What is chronic pain? - Causes, Symptoms, Diagnosis, Treatment

What causes chronic pain?

Chronic pain is pain that prevails for over three months post-onset. The pain can be there throughout the period, or it may come and go in episodes and can be felt anywhere in the body.

It interferes with daily activities, such as working, sleeping, physical health, and social relationships. This disturbance in the physical response creates a cycle of additive psychological dysfunctions that are difficult to break.

The etiology of chronic illness can be traced to primary and secondary causes. The primary causes often include a physical injury sustained by the body and residual pain that is felt for a more extended period, even post-recovery.

However, in secondary cases, people experience chronic pain without any prior injury. The exact causes of chronic pain without damage aren't well understood. The pain may sometimes result from an underlying, often undiagnosed health condition, such as: 

• Fibromyalgia: The pain is felt in muscles and joints. 
• Endometriosis: A disorder where the uterine lining grows outward from the uterus, causing painful lower body sensations. 
• Chronic fatigue Syndrome: Characterized by an extreme, prolonged weariness that's often accompanied by pain.
• Digestive Disorders: IBD ( inflammatory bowel disease) is a group of illnesses that causes painful digestive tract inflammation.
• Temporomandibular joint dysfunction: A condition that causes distressing clicking, popping, or locking of the jaw.

Some of the most common types of chronic pain include; post-surgical pain, post-trauma pain, lower back pain, cancer-related pain, and arthritis-related pain.

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What are the Symptoms of Chronic Pain?

Chronic pain symptoms can vary from mild to intense. It can persist day after day or come and go. The pain can feel like:

• A dull ache, Throbbing, Burning sensation throughout one or more body parts.
• Shooting. Squeezing, Stinging in fingers, toes, etc.
• Soreness and Stiffness in muscles around the back.

Sometimes the pain is just one of many symptoms, which can also include:

• Cognitive: Trouble falling asleep, consistent sleeping, difficulty making complex decisions
• Emotional: Highly irritable, need for isolation, aggressive behavior
• Mood Related: Feeling very tired or wiped out, not feeling hungry; mood changes, and a lack of energy. 

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How is chronic pain diagnosed?

Chronic pain diagnosis is often made by both a physician and a mental health practitioner due to the considerable overlapping triggers and underlying causes. The pain is considered chronic if it comes and goes (recurs) for three months post-onset. While pain is subjective, only the person undergoing it can determine and explain it; it can be challenging for healthcare providers to determine the cause. 

In such a case, the healthcare professionals would want to know the following to establish a case history and then subsequently identify the root cause of the pain through a battery of tests.

• Location of the pain and description: for example, felt on fingertips and toes, a stinging sensation
• The intensity of the pain in comparison to general acute pain: on a scale of 1-10
• Frequency of occurrence: over a month in the form of episodes or other
• Significant distress caused in daily functioning: family, personal, and workspace setting 
• Previous history of illness and injury

Certain conditions, deficiencies, etc., can lead to chronic pain syndrome. To further probe the causes for a diagnosis, there may be a need to conduct imaging tests to determine if there is joint or tissue damage that may explain your pain. 

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Bio-psycho-social treatment for chronic pain

Chronic pain management involves a process in which healthcare professionals first try to determine and treat the cause. But occasionally, they can't find the source. If so, they turn to managing the pain generated due to the underlying injury or illness. Chronic pain is treated in many different ways, with each approach tailored to the person's individual needs, such as 

• The type of pain you have
• The cause of your pain, if known
• Age and overall health

The best chronic pain treatment plans use a variety of biopsychosocial strategies, including medications, lifestyle changes, and therapies.

Medications for Chronic Illness

• Anticonvulsants: for nerve pain
• Muscle relaxers
• Topical products: (applied to the skin) containing pain relievers or ingredients that create soothing heat or cold effects on the surface of the skin of the body part affected.
• Sedatives: to help with the onset/ maintenance of insomnia

Psychotherapy for Chronic Illness 

1. Cognitive Behavior Therapy CBT: To learn ways to redirect the coping for the pain to healthy a d adaptive styles.
2. Occupational therapy: To know to do everyday tasks differently to lessen pain or avoid injury.
3. Physical therapy: Involves exercises that stretch and strengthen your body, which can help ease your pain.

Social Support for Chronic Pain

How to treat chronic pain syndrome is a question everyone asks, but the solution lies beyond treatment options as well. Friends, family, and support groups can lend a helping hand and offer comfort during difficult times. Whether you have trouble with daily tasks or need an emotional boost, a close friend or loved one can provide the support you need. The main goal of treatment is to relieve pain and increase mobility. The severity and frequency of chronic pain can vary among individuals. Medical treatments, lifestyle remedies, or a mix of these methods may be used to treat your chronic pain.

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