Chronic Pain Syndrome
Chronic pain affects 25 to 30% of Canadians. It is generally defined as pain that lasts longer than 3 to 6 months for an illness caused by medical problems such as arthritis, cancer, diabetes, disc herniations, and fibromyalgia. It can also be caused by injuries caused by motor vehicle, work-related or other accidents that do not resolve in 3 to 6 months. Because there is no single cause of chronic pain, treating chronic pain is complicated, which makes assessment, diagnosis, and treatment difficult.
Chronic pain is grouped based on the source of the pain. Pain that is caused by damage to nerves, the brain, or the spinal cord is termed neuropathic pain. Pain that is caused by continued tissue damage due to medical conditions such as arthritis, cancer, lupus etc. is termed nociceptive pain. Some types of chronic pain are a combination of neuropathic and nociceptive pain whereas, for some other types of chronic pain, no cause has yet been found.
Chronic pain can have a physical and psychological component. Physical de-conditioning and the inappropriate use of medications are factors known to be responsible for pain leading to disability. Other factors that possibly add to the problem are psychological issues related to one's inability to cope with ongoing stress, depression, and anxiety. Chronic pain also brings about changes in the way pain signals are processed in the brain and spinal cord. Unfortunately, as pain and disability intensify, irritability, anxiety, frustration, depression, and problems with memory and concentration can deepen and increase the perception of disability. Chronic pain can also lead to social withdrawal and isolation.
Treatment
Early recognition of chronic pain is essential. The longer the pain persists, the more resistant it becomes to treatment.
In many cases, typical treatments for acute pain, such as rest, immobilization, painkillers, and opioids, simply worsen chronic pain and escalate the cycle of increasing pain. Chronic pain is a complicated, multifaceted illness that affects every aspect of a person's life including family, work, and everyone around them. As a result, no single medical specialty can adequately address the needs of someone suffering from chronic pain.
In fact, the only effective way to treat chronic pain is through an integrated, multidisciplinary approach where all the physical, emotional, and psychosocial issues of the person and his / her family can be addressed. The earlier treatment of persistent pain begins, the easier and faster it can be resolved.
At a minimum, a good interdisciplinary team should include:
- A doctor experienced in pain management
- A health care professional for counselling (e.g. a psychologist or psychiatrist)
- A physical therapist or rehabilitation specialist to assess physical conditioning requirements
- Support staff knowledgeable about managing chronic pain
Pain relievers may help some forms of chronic pain but are ineffective for some people. Other methods are usually needed to adequately control pain. These can include:
- Physical activity
- Muscle strengthening
- Education (such as the development of coping skills and learning of relapse prevention skills)
- Reduction of inappropriate medications
- Treatment of symptoms of anxiety and depression
- Establishment of social support systems
- Taking personal responsibility for recovery
For more information on the conditions we treat and services we offer, or to book an appointment please call us on 416 489 5313 (Finch) / 416 604 4404 (Jane) or email us at info@physiowell.ca.
