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Pain is universal and complex and usually protective mechanisms, which signals a response, such as removing a finger from a hot stove. Pain  has plagued mankind since our beginnings (The History of Pain Practice). Pain, is also a response to injury, such as acute sprain, toothache or headache. Chronic pain is pain that lingers after the normal healing process is complete. Usually pain that last longer than six weeks is considered chronic pain. There are many causes of chronic pain; some are due to injury or damage to nerve fibers (neuropathic pain); some due to diseases, shingles (Herpes Zoster), diabetes; some due to trauma, such as injury, surgery, or amputation; it can also occur without disease or a known injury. This can happen in part, because the nervous system, which sends messages, can undergo rewiring and short circuits, which can obscure the initial or underlying cause of the pain. Chronic pain can range from mild, to severe, to disabling and can last from a few weeks or months to many years. 

Usually emotional and psychological components develop. These are sometimes significant and cause behavioral changes in the individual including, sadness, anger, and depression. Over time, a sense of helplessness to control the pain can lead to "pain behavior", which can become habitual crutches, that can undermine your  ability to effectively manage the pain. Chronic pain can exact a toll on the individual, the family, the work place, and the health care  system.

Millions of people world wide seek treatment for chronic pain every year. On occasion certain medications, nerve blocks or physical therapy can make a big difference, however, in most cases a multiple-part approach to ending the downward spiral of chronic pain is required. Reversing this spiral is now commonly referred to as pain management. Pain management includes, not only medication, but also a comprehensive plan of relaxation, exercise and behavioral change. There is no magic bullet for relief of chronic pain. Managing pain is not about making the pain disappear, it is about keeping pain tolerable and there are several ways to accomplish this.

Keep a Pain Journal: Record the various activities and therapies that reduce or alleviate your pain. A journal also helps track the ebb and flow of pain, so you are aware of them and know when the pain worsens and how to ease it.

Get Started on an Exercise Program: Exercise improves overall fitness, increases strength and flexibility and can reduce the risk of further injury and helps control pain.

Balance Your Life: Find a healthful balance of activities, which should include work time, exercise, recreation, hobbies, relaxation, rest and socialization with family and friends. This balance can ease pain and elevate your mood.

Medications: All medications have side effects and there are toxic risks with all medication. So which medication to use and when to use one for chronic pain is very complex.

Complementary Medicine: Unconventional therapies used (yoga or Tai Chi), which promote physical strengthening are safe and sensible when combined with exercise, diet and treatments prescribed by your doctor.

Alternative Medicine: This therapy is used instead of, or in conjunction with, traditional medical care, including homeopathic or naturopathic practitioners. The Food and Drug Administration do, not regulate herbal medications, while they may be beneficial; they may also be toxic and may interfere with prescription medication. Take with care. 

Some Tips to Help in Managing Chronic Pain

  • Write yourself a contract: Pledge to yourself that you are committed to managing your pain.
  • Keep your home environment healthful: Remove all items from your home that might lure you into unhealthy habits. Your home should reflect your positive active attitude.
  • Set goals for pain management: Set specific goals to address your greatest pain problems.
  • Monitor your progress: Prepare some type visual aid or chart to display your progress.
  • Accept support: Support of family, friends and physician will help you keep going on track on difficult days.
    Team up with your doctor: Your doctor can work with you to overcome obstacles, keep him/her posted on your progress.
  • Plan each day: Schedule your exercise, relaxation, rest, and work. Make a list of things to do in order to accomplish your goals.
  • Stay positive: Think that you will control the pain. Keep your spirits up, this will help to maintain your ability to overcome and manage pain.
  • Reward yourself: If you treat yourself to something enjoyable when you reach a goal, it will reinforce a positive attitude. 

 

Author: Robert V. Plehn, M.D., DABA, FACA
 Medical Director, DoctorsForPain.com
 
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                                                        01/16/2010