Approximately 35% of Americans have complaints of severe pain, and almost 50 million Americans are disabled partially or entirely due to this condition. Coping with pain is an extremely common symptom that causes people to make multiple appointments with their physician. This problem is managed better using a multidisciplinary approach which requires close integration with various health care providers, as pain has biological, psychological and sociological components.
What is Chronic Pain Syndrome?
Chronic Pain Syndrome (CPS) is a constellation of symptoms which usually do not respond well to the medical model of care, and is quite a challenge to people in the health care professions. CPS is a poorly defined illness. Some researchers believe that consistent pain lasting longer than 6 months and others have used 3 months as the minimum standard for diagnosis. Other researchers suggest that any pain which persists longer than the average healing time should be considered chronic pain. In general, chronic pain is defined as any pain that lasts more than six months versus acute pain, which is pain that last less than thirty days. Once again, any pain that lasts between a month and half a year is classified as sub-acute pain, and is not considered to be a chronic condition.
Chronic pain syndrome (CPS) is a problem that presents a challenge to healthcare providers because of its, unclear cause, and poor response to the medical treatment model. The pathology of chronic pain syndrome (CPS) is complex, involves many factors, and still is poorly understood by those in the medical community.
Some researchers have suggested that CPS might be a learned behavioral response that begins with a noxious stimulus that causes pain. For example, a tooth extraction or surgery. This pain behavior then is rewarded externally or internally. Internal reinforcers are relief from personal factors associated with various emotions (guilt, fear of work, sex, responsibilities). External reinforcers include such factors as attention from family members and friends, socialization with the physician, medications, compensation, and time off from work. Thus, this pain behavior is reinforced, and then it occurs without any noxious stimulus.
Chronic pain can seriously affect people’s lives in many different areas. Emotional symptoms are depressed mood, a reduction in energy level or fatigue, decreased activity level and decrease in libido, along with coping styles related to excessive use of drugs and alcohol to manage the pain. What helps is for people to try to keep areas of their life in balance. In order to cope, people need to realize that pain causes emotional distress. In most situations chronic pain sufferers can overcome the anxiety and fear that is brought about by chronic pain. By concentrating on a balanced approach when handling everyday tasks or responsibilities, chronic pain sufferers can learn to manage the pain constructively. For example, be careful when taking on daily tasks. Doing too much or not enough can result in added stress and increase pain. If people are taking medication, always take the medicine at the same time every day to prevent any unnecessary distress.
When it comes to pain, the amount of stress and anxiety that is created varies. Therefore, behavioral therapy can help the chronic pain sufferer successfully cope with the pain, and gather the needed methods to cope with everyday stressors. By learning effective coping strategies people can find the drive and determination to live happier and more productive lives.
Cognitive and Psychological Symptoms
Chronic pain not only affects a patient physically, it can also have pronounced cognitive and emotional effects. Therefore, the psychological ramifications as well as physical discomfort can, at times, be difficult to manage. Because of chronic pain, people may be subjected to: forgetfulness, difficulties in performing everyday tasks, problems with communicating, and a lowered ability to concentrate.
Because of the prevailing pain of the disorder, fibromyalgia provides an excellent example of what kinds of cognitive and emotional difficulties can emerge from chronic pain. For example, the fibromyalgia patient often suffers from forgetfulness, an inability to concentrate, a reduced attention span, and the inability to respond with any quickness or adeptness when performing certain daily tasks. These kinds of cognitive problems are linked to the anxiety and depression symptoms, which are associated with the disorder.
Pain certainly can have profound psychological effects on the lives of the sufferers. For example, in the case of fibromyalgia, patients usually experience widespread pain which is a pain that is exacerbated by any type of pressure. This condition can give way to such symptoms as tiredness, insomnia, problems with swallowing and joint stiffness. The researchers Mork et al., investigated whether physical exercise and high body mass index (BMI) influence an individual’s risk of developing fibromyalgia. The study included 15,990 women, none of whom at baseline had fibromyalgia or any other physical impairment. By 11-year follow-up, the incidence of fibromyalgia had reportedly occurred in 380 women. The authors noted that only a weak link existed between exercise level and fibromyalgia risk. However, women who were obese or overweight had a 60% greater risk for developing fibromyalgia than did women of average or normal weight.
Conditions that Cause Chronic Pain
Chronic pain is connected with various illnesses and disorders. People suffering from any of the following illnesses may experience some of the cognitive and psychological symptoms that are linked to chronic pain. These illnesses or conditions include:
- Arthritis
- Back Pain
- Chronic Fatigue Syndrome
- Clinical Depression
- Fibromyalgia
- Migraines and Headaches
- Sciatica
- Irritable Bowel Syndrome
- Myofacial Pain Syndromes
- Complex Regional Pain Syndrome (CRPS)
A Few Tips on How To Learn To Live With Pain
Emotional stress can be influenced by a number of factors with respect to chronic pain. When beset by stress or anxiety, the chronic pain sufferer needs to consider: The degree of pain that is felt on a scale of 1-10, sleep patterns, triggers that bring on pain, ways they are coping with the pain, and the amount of psychological and emotional support they are receiving.
Look for Natural Ways to Cope with Pain: Managing pain-associated anxiety is ideal for keeping pain under control and enhancing the immune system functioning. The chronic pain sufferer can enjoy a better quality of life by using alternative treatments, such as Cognitive Behavioral Therapy, eating healthily, and following a regular regimen of exercise. Therefore, finding natural alternatives to relieve pain is preferred over dependence on medication, which can reduce the sufferer’s overall enjoyment of life.
Exercise is one of the best ways to reduce pain. Chronic pain can be helped, as well, by following a healthy, nutritious diet. Exercise produces endorphins, which are mood-elevating hormones that are useful in combatting pain. To relieve pain the endorphins work in conjunction with analgesic-type receptors in the nerve endings, spinal cord and the brain. Exercise is probably the best way to treat pain as the endorphins that are produced during a workout are usually many times more powerful than analgesic medications and are non-addictive. Chronic pain sufferers can reap the benefits that are provided by endorphins by taking part in daily or regular exercise. These proven pain relievers can reduce anxiety and the existences of the symptoms associated with stress and effectively manage chronic pain.
Try to Make a Few Behavioral Changes. People need to examine how they are currently feeling to better manage pain. For example, if people feel frustrated or irritated then it is useful to recognize the feelings and then examine the behaviors that go along with having that irritable feeling. It is helpful to examine behaviors to assess the need to possibly initiate a change in attitude or behavior.
Pain Medications. There are two main types of medicines that are prescribed for the reduction of pain. Health practitioners recommend people use drugs that fall under the classification of analgesics or NSAIDS (nonsteroidal anti-inflammatory drugs). They may also recommend antidepressant medications in some cases as well. Among analgesics, acetaminophen (sold under the well-known brand of Tylenol) is often used to reduce pain.
Nonprescription NSAIDsWhile analgesics are made specifically to relieve pain, NSAIDS are designed to reduce both pain and inflammation. Therefore, NSAIDs are often used to manage arthritis pain as the discomfort is brought on by swelling and inflammation of the joints. The most popular NSAIDs that are sold as nonprescription, over-the-counter medications are ibuprofen and aspirin.
NSAIDs not only relieve pain and reduce inflammation and swelling, they also thin the blood. Therefore, they have been found to be helpful, in low doses, in preventing heart attacks. On the other hand, frequent use of NSAIDs can cause stomach upset and/or kidney difficulties. Therefore, patients should inform their doctors what medications they are currently taking to avoid any adverse drug interactions or side effects. Women who are pregnant, asthma sufferers, individuals with kidney or liver problems, people taking medicines for high blood pressure, and those individuals who have had ulcer problems in the past should be careful about taking NSAIDs. Please consult your physician.
Holistic Treatments Methods attempt to help treat the root causes of the pain, not just the symptoms. Practitioners take into account all aspects of one’s life to assess which treatments or herbal supplements will help best to manage the pain.
Physical and Occupational therapy
Acupuncture, Massage, Trigger Point Therapies
Chiropractic Therapy
Cognitive Behavioral Therapy, EMDR,
Hypnosis, Meditation and Visualization Techniques
Herbal Medicines
Attempt to Focus on Positive Thinking
Pain, as indicated, affects not only memory, but how people think and feel about life in general. It is understandable that the more suffering people feel the more cynical, angry and negative people become. How To Learn to Live with Pain is no easy task! Try to realize that you are not feeling well and then attempt to discover new ways to self sooth and comfort yourself. Try to view yourself from a healthy and positive perspective by acknowledging all of your sound working physical parts, such as, “My left arm feels terrific”. This technique, if practiced consistently works by changing your overall outlook on life, instead of focusing on the negative you are now focusing on the positive. Psychological interventions do indeed help manage pain. Consider, asking your physician for a referral to a health psychologist, to assist in learning new ways to cope, and get back into enjoying life’s treasures.
I Wish You Well On Your Journey,
Dr. Cheryl MacDonald, RN., Psy’D.
Health Psychology of San Diego
760 439-9331
References:
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Manish K Singh, MD; Chief Editor, Chronic Pain Syndrome, http://emedicine.medscape.com/article/310834-overview#a0101
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