Chronic Pain Series
This is the last in a three-part series on chronic pain. Click here to see the first part, Chronic Pain: An Overview. Click here for part two, Two Types of Chronic Pain: Neuropathic and Musculoskeletal Examined.
Millions grapple with chronic pain every day. While everyone’s pain is unique, chronic pain sufferers agree that it can affect your ability to sleep, work, perform routine activities, and enjoy life. Developing a pain management strategy often involves a process of trial and error, starting with understanding the type and source of the pain. This month KnovaSolutions focuses on inflammatory and compressive pain.
Inflammation is the body’s natural way of protecting against foreign substances. The body sends white blood cells and chemicals to the site to help heal infections and injuries. Increased blood flow causes redness and warmth, and the leaking of fluids into the surrounding area, resulting in swelling. This can stimulate nerves and cause pain.
Inflammatory disorders, such as rheumatoid arthritis, lupus, fibromyalgia and gout, arise when the body’s protective process (or immune system) triggers an inflammatory response for no apparent reason, causing damage and disease. While the cause of the underlying condition is not easily explained, it is believed that family history, factors like smoking and being overweight, and age may increase the likelihood of developing inflammatory conditions. Treating inflammatory pain will begin by trying to treat, manage or slow down the underlying disease process.
Compressive or mechanical pain refers to pain in the body’s support structure (spinal joints, discs, vertebrae or soft tissues). Pain may also radiate out from the spine to muscles and ligaments.
While compressive pain can occur in the neck area, low back pain is by far the most common type of compressive pain, in fact, 85 percent of people will seek care for it. Lower back compressive pain can extend to the buttocks and thighs. The pain can feel like a deep, aching pain and/or a spasm, and is worsened when bending over or with lifting heavy objects.
Diagnosing compressive pain is similar to identifying other types of chronic pain: a medical history and exam. If your provider thinks your pain is mechanical, additional testing may not be necessary, but if an infection, tumor or pinched nerve is suspected, blood testing, x-rays, MRIs or CT scans, and nerve conduction studies may be necessary.
Treatment for the majority of patients with compressive pain involves a period of rest for up to 48 hours and the use of over-the-counter (OTC) pain relievers. It’s believed that physical activity promotes recovery from back pain. Those with moderate to minor pain are encouraged to stick to their normal schedule.
Mind/Body Therapies for Pain Management
Pain and stress are closely linked. Pain can cause stress and being under stress can worsen pain. The body reacts by driving up heart rate and blood pressure, making breathing fast and shallow, and tightening muscles. Chronic stress, such as worrying about finances or health, and feeling trapped in an unhappy marriage or bad job can cause the nervous system to stay on high alert. Stress hormones run high and muscles stay tense.
As people learn more about the relationship between mind and body, many find help from complementary therapies, including counseling, relaxation therapy, meditation and biofeedback.
It’s not surprising that depression, anxiety and irritability are very common among people with chronic pain. Counseling is known to help. It does not treat the pain, but teaches strategies for learning to deal with the pain.
Sometimes simply talking to an impartial person about being in constant pain can feel like a relief. Plus s/he can help break down tasks into more manageable sizes, teach relaxation techniques that might improve your sleep (a problem for many pain sufferers), help reframe problems and more.
Relaxation techniques can slow down racing thoughts, reduce stress hormones, relax muscles and promote a sense of well-being. Regular use can reverse the long-term effects of chronic stress and pain. Relaxation exercises include slowly tensing and releasing muscles starting at the top of the head and working down to the feet, or vice versa.
Meditation can reduce anxiety, lower blood pressure and increase the body’s tolerance for pain. Mindful meditation may involve sitting or lying quietly while being aware of your breath. When pain or worries enter your thoughts, simply notice them as if they are a cloud passing by, then return your thoughts to your breath. Yoga, prayer or repeating/chanting a phrase can help you achieve a meditative state.
Biofeedback is used in tandem with guided imagery to teach how to consciously slow heart rate, release muscle tension and lower blood pressure. With the use of electrodes, it is possible to measure how heart rate and muscle tension change as you go from “normal” to a relaxed state. Guided imagery allows you to imagine that you are in a peaceful place, which helps to divert your attention away from pain and stress.
Pain Treatment Options
- Resting and/or avoiding activities that aggravate pain as an injury heals.
- Moderate exercise, including physical therapy to maintain mobility and strength.
- Decreasing stress on joints by using splints, braces or canes, or wearing compression gloves or sleeves to keep fluids out of your joints.
- Self-care measures including alternating hot and cold for 20 minutes each, warm compresses or baths.
- Over-the-counter medicines, such as ibuprofen, aspirin or naproxen, and prescription medications such as narcotics for short-term, severe pain.
- Complementary therapies such as counseling, relaxation therapy, meditation and biofeedback.
Need More Info?
If you or someone in your family struggles with chronic pain, your KnovaSolutions nurse is a source for additional information and support. Let us know how we can help — 800/355-0885.
The information contained in this newsletter is for general, educational purposes. It should not be considered a replacement for consultation with your healthcare provider. If you have concerns about your health, please contact your healthcare provider.
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