24 Jan Chronic Pain – Non Cancer
Chronic pain is pain that lasts for more than three months, or beyond normal healing time. Although chronic pain can be very severe, ”chronic” actually refers to how long the pain lasts rather than how severe it is.
There are different types of chronic pain, such as nerve pain, pain from bones, muscles and joints, as well as cancer pain. Chronic pain can be anything from mild to severe. It is different to acute pain, such as pain from an injury, which happens quickly and doesn’t usually last for long.
Conditions like lower back pain, osteoarthritis, rheumatoid arthritis, neuropathic pain, fibromyalgia, and a range of other conditions can fall under the description of non-cancer chronic pain. What they all have in common is that they won’t go away.
Chronic pain can be due to chronic illnesses like migraine, osteoporosis, arthritis and other musculoskeletal ailments. It can also be pain that lingers after an injury or surgery. Sometimes there is no apparent cause.
Normally, if you suffer an injury, the nerves from that part of your body send signals to the brain. The brain reads these signals as pain.
But when someone has chronic pain, the nerves that carry pain signals to the brain or the brain itself are behaving in an unusual way. The nerves might be more sensitive than usual, or the brain might be misreading other signals as pain.
Chronic pain can be caused by ongoing disease states like arthritis in all its forms, cancer, lupus, multiple sclerosis or any of a myriad of conditions. It can be a consequence of trauma such as surgery, a car or work accident, or a fall. It can be a consequence of a minor injury which leaves ongoing pain. Sometimes the long-term nature of the pain is not indicative of ongoing disease or damage.
The longer pain persists, the more complex it becomes. Even if it is caused by a disease, it starts to involve multiple body systems beyond the nervous system. The endocrine (hormone) system, the gut and other body systems start to become involved.
Risks and complications
Chronic pain can make it hard to work, take care of yourself and do the things you enjoy. It can also affect your sleep and mood. More than half of Australian adults with chronic pain become anxious or depressed because of their pain. It’s vitally important to treat anxiety or depression should they be associated to your chronic pain.
In some cases, long-term opioid or non-opioid drugs is prescribed for the management of chronic pain. However, these are beset with problems; The risk here can be serious side effects, without good evidence of long-term benefit.
People who live with non-cancer chronic pain 24/7 are in no doubt as to the nature of their problem. It is debilitating, exhausting and has an impact on all parts of a person’s life. It takes courage and strength to live with pain that is uncontrolled and unpredictable. However, it is important to consult your doctor to be certain there isn’t an undetected underlying cause.
Treatment / Management
Drug treatments alone are not the answer to chronic pain. Drugs used to treat pain are generally divided into opioids and non-opioid medicines. Opioids are strong painkillers like morphine, fentanyl or oxycodone or codeine. They might be prescribed for short periods but are not very effective in chronic pain that is not caused by cancer. Long-term use of opioids has potentially serious risks, including accidental fatal overdose, dependence or addiction.
Non-opioid pain medicines, like paracetamol and ibuprofen, can be effective at relieving pain, but should generally be used only for a short period and in combination with self-management techniques.
People with chronic pain who actively manage their pain on a daily basis tend to do better than those who rely on passive therapies, like medication or surgery. Most people benefit from a range of different treatments and self-management, such as:
- psychological techniques — you can see a psychologist or use online self-help sites
- pacing your activities
- relaxation techniques such as meditation
- exercise such as walking, swimming, cycling or tai chi
- improving your sleep.
The aim of managing chronic pain is to allow you to resume do things such as socialise, work and be active generally. Reliance on medication is usually short term as you learn to regain function and cope with the symptoms of chronic pain. Your doctor will help you develop a plan for managing your chronic pain.