Special Programs

What is Chronic Pain?

Pain is the body's way of telling the person that something is wrong. Everyone experiences pain during their lifetime usually from minor incidents such as cutting their finger or pulling a muscle. These minor injuries heal quickly and the pain stops. 

Chronic pain however can last from three to 6 months or longer. Chronic pain can begin without any obvious cause for example arthritis but it usually starts after a more serious injury or as a result of health condition such as cancer and can last from three to six months or longer. Other causes of chronic pain include migraines, surgery, injuries, fibromyalgia, back problems, and nerve damage.

How We Process Pain?

When someone injures them self the injury turns on pain sensors in that area. These sensors send a message in the form of an electrical signal, which travels through their nerves until it reaches the brain. The brain processes the signal and sends out the message that the person is hurt. The sensation of pain therefore comes from a series of messages that move through your nervous system.

When the body repairs the wound or injury the cause of the pain is resolved and the pain signal usually stops however with chronic pain the nerve signals can keep firing even after the wound or injury has healed. Chronic pain however can also be related to medical conditions which don’t heal but continue to deteriorate such as cancer or arthritis.

How does Chronic Pain Affect a Person?

Chronic pain can significantly undermine a person's day to day life and keep them from doing the activities they want and need to do. These often dramatic, forced changes in a person's lifestyle sometimes accompanied by loss of independence can result in:

• Mental health issues such as depression, anxiety and loss of motivation. 
  
• Health issues such as sleep deprivation, fatigue, loss of appetite and muscular tension.
  
• Cognitive issues such as difficulty focusing, forgetfulness, and deterioration of judgement and decision- making skills.
  
• Social and relationship issues caused by withdrawal, irritability, and loss of libido.
  
• Significant economic consequences such as loss of a job.
  

Chronic Pain is a Complex Phenomenon

Injury signaling, negative emotion/cognition, and stress are interdependent in that these three feed one another making it difficult to disentangle them. Pain also raises an individual's stress levels and interferes with their sleep causing sleep deprivation and increased stress which makes the pain feel stronger. We also know that there is a link between your emotions and pain which can create a cycle. When you hurt, you're more likely to feel depressed which makes your pain even worse. The link between depression and pain is why doctors often use antidepressants as one treatment for chronic pain. These drugs can help with both the pain and the emotional strain it causes.

Studies researching the neurobiology and pathophysiology of chronic pain indicate that chronic pain negatively impacts multiple aspects of patient health, including sleep, cognitive processes and brain function, mood/mental health, cardiovascular health, sexual function, and overall quality of life and found that the negative impact on these different aspects of a person's life are interdependent causing the pathophysiology of the chronic pain to become increasingly more complex and this potentially more difficult to treat over time. 

Pain Medication

Opioid pain killers are frequently prescribed to help the person initially cope with the acute pain following major surgery or severe injury. The short-term use of pain killers such as hydrocodone and hydrocodine is valuable in helping a person initially cope with acute overwhelming pain however the long-term use of these opioid painkillers to treat chronic pain places the person at risk for developing chemical dependency and addiction disorders.

Early Effective Multimodal Therapies to Prevent Opioid Addiction 

Research studies indicate that it is important that chronic pain is managed with the objective of minimizing or avoiding its associated long-term complexities and consequences such as opioid addiction. Early and effective multimodal treatment strategies, including analgesic therapy that controls pain intensity, anti-depressant treatment and cognitive behavioral therapy to relieve the inevitable depression that accompanies chronic pain, are essential to improving outcomes and returning patients to normal levels of function.

The Woodlands Behavioral Health and Wellness Center works in conjunction with pain management doctors providing analgesic therapy interventions to provide assessment and the following multimodal treatment strategies:

Psychological Assessment required by private and federal health insurance programs for authorization of analgesic therapy interventions.

Psychiatry, antidepressant medication and Cognitive Behavioral Therapy which is the gold standard treatment approach to alleviate the symptoms of depression and anxiety that inevitably develop as a result of chronic pain.

Clinical massage and Relaxation Therapy to reduce muscular tension related to chronic pain and help the client sleep. Massage can reduce stress and relieve tension by enhancing blood flow. Guided visualization another relaxation technique, may be another worthwhile pain-controlling technique. 

Weight loss achieved by a combination of dietary changes and increased physical activity has been shown to be helpful for some people suffering from osteoarthritis. 

Neurofeedback and biofeedback to teach clients how to voluntarily reduce their symptoms of stress without having to resort to tranquilizers, which are addictive.

Trans cranial stimulation (TMS) which is effective in reducing depression and consequently pain.

Family /Marital Therapy to improve relationships that have been negatively impacted by one partner's chronic pain. 

Clinical Nutritional Counseling and Supplementation , which educated the clients how to make changes in their diet which will help them manage their chronic pain more effectively. Changing dietary fat intake and/or eating plant foods that contain anti-inflammatory agents may help ease pain by limiting inflammation. Evidence indicates that glucosamine sulfate and chondroitin sulfate relieve pain due to knee osteoarthritis and increase mobility. 

Alternative Addiction Services which help clients on an recover from opioid addiction or other chemical dependency disorders such as alcohol abuse. 

Sources:

American Academy of Family Physicians: "Chronic Pain."

American Psychological Association: "Coping with chronic pain."

American Society of Regional Anesthesia and Pain Medicine: "Types of Chronic Pain."

Fine, Perry, Department of Anesthesiology, School of Medicine, Pain Research Center, Salt Lake City, 

Institute for Chronic Pain: "Understanding Chronic Pain."

Mayo Clinic: "Is there a link between pain and depression?"

Medscape: "Chronic Pain Syndrome Clinical Presentation."

National Center for Complementary and Integrative Health: "Chronic Pain."

Nemours Foundation: "Why Do I Have Pain?"

NIH Medline Plus: "Chronic Pain: Symptoms, Diagnosis, and Treatment."

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