Friday, October 31, 2014

Chronic Pain Syndrome

Definition

Chronic pain syndrome consists of chronic anxiety and depression, anger, and changed lifestyle, all with a variable but significant level of genuine neurologically based pain.

Description

Rare is the person who has not experienced pain and misery from a kidney stone, eye scratch, childbirth, or other problem. But the eye healed, the stone was passed, and the baby born. In each case, pain flared up in response to a known cause. With treatment, or with the body's healing powers alone, the pain went away.

Chronic pain is different in that it persists. Pain signals keep firing in the nervous system for weeks, months, even years. There may have been an initial mishap, a sprained back or a serious infection, from which the patient has long recovered. There may be an ongoing cause of pain such as arthritis or cancer. But some people suffer chronic pain in the absence of any past injury or evidence of body damage. Whatever the matter may be, chronic pain is real, unrelenting, and demoralizing.

Pain of such proportions overwhelms all other symptoms and becomes the problem. People may not be able to work. Their appetite falls off. Physical activity of any kind is exhausting and may aggravate the pain.

Soon the person becomes the victim of a vicious circle in which total preoccupation with pain leads to irritability and depression. The sufferer cannot sleep at night and the next day's weariness compounds the problem, leading to more irritability, depression, and pain. Specialists call that unhappy state the "terrible triad" of suffering, sleeplessness, and sadness, a calamity that is as hard on the family as it is on the victim.

The urge to do something, anything, to stop the pain makes some patients drug-dependent, drives others to undergo repeated operations or worse, and resort to questionable practitioners who promise quick and permanent "cures."

Chronic pain may be headache, low back pain, cancer pain, or perhaps arthritis pain. Other pain disorders stem from neuralgias and neuropathies that affect nerves throughout the body.

Diagnosis

Diagnosis is often based on the following:

  • The patient has chronic complaints of pain
  • Symptoms frequently exceed signs on physical exam
  • There is minimal relief with standard treatment
  • History of having seen many physicians
  • Frequent use of several nonspecific medications

Questions

What is causing the symptoms?

What type of treatment will you recommend to relieve the pain?

How effective is this treatment?

Can you explain how acupuncture and local electric stimulation work?

And how effective is each procedure?