It’s important to note that all pain is real! Chronic pain is not “all in your head.” It is pain that persists beyond the acute stage (greater than two months). It often occurs independent of actual tissue damage, meaning that there is no damage to muscle, tendon, ligament, bone, etc that is causing the pain.
Chronic pain involves changes that occur within the brain in response to pain that lasts for long periods of time. Areas in the brain that are not associated with perceiving pain begin to perceive signals as pain – meaning that activities that should not cause pain are now painful! This can significantly affect the quality of one’s life.
Chronic pain affects almost 1 in 3 people worldwide! The cost in the US is about $600 billion annually for medical treatment, lost wages, and lost work time. Chronic pain is the most common reason to seek treatment and the most common reason for disability and addiction. The cost of treatment for chronic pain in the US is even greater than those for cancer, heart disease, dementia, and diabetes care.
Currently, chronic pain is not managed well by healthcare providers. A common treatment is the use of opioids. Opioids (e.g. codeine, morphine, hydrocodone (Norco), oxycodone, fentanyl) are meant for short term management of acute pain. They are not meant for long term management of chronic pain. Medication alone cannot treat chronic pain. When other treatments are added in addition to medication, outcomes are shown to be better. Some people on long term opioid treatment actually experience the side effect of hyperalgesia (or hypersensitivity) which increases pain!
How to Manage
There are several other ways to manage chronic pain in addition to medication.
• Exercise – start with light, painfree activities and increase as you are able
• Reduce stress as stress causes increased inflammation which can lead to increased pain
• Learn more about your condition – learn how others manage to control their pain and maintain their function
• Keep up with normal activities as much as possible
• Improve your overall health
• Avoid bed rest and inactivity – Bed rest will not improve your pain and may make it worse, as it leads to other problems such as weakness, weight gain, and poor circulation.
• Consume an anti-inflammatory diet
– Emphasizes plant-based foods and anti-inflammatory spices: turmeric, ginger
– Nutrient deficiency is common in chronic pain and can be worsened by long term use of analgesics (common deficiencies include vitamin D and magnesium)
– Make sure you have the correct intake of omega 3 fatty acids
• Make sure you are hydrated
– Dehydration can amplify chronic pain symptoms such as headaches, muscle aches, joint stiffness, and fatigue
– Proper hydration is key in managing pain and improving our body’s function
– Caffeine intake to address loss of sleep, fatigue, and headaches can contribute to dehydration
– The recommendation for appropriate amount of water varies but 64 oz is a great place to start
• Make sure you are getting enough sleep
– Position modification
– Stretching before bed
– See if there are other factors other than pain that are contributing to loss of sleep
– Caffeine intake
– Stimulants such as light or noise
– Use of cell phones or other electronics prior to bed
• Physical therapy or occupational therapy to increase strength, increase mobility, and improve function as well as to address pain
• Be your own advocate when seeking treatment. Only you know what you are feeling and how it affects you. Work to find the treatment that is best for you!
This blog was specially written by our friend and guest writer Rachel Zimmerman, DPT.
Rachel is clinic director at ATI Physical Therapy in Green Bay, WI. You can find out more about her clinic or find a location near you at ATIpt.com!