Pain Awareness Month

Nearly 100 million Americans experience chronic pain, but this affliction remains one of the most difficult conditions to identify, treat, and explain to patients. The importance of education about the causes, symptoms, and management of chronic pain is why September is Pain Awareness Month.

Understanding Chronic Pain

The many different causes of chronic pain underscore how important it is to define the term. Chronic pain is pain that lasts at least 12 weeks. Sometimes this is caused by injury or ongoing illness, but lasts for a longer period than pain reasonably and typically should. Elderly adults are more at risk for chronic pain, but it can affect people of any age.

Facts About Chronic Pain

• 1.5 billion people around the world are stricken with chronic pain.
• Chronic pain is the most common cause of long-term disability in the United States, and affects more Americans than diabetes, heart disease, and cancer combined.
• 80 percent of Americans will experience back pain at some point.
• Pain causes workers to lose 4.6 hours of productivity per week on average.

Living with chronic pain can be debilitating or at the very least a serious obstacle to enjoying and functioning during your everyday life. It can reduce mobility, flexibility, strength, and endurance, further proving a challenge to accomplishing daily tasks or engaging in enjoyable activities. It can also have a pronounced, negative impact on mood and morale.

If you're afflicted with chronic pain, it's important to consult a doctor to establish the type and cause of pain. This is not always immediately recognizable. Pain is subjective to everyone, and a doctor will often have to depend on a patient's description of the pain to begin identifying it. It helps to have an idea of how to describe pain in terms familiar to doctors, especially if there's no obvious source such as a recent injury.

Is your pain...

• ...constant, or intermittent (leaving and returning with no apparent reason)?
• ...sharp, or dull?
• ...causing an aching or burning sensation?

No test can precisely locate or measure pain, but these questions will help a professional narrow down the potential types and causes of your pain.

Types and Causes of Chronic Pain

Types of Chronic Pain:

• Arthritis pain
• Cancer pain
• Headaches
• Lower back pain
• Neurogenic pain: pain caused by nerve damage.
• Post-surgical pain
• Post-trauma pain

Causes of Chronic Pain:

• Chronic fatigue syndrome
• Endometriosis: when uterine lining grows outside of the uterus, causing pelvic pain.
• Fibromyalgia: chronic widespread pain in bones and muscles.
• Inflammatory bowel disease
• Interstitial cystitis: a chronic bladder condition that causes bladder pressure and pain.
• Temporomandibular joint dysfunction (TMJ): pain and dysfunction affecting jaw muscles and the joint connecting the mandible to the skull.
• Vulvodynia: chronic vulva pain.

These underlying conditions are varied and often difficult to immediately diagnose, particularly compared to pain related to a recent injury or surgical procedure. Chronic pain is most common in elderly adults, but also is more likely to occur in women, and in overweight or obese persons.

Treating Chronic Pain

Treatment for chronic pain issues is varied, both due to its many causes as well as the numerous symptoms that may be concurrent. Often accompanying chronic pain are fatigue, sleep disturbance, decreased appetite, and changes in mood, symptoms that make chronic pain more difficult both to diagnose and to treat.

As everyone's experience with chronic pain is uniquely personal, treatment will be tailored to a specific person's cause and type of pain, as well as any accompanying symptoms. A "pain history," or record of instances and locations of pain kept by both patient and doctor is helpful not only in diagnosis, but also in determining the best course of treatment. Below are some of the treatment options available.

Medications:

• Over-the-counter pain relievers: acetaminophen (such as Tylenol), as well as non-steroidal anti-inflammatory drugs (NSAIDs) like aspirin (Bayer), and ibuprofen (Advil, Motrin).
• Adjuvant analgesics: these are not primarily designed to control pain, help manage chronic pain.
• Opioid pain relievers

It bears mentioning that the body can develop a tolerance to the effects of opioid pain relievers, creating a need for increased dosages, a cycle called dependence. They can also be addictive. Any use of opioids should be discussed seriously with a medical professional, and continued use should be monitored regularly by your doctor.

Medical Procedures and Options:

• Acupuncture
• Biofeedback: the use of electronic bodily monitoring to train someone to control a bodily function.
• Electrical stimulation: using mild electrical pulses on the muscles to reduce pain and improve movement and function. Also known as TENS, or Transcutaneous Electrical Nerve Stimulation.
• Nerve block: anesthetic or anti-inflammatory injections.
• Surgery

In addition, there are numerous lifestyle remedies that can be used to manage chronic pain and its effects. Much of this may involve self-management, which may include communication techniques, stress management, proper diet and exercise, and activity pacing, managing your level of activity to prevent overexertion on days when pain has eased.

Lifestyle Management Techniques:

• Exercise: produces endorphins, which improve mood and block pain signals. Also strengthens muscles and improves mobility, which may help treat the source of the pain.
• Cold compression therapy: use of cold to relieve pain and reduce swelling; common for athletic injuries.
• Heat therapy: use of heat to relieve pain and relax muscles.
• Massage
• Physical therapy: helps maintain muscle strength, mobility, and function.
• Relaxation therapy: methods such as yoga, tai chi, meditation, and progressive muscle relaxation.
• Well-balanced diet: a low-fat, low-sodium diet can help reduce stress and promote healthy immune response, as well as keep weight down during periods of limited mobility.
• Psychotherapy: therapy to manage the frustrations and mood changes that can accompany chronic pain.

Lifestyle management is an often overlooked, but vital, element of managing chronic pain. Managing not only pain, but also mental health, is important to continuing to live an active and enjoyable life, and many people suffering from chronic pain seek out psychotherapy and support groups. Communication is key: learning how to communicate to your loved ones your physical needs and situation can be invaluable.

All pain is personal. It affects different people in different ways and to different degrees. Don't be afraid to explain to your loved ones how you're feeling! They're there to support and comfort you, and you can guide them towards how best do so. Pain Awareness Month is about helping people understand the challenges of chronic pain.