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Chronic Pain Management
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Resource Description: 
Since 1980, the ACPA has offered peer support and education in pain management skills to people with pain, family and friends, and health care professionals.
The American Pain Foundation (APF) Action Network believes people have the right to timely, appropriate and effective pain care and is dedicated to SPEAKING OUT for the rights of people with pain.
The mission of NINDS is to reduce the burden of neurological disease - a burden borne by every age group, by every segment of society, by people all over the world.
Episode number: 
802

(Source: NINDS / NIH) While acute pain is a normal sensation triggered in the nervous system to alert you to possible injury and the need to take care of yourself, chronic pain is different. Chronic pain persists. Pain signals keep firing in the nervous system for weeks, months, even years. There may have been an initial mishap -- sprained back, serious infection, or there may be an ongoing cause of pain -- arthritis, cancer, ear infection, but some people suffer chronic pain in the absence of any past injury or evidence of body damage. Many chronic pain conditions affect older adults.

Symptoms of chronic pain

Common chronic pain complaints include headache, low back pain, cancer pain, arthritis pain, neurogenic pain (pain resulting from damage to the peripheral nerves or to the central nervous system itself), psychogenic pain (pain not due to past disease or injury or any visible sign of damage inside or outside the nervous system).  A person may have two or more co-existing chronic pain conditions.  Such conditions can include chronic fatigue syndrome, endometriosis, fibromyalgia, inflammatory bowel disease, interstitial cystitis, temporomandibular joint dysfunction, and vulvodynia.  It is not known whether these disorders share a common cause.

Treatment of chronic pain

Medications, acupuncture, local electrical stimulation, and brain stimulation, as well as surgery, are some treatments for chronic pain. Some physicians use placebos, which in some cases has resulted in a lessening or elimination of pain. Psychotherapy, relaxation and medication therapies, biofeedback, and behavior modification may also be employed to treat chronic pain.

Many people with chronic pain can be helped if they understand all the causes of pain and the many and varied steps that can be taken to undo what chronic pain has done. Scientists believe that advances in neuroscience will lead to more and better treatments for chronic pain in the years to come.

Source: NINDS / NIH  

Facts about pain:

  • Pain affects more Americans than diabetes, heart disease and cancer combined.
  • Pain is cited as the most common reason Americans access the health care system. It is a leading cause of disability and it is a major contributor to health care costs.
  • According to the National Center for Health Statistics (2006), approximately 76.2 million, one in every four Americans, have suffered from pain that lasts longer than 24 hours and millions more suffer from acute pain.
  • Chronic pain is the most common cause of long-term disability.
  • The diversity of pain conditions requires a diversity of research and treatment approaches.
  • Pain can be a chronic disease, a barrier to cancer treatment, and can occur alongside other diseases and conditions (e.g. depression, post-traumatic stress disorder, traumatic brain injury).
  • For infants and children, pain requires special attention, particularly because they are not always able to describe the type, degree, or location of pain they are experiencing.
  • Discoveries of differences in pain perceptions and responses to treatment by gender has have led to new directions for research on the experience and relief of pain. For example, medications called kappa-opioids provide good relief from acute pain in women, yet increase pain in men.
  • NIH-supported scientists identified a gene variant of an enzyme that reduces sensitivity to acute pain and decreases the risk of chronic pain.
  • COX-2 (cyclooxygenase-2) is a major contributor to pain associated with inflammation. A study of genes affected by COX-2 led to the discovery of its role in connection to multiple cellular pathways that contribute to pain relief and adverse side-effects.
  • Behavioral interventions for pain also demonstrate promise for providing pain relief either in conjunction with or in lieu of drug interventions. For example, NIH-supported research has demonstrated that individualized pain management programs may reduce cancer pain for some patients.

Source: NIH Fact Sheets 

Key Point 1 

Pain can be useful, alerting us to the fact that something isn’t right, but chronic pain can become the problem rather than the symptom.  The emotional toll of chronic pain can also make pain worse and may compromise the body’s healing abilities and cause changes in the way our brains work.

Key Point 2

The goal of chronic pain management isn’t to make the pain go away but to make the patient’s life more livable and less painful.  Being able to live the most normal, active and functional life with the least pain is the goal.

Medline Plus

Medline Description: 

Interactive Medical Search logoConduct an off-site search for Chronic Pain from MedlinePlus.  These up-to-date search results are based on search terms specific to Second Opinion Key Points.

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