What is Chronic Pain?
Chronic pain is characterized as pain that persists for up to six months or longer, although the time in which a physician may deem continuous pain as chronic may vary. This form of pain may be mild, moderate, or severe, continuous or periodic, completely incapacitating or somewhat irritating.
The most common form of chronic pain that is reported is spinal pain followed by headaches and pain in areas such as the back, neck, joints, and pelvis. Muscle and nerve pain can also become chronic conditions.
Causes of Chronic Pain
There are a number of causes of chronic pain including injuries, trauma, infections, or underlying conditions such as tendinitis orcarpal tunnel syndrome.. In some cases, individuals may experience chronic pain that did not arise from an injury or apparent bodily damage. When this occurs, nerve inflammation may be causing the pain.
There are several risk factors for chronic pain such as stress, depression, fatigue, anxiety, and anger, all of which can hinder the body’s ability to release pain-relieving hormones and thereby increase pain sensations.
Chronic pain is often diagnosed by physicians when it begins to interfere with every day activities or decreases an individual’s quality of life. A quality of life scale is often used to assess a patient’s pain as well as potential improvement due to treatment, worsening of symptoms, or complications from the treatment.
Treatment for Chronic Pain
There are various treatments for chronic pain including:
Adhesiolysis (for chronic back and neck pain)
- Nerve blocks (e.g., superior hypogastric plexus block, sympathetic block, or medial branch block)
- Radiofrequency ablation
- Vertebroplasty and kyphoplasty for chronic spinal pain
- Steroid injections
Adhesiolysis is also known as epidural adhesiolysis or percutaneous epidural adhesiolysis, and involves inserting a needle and catheter near the posterior rather than placing it into the spine to reduce the risks that are associated with improper placement. Once the needle and catheter are placed correctly, a combination of medications and steroids are injected in order to relieve inflamed and irritated nerve roots that may be causing chronic back or neck pain.
A nerve block is similar to adhesiolysis in that it involves the insertion of a needle into regions where affected nerve roots are located and the subsequent administration of medication through the needle. During this procedure, a steroid and anesthetic, or a substance that disintegrates nerve tissue, may be injected in order to relieve chronic pain. This method can lead to long-term pain relief.
Radiofrequency ablation involves the insertion of a needle and an electrode that removes nerve tissue through high levels of heat. Although high levels of heat are utilized, the procedure is minimally invasive and has been shown to relieve chronic pain by disrupting affected nerves that are responsible for the pain.
Vertebroplasty and kyphoplasty are procedures that entail inserting a needle through the skin and spinal vertebrae that are causing chronic spinal pain. An imaging technique such as x-ray imaging or fluoroscopy is used during the placement of the needle to ensure that it is inserted correctly. Vertebroplasty involves injecting cement through the needle in order to help restore the length of the spinal column and straighten excessive spinal curving. Kyphoplasty involves inserting one or two inflatable balloons between the vertebrae as opposed to cement. The one-balloon kyphoplasty approach is often preferred by professionals over vertebroplasty, as it avoids the risk of cement leakage, has a shorter operating time, and lowers the exposure to radiation from the imaging equipment.
Vertebroplasty has been shown to enhance the healing and repair of vertebral compression fractures, which may cause chronic pain, for longer periods of time than kyphoplasty. However, kyphoplasty has been shown to provide a rapid reduction of chronic pain and accelerated recovery periods while helping restore vertebral length. Both procedures provide rapid pain relief that is typically reported during the first 48 hours after treatment.
Steroid injections may be cervical or epidural and involve using a needle to inject steroids and an anesthetic into the region where affected nerve roots are located. Medication is administered between vertebrae in the neck for the cervical steroid injection and medication can be administered to different locations for the epidural steroid injection. The steroids lead to a reduction of inflammation, while the anesthetic leads to a reduction in or elimination of pain. Both of these are brief procedures and some patients have reported experiencing immediate pain relief. Steroid injections can also be repeated if necessary in order to improve the treatment outcome.
Opioids are medications such as methadone, oxycodone, morphine, and codeine that are prescribed to treat chronic pain. These types of pain-relieving medications are stronger than over-the counter or prescription strength acetaminophen and ibuprofen, but are generally a short-term form of treatment as prolong use may lead to drug abuse, dependence, or an overdose. Physicians closely monitor patients who are prescribed opioids and different types of treatments are suggested if the effectiveness of the opioids begin to decrease.
Acupuncture is a treatment method for relieving chronic pain that originated from Chinese medical practices. This procedure entails placing needles in specific regions of the body where the pain or discomfort is felt, as well as distant areas that may be contributing to the pain. The specific placement of the needles has the ability to reduce stiffness, inflammation, and pain. Its effectiveness at improving chronic pain is also attributed to the release of endorphins into the body, which are pain relieving hormones. There are various types of acupuncture such as traditional needle acupuncture, laser acupuncture, manual or finger acupuncture, and electroacupuncture, which involves electrically charged needles or electrical pads.
Chronic pain is often described as pain that persists for at least six months or more. The pain may be mild, moderate, severe, continuous, periodic, irritating, or incapacitating. Common forms of chronic pain include spinal pain, headaches, back pain, neck pain, joint pain, and pelvic pain.
Causes of chronic pain are typically injuries, trauma, infections, or conditions such as carpal tunnel syndrome, tendinitis, or osteoporosis. Risk factors such as stress, depression, fatigue, anxiety, and anger can decrease the ability of the body to release pain-relieving hormones.
There are numerous forms of treatment for chronic pain, including adhesiolysis, nerve blocks, or acupuncture.
A quality of life scale if often used to determine a patient’s level of pain as well as types of treatment that should be utilized. It may be necessary to combine different forms of treatment in order to experience long-term relief.