News& Information

September-Chronic Pain Awareness Month

Author:Dr.Irena Mehandjiska Shumanska

 Managing Chronic Pain 

Chronic pain is defined as a condition that lasts for more than 6 months. Besides the pain, the condition can be combined with symptoms such as weakness, numbness, insomnia, and depression. Chronic pain can be mild or severe, can come and go, and last a long time, can be mildly uncomfortable or disabling. The most common types are headache, arthritis (inflammation of the joints) pain in joints, pain from injury, and back pain.

The causes of chronic pain can be different, one of the common cause is aging that impact the bones and joints and causes chronic pain. Another one is damaged nerves and injuries that are not healed completely. Some types of chronic pain can be caused because of incorrect posture, incorrect weight lifts, and overweight that additionally gives pressure to the back and knees. Some congenital disabilities like abnormal curvature of the spine, injuries, and sleeping on non-orthopedic mattresses can be also a cause for chronic pain. Chronic diseases like cancer, multiple sclerosis, stomach ulcer, and AIDS are also one of the causes of chronic pain.

 Ways on managing chronic pain 

Many people that experience chronic pain can acquire some level of control over the pain with exercise and psychosomatic treatment. For that reason, a team of health professionals works together with the patient and very often the goal is not complete elimination of the pain but developing a strategy that will help the patient to control the pain and learn how to live with it. Treating chronic pain with painkillers and rest only, did not give good results through the years of medical practice. Nowadays is a multidisciplinary, multimodal, and individualized approach to pain care. People are recommended not to bed rest for weeks or months but to exercise and continue to work.

Conventional medicine 

To reduce chronic pain, conventional medicine recommends a combination of exercise, staying at work, physical therapy, and painkillers.

Pain in muscles and bones can be reduced by taking painkillers such as acetylsalicylic acid(aspirin), ibuprofen, or acetaminophen. For severe pain, a muscle relaxant, anxiolytics, antidepressants, NSAID (non-steroidal anti-inflammatory drugs) are prescribed depending on the complexity of the symptoms.

 When the pain comes from injuries, where there is swelling and inflammation, restricted numbers of corticosteroid injections are prescribed. If the injury is severe besides the oral therapy the patient in this condition needs to rest, needs to be immobilized and sometimes a muscle /ligament traction and surgery are recommended.

Alternative medicine

For treating chronic pain there are many alternative ways too. Some of them focus on the body, some on the mind, and some of them focus on both, body and mind. The methods that are used are acupressure, acupuncture, aromatherapy, chiropractic methods, healing with herbal medicines, and homeopathy.

Lifestyle 

In the treatment of chronic pain, it is very important, the patient to take part. That means he/she needs to make changes in the lifestyle. That includes special exercises and diet and by that, learn how to control the pain, especially with exercise, how to provoke the body to release endorphin a hormone that is a natural analgesic (acting to relieve pain).

Short rest can calm the pain but if you rest for a long time that can lead to shortening and weakening of the muscles that will increase the pain and might lead to injuries when you start to move more actively again. If chronic pain is your everyday problem, you can try shaping exercises.

That means if the chronic pain is a very long time part of your life and is disabling many of the everyday activities you should try making a gap between the exercises. For example, if your pain tolerance is 10 minutes of stretching or walking you can divide the time of 5 minutes, exercise, two times a day. After some time, you can prolong the time of exercising.

Here are some exercises that you can do and they won’t put too much strain on you.

*daily activities, hobbies

*walking

*using an exercise bike

*dancing, yoga, pilates

*swimming

If you are working and suffering from chronic pain it is better to stay at work even though you’re in pain. Many studies show that when people with chronic pain, stay at home, become less active and depressed and in most cases, the pain becomes worse.

Psychosomatic treatment

This kind of treatment is guided by a specialist in the same field. They recommend, instead of having negative beliefs about chronic pain, the patients should develop positive thinking about the process of dealing with chronic pain and living with it. Cognitive reconstructions, visualization, hypnotherapy, meditation, and yoga are part of the psychosomatic treatment.

The cognitive reconstruction is a technique that teaches the patient to change the inner monolog from “I Can’t”, “It won’t go away” to “I don’t know what the future brings but I know how to deal with it now”.

The visualization teaches the patient to imagine the pain as a picture in colors that has a shape and then try to imagine that picture as a smaller and picture that you actually like.

September is a chronic pain awareness month and this year theme is

 “My Pain Plan” that focuses on the individualized, multidisciplinary approach to pain care. If you are suffering from chronic pain and you still don’t have your own personal pain plan consult your GP to help you find a team of health professionals to help you build individualized and multimodal pain care.

Reference:

*Main CJ, Spanswick CC (2001). Pain management: an interdisciplinary approach. Elsevier. p. 93. ISBN 978-0-443-05683-3.

* Finan PH, Smith MT (June 2013). "The comorbidity of insomnia, chronic pain, and depression: dopamine as a putative mechanism". Sleep Medicine Reviews. 17 (3): 173–83. doi:10.1016/j.smrv.2012.03.003. PMC 3519938. PMID 22748562.