or she does work, they have been completely marginalized by the stigma and their inability to function at optimal levels. The addition of narcotics serves to fully debilitate the chronic pain sufferer, usually addicting them to pain medication in the process. The spiral continues downward into worsening depression, hopelessness, loss of identity, loss of self-esteem, and, very possibly, loss of everything around them that was ever important to them.

Pretty grim, huh? Well, it’s not without hope and certainly not without resolution. However, it takes a concerted effort including, at times, treatment to get off the pain medication. But it can be done! More and more chronic pain sufferers every day are seeking alternative “bad back” or chronic back pain treatment strategies. Many people suffering from the devastating and deadly complex of chronic pain and depression, addicted to narcotics, are starting to understand that traditional pain management, with its “let’s thrown medication at it” mentality is a black hole from which, if not fully extricated from in time, will completely suck the life out of the individual at risk, literally and figuratively.

The program? Exercise, get off the medication, education, and re-entry into your life. Sounds simple but it’s not. The chronic back pain may continue for quite a while and medication may be required to alleviate the symptoms of depression. However, if an individual really wants help, it is available. The result may be a new life, one far from the devastating reality of the old one. Exercise, get off the meds, education, and re-entry. Stare with a good, individualized exercise program, get treatment if necessary to get off the pain killers, go back to school or begin to educate yourself, it does wonders for your self-esteem, and re-enter your life, become involved with your family again, with friends, with your dog if you have one. And then? Take life as it comes, one day at a time, as they say. The results will be worth it. The journey? Fantastic!

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T Dozier asked:




It seems that there is no hope of becoming a full person again, but I am here to inform you that it can be done. You have to give yourself the benefit of the doubt that you can overcome this awful pain that your body experiences. This is where mind body healing technique comes into the picture. I personally, have had to deal with pains in my low back, knees, and neck for some time now. It has taken a very devastating toll on my entire life. But, the first course of action that I finally decided to take was the beginning of my relief from chronic pain.

Have you ever given much thought to the saying “what the mind can conceive the body can achieve”? Well, I am here to tell you that this may be the only option that is available to you. This method of defeating chronic pain probably will not work for everyone, but there is hope if you allow yourself not to become a victim to your chronic pain and there is the possibility of you becoming pain free.

One thing that definitely holds some people back from being able to overcome their chronic pain issues, is the ability to pull away from negativity that we sometime receive from friends or family members. But, on the other hand our friends, family, doctor, or pain therapist, can be our worst enemy. We sometime can give in to being pampered, which in turn leaves us not being able to overcome our chronic pain. It is somewhat like when you over pamper your child at times, when instead a more precise course of action maybe what is called for. I have seen in some cases where people let others alter their recovering from chronic pain, not letting the person be responsible for themselves. They do not do these things intentionally, like getting things for them and such, but this may not always be the best thing to do in some cases.

After a person has surgery or something similar, chronic pain can take over ones life, but you do not have to let it be that way. I have dealt with the effects of pain for some 20 plus years now and the thing that helps me the best is to not give in to it. It is a tough journey and it helps to have someone with whom you can have at your side to achieve your relief from chronic pain. My grandmother always told me “baby, no one knows your pain or what you are going through but you”. This statement alone has made me sit up and take notice of my situation.

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Erica Thompson asked:




I cannot stress enough how important it is to get the right coping skills and help in order to keep from giving up or giving in. People with Fibromyalgia Syndrome (FM), Chronic Myofascial Pain (CMP) and any other chronic pain conditions, can benefit from counseling by a certified therapist for: stressful life conditions, depression and/or anxiety, abuse histories, adjustment issue to chronic illness, poor support system and many other challenges we face.

There is a connection between FM, CMP and depression. The stress from constant pain and fatigue can cause anxiety, depression, inactivity and social isolation. It is also possible that anxiety and depression are part of FM and CMP, just like the pain. Depression and chronic pain can greatly interfere with the way you cope with activities at home or at work. As a sufferer myself, I know exactly what that’s like.

Chronic pain sufferers most often need a combination of medications (I am on an anti-depressant and several other meds), alternative therapies, cognitive behavioral therapy, and a change in lifestyle habits. So it is important to openly discuss any symptoms of depression you have with our doctors. Medication is not enough by itself and some prescription drugs make our depression and anxiety worse.

Some people with fibromyalgia and chronic pain may be aware they are depressed. Others may not realize they are depressed, but they know something is just is not right.

Researchers have found that fibromyalgia patients have an inability to process and handle stress. Studies have shown that the breakdown in the adrenals, hypothalamus, pituitary and thyroid glands play a key role in FM patients’ lack of coping mechanisms. Not only does chronic pain cause enormous stress in our lives, but we are unable to manage it.

All people have stress in their lives which may be unavoidable. FM and other chronic pain sufferers have even more. Counseling and/or stress management can help us cope with our symptoms and improve our overall reactions to stress.

I have been seeing a certified therapist that has really helped me discover some of the issues that may contribute to my pain. It’s also not just about the here and now, but past experiences that we think are in the past, are really still simmering in our sub-conscious, affecting our emotional state and our inability to cope with the stress that’s right in front of us. I resisted therapy for years! I did not want to go to yet another doctor that I would have to convince that my pain is real and not “all in my head”. It took seeing several different counselors before I found one that REALLY GOT IT! It feels like a GREAT weigh has been lifted off my shoulders. My stress and anxiety are becoming manageable and I feel less and less depressed.

Counselors trained in treating FM and other chronic pain patients can be very helpful, but we have to put in some work ourselves. Its not easy to make the changes required to make therapy successful, but we need to correct the self-defeating thoughts and actions that have led us to seek help from a professional in the first place.

Research shows that a combined multidisciplinary treatment approach is the most effective way to achieve symptom relief. There is no cure for fibromyalgia, but there is hope if we seek and get the right help! Counseling can really make a difference along with the other treatments you may be receiving!

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