Chronic pain is a condition that affects more than 20 percent of adults in the U.S., with many in that population that are so severely affected they can’t carry out their daily activities or work.
While the name of the condition suggests the pain will last indefinitely, it is possible to manage and even recover from it with the right treatments and the right state of mind. However, it’s not a simple process – chronic pain is a complex issue that must be examined by someone trained specifically in pain management, such as anesthesiologist Dr. Subrata Chakravarty with more than 15 years of experience in the field.
Understanding Chronic Pain
The term is sometimes misunderstood as an injury that doesn’t heal. However, chronic pain lasts far beyond when the injury is gone – beyond three months, to be more specific. Although the physical injury may no longer be apparent, in chronic pain patients the body continues to signal a pain response to the brain, possibly due to nerve damage.
The pain associated is not always severe, chronic pain can present itself as a dull headache that occurs regularly, or something more alarming like sharp pains or a burning sensation. While many cases of chronic pain begin with an obvious injury, in some cases there is no apparent cause at all.
In the case of chronic pain conditions that don’t seem to have an underlying issue such as fibromyalgia, for example, there will be no signs from medical imaging that the condition exists (although there is a blood test that may be used in coming years for a diagnosis.) That may lead a physician – or even the patient – to believe the pain is imagined or to not take proper treatment action to address the problem. Yet the patient will still suffer the symptoms, in some cases for years.
Medical Pain Management Approaches
Some over-the-counter pain medications may provide temporary relief for chronic pain patients. However, doctors not trained in pain management will often turn to solutions such as opioid drugs to help give their patients immediate relief.
Dr. Subrata shares that unfortunately, the nature of these opioid medications is that they’re highly addictive, which can lead to abuse. However, an anesthesiologist well-versed in pain management techniques can prescribe appropriate doses and provide ongoing supervision to ensure there’s a proper treatment plan in place.
There are other therapeutic approaches to tackling pain that can include the use of steroids, as well as drugs not usually associated with pain – such as anticonvulsants and even antidepressants. According to Subrata Chakravarty, the latter can help block out pain signals by increasing neurotransmitters in the spinal cord, which becomes more effective as the drug has a chance to work over weeks or months. These antidepressant medications are thought of as lower risk by some physicians because they’re not generally associated with addictive behaviour – although there are withdrawal symptoms from stopping this medication abruptly.
Aside from medications, anesthesiologists like Dr. Subrata also have other options to manage pain. A nerve block is one popular solution that blocks pain signals and can be performed surgically or non-surgically. An anesthesiologist can administer an injection into a nerve site, which will render it temporarily numb. In the surgical version, doctors can sever nerves that are sending the pain signals – which is a more permanent and invasive solution.
Meanwhile, other approaches such as acupuncture and massage therapy have been found to increase endorphins and naturally reduce the effects of chronic pain.
Changing Mindset Towards Recovery
Recovery can mean different things – it can be the complete absence of symptoms, or it can be learning to achieve higher function despite symptoms persisting. In many cases, it’s the psychological impact of chronic pain that makes it debilitating. It’s hard for some people to accept they have the condition, and to feel like they have no control over it.
That’s why recovery from chronic pain requires a multidisciplinary approach that includes care from an experienced anesthesiologist. Dr. Subrata shares that an important component is how the patient themselves chooses to react to the pain: seeing it as a barrier that prevents them from enjoying life; or changing how they approach tasks after accepting pain will be a factor.
With this in mind, a patient can effectively remove pain from the equation when they set realistic expectations of themselves based on their condition. That may mean that weekly activities such as cleaning the house gets done in phases rather than all at once, or that a physical activity such as hike gets shortened.
When a patient can continuously conquer managed tasks, Subrata Chakravarty says it will boost their sense of motivation and confidence that are so often decimated by chronic pain. This process of building confidence and motivation is helping individuals make pain more of an afterthought rather than a hurdle that causes some people to avoid engaging altogether.
While muscle pain is usually an indicator that they need a break from activity, it’s not the case with chronic pain. Because there is not actually an underlying cause anymore, avoiding activity can worsen the condition by making muscles and joints stiff. Pushing past the belief that pain means movement is harmful is an important step on the road to recovery, says Dr. Subrata Chakravarty.
Dr. Subrata notes that learning what sets off chronic pain is also a key component in ongoing pain management. For example, stress and anxiety can make pain seem more prominent, which in turn can cause more stress. While environmental stress is often inevitable, relaxation techniques such as deep breathing is a natural way to lessen some of the effects of the stress hormone, cortisol.
Cutting down or eliminating caffeine and nicotine can also help you cope with stress, as both are stimulants that can activate pain responses. Meanwhile, a diet can be modified to limit the inflammation associated with pain. The staples of this diet are vegetables such as broccoli and cauliflower, while avoiding refined sugar and red meat.
In the end the pain may still linger, but a patient can learn their way around it to live a happier and fuller life.