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
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.
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
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.
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.
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
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.
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.
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.
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,
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
- Reward yourself: If you treat yourself to something
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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