What is Chronic Pain?
Chronic pain is one of the most common reasons people seek medical help.
In 2016, the CDC conducted a survey on US citizens and discovered the following:
- 50 million adults suffer from chronic pain
- 19.6 million adults have high-impact chronic pain symptoms
- Approximately 30% of patients report severe pain lasting for more than 6 months.
When severe pain lasts for more than 3 months, it is known as high-impact chronic pain. This type of pain is commonly associated with disabilities that limit a patient’s daily activities.
What exactly is chronic pain? What causes it and why should this be a concern?
Contrary to what most people believe, pain is not necessarily a bad thing. It is a signal that our body uses to communicate. Without it, we would never know if something was wrong.
For example, if you’ve ever touched a hot stove, be grateful that you felt pain. It’s your body's way of saving you from further injury. However, when pain lasts for more than 12 weeks, it becomes a concern.
Most tissue-related injuries heal within that timespan. Pain that continues to persists afterward, can signify a serious problem that should not be overlooked.
When it comes to cancer-related pain, there are two types: malignant and chronic. It is important to know the differences between these two types, as treatment differs depending on the situation. If you want to learn more about the effects of chronic pain and how to treat it, read on.
What is the burden of chronic pain?
Ketamine for Chronic Pain
Ketamine is most effective with neuropathic pain like Complex Regional Pain Syndrome, post-herpetic neuralgia (shingles) and phantom limb pain.
Most Common Causes of Chronic Pain
Fibromyalgia, or FM is characterized by widespread musculoskeletal pain, cognitive disturbance, psychiatric conditions, fatigue, and various somatic symptoms for at least 3 months. The exact cause and the underlying mechanisms that cause FM are not yet known. This disorder mainly affects muscles, tendons, and ligaments, but without any evidence of inflammation.
On physical exams and laboratory work-ups, the patient appears normal. As a result, some practitioners believe that the pain a patient experiences is psychogenic. Recent studies however, postulate that pain felt by patients with fibromyalgia, involves the somatosensory system - which is the body's center for pain regulation.
The musculoskeletal pain of fibromyalgia usually involves at least six different sites. These sites include the upper back and spine, the lower back, the legs, the chest, and the arms. Patients that often compare the pain they feel to that of someone who has the flu. Some patients report joint pain similar to synovitis, but there’s little evidence that leads to that outcome.
Fatigue and sleep disturbances are also a common finding in fibromyalgia. Many patients have reported sleeping for at least 8 hours, but still feeling tired. They also report feeling fatigued after doing simple activities. Emotional fatigue may play a role in these outcomes.
Some patients also complain of headaches and changes in sensation. Numbness, crawling and tingling sensations in their extremities, can also manifest in patients with fibromyalgia. By the time patients are diagnosed with fibromyalgia, approximately 30-50% have also been diagnosed with depression and/or anxiety.
Chronic Nerve Pain
Nerve or neuropathic pain is characterized by burning sensations in nerve distributions, which can be extremely painful. It can indicate nerve damage, or a generalized disease of the central nervous system, When this pain persists for more than 12 weeks, it becomes chronic neuropathic pain.
One well-known type of neuropathic pain is phantom limb syndrome. People who are missing limbs due to amputation often experience pain where it used to be. This is because the brain still receives pain signals from malfunctioning nerve pathways.
Other causes of nerve pain include direct damage to nerve cells. Patients with uncontrolled diabetes may also experience chronic nerve pain. It can also originate from infections such as Herpes virus, Syphilis, HIV, and from nervous system disorders like multiple myeloma and multiple sclerosis.
Complex Regional Pain Syndrome (CRPS)
Like fibromyalgia, Complex Regional Pain Syndrome is a disorder of the somatosensory system. However, CRPS can also be due to inflammation and is usually preceded by an inciting event 4 to 6 weeks earlier. This event involves accidents that result in a fracture, crush injury, sprains, or undergoing surgery. A small percentage of people with CRPs do not have an identifiable inciting event. Postmenopausal women are also at higher risk of CRPS.
CRPS has specific sensory, motor, tropic and autonomic changes. Symptoms include acute pain, redness, and swelling in the affected limb. This pain is often described as a stinging or tearing sensation that is felt deeply. It worsens when the limb is moved or touched. Pain is felt most intensely at night and when there are temperature changes.
Some patients also experience abnormal pain sensations like allodynia, which is defined as sensation of pain from a stimulus that doesn’t cause pain. For example, someone who feels pain from brushing their hair may be suffering from allodynia. People with CRPS may also experience decreased sensations in the distal parts of their limbs.
Overtime, the affected limb’s motor movements may become limited. This is due to the abnormal pain response and sensations that manifest from CRPS. The autonomic component of CRPS is responsible for changes in temperature, sweating, and edema. Trophic changes like localized hair growth or skin atrophy may also be observed in patients with CRPS.
Chronic pain is extremely bothersome. Patients with chronic pain often feel intense pain at the slightest touch or stimuli. Additionally, many people with chronic pain live a lesser quality of life. This is due to interruptions in their sleep, over-dependence on family members, and emotional hardships.
Some Treatment Options for Chronic Pain
Besides medication, there are a number of alternatives for the treatment of chronic pain. Drugs like opioids and NSAIDs have associated risks with prolonged use. Opioids may induce tolerance and dependence, and NSAIDs can cause kidney damage. Those who are diabetic, hypertensive, or taking other medications are especially at risk. However, there are ways to manage chronic pain without the use of medication.
The Injection & Infusion Clinic of ABQ can help. We offer ketamine infusions to provide pain relief to those suffering from chronic pain. Besides dealing with chronic pain, we also have solutions for depression, fibromyalgia, CRPS, and PTSD. If you’re looking for a healthcare clinic that makes every patient feel cared for, give us a call at 505-445-4300 today! We are located conveniently in Albuquerque, New Mexico. We do require a referral for pain ketamine infusions. You can self-refer for mental health ketamine infusions.