How to cope with chronic pain

Chronic pain is something that can make any person's life unbearable.Even mild but constant pain affects the nervous, endocrine, cardiovascular systems, immunity and the whole organism.Very often it leads to excessive irritability, aggressiveness or, conversely - to apathy and depressed, withdrawn, depression.About the types and causes of chronic pain, its impact on the body and modern methods of treatment, we will tell you in detail in this article.

Chronic pain is one of the common problems in medicine. For example, in the United States, it is diagnosed in more than 20% of adults, and in 7% it significantly limits daily activity. Most often with chronic pain syndrome in patients face therapists, neurologists and rheumatologists, but doctors of other specialties know about it firsthand.

Pain is considered chronic if it

• lasts longer than 3 months or persists longer than a month from the healing of an acute injury;
• accompanies non-healing wounds/inflammatory processes (e.g. pressure sores, trophic ulcers).

Chronic pain has its own characteristics. It is caused by prolonged pain impulses (nociceptive or neuropathic) occurring against the background of chronic disease or damage (e.g. malignant tumor, intervertebral hernia, rheumatoid arthritis). Due to constant stimulation, the sensitivity of the nervous system increases, and a person begins to feel pain constantly, even if the stimuli themselves weaken or disappear altogether.

This is the main difference between chronic pain and acute pain: while acute pain gradually decreases and disappears after recovery from the disease / wound healing, chronic pain stays with a person for a long time.

How does daily pain (headache, joint pain, muscle pain and others) affect the body:

• Limits physical activity;
• leads to constant reflex muscle tension - over time, spasmed muscles also begin to hurt and creates a “vicious circle”;
• disturbs sleep;
• can provoke high blood pressure, angina attacks;
• causes anxiety, depression, irritability;
• leads to relationship problems and sometimes social isolation;
• significantly reduces the quality of life.

Why does chronic pain occur?

The causes of chronic pain syndrome are many. In addition, it can arise under the influence of various factors that “unite” and aggravate unpleasant sensations. The main causes of chronic pain (in the abdomen, muscles, lower back, joints and other organs) include:

• long-term inflammatory process - rheumatoid arthritis, osteoarthritis, Crohn's disease;
• trauma, degenerative diseases - a frequent “culprit” of low back pain;
• disorders of the nervous system (“neurological” pain) - e.g. migraine;
• chronic diseases (diabetes, cancer, herpetic infection, fibromyalgia) - the main causes of neuropathic pain;
• psychological disorders - prolonged exposure to stress, depression lead not only to the development of psychosomatic diseases, but also to chronic pain syndrome. And it is very difficult to treat;
• other factors (for example, genetically determined increased pain sensitivity, metabolic disorders, dyshormonal diseases) - they can cause the transformation of acute pain into chronic pain.

The main types of chronic pain

Chronic pain can affect any organ or part of the body. Sometimes its source is obvious - with discomfort in the lower back, you should first look for a problem in the spine.

But it often happens and so that the pain is not what “hurts”. For example, with inflammation of the trigeminal nerve unpleasant sensations can occur in the teeth, and with myocardial infarction - in the lower jaw, stomach and even shins.

But still there are types of chronic pain that occur most often - these are the ones we will consider in our article.

Chronic pain in the abdomen

The main causes of chronic abdominal pain are inflammatory processes (for example, nonspecific ulcerative colitis), adhesions, irritable bowel syndrome (IBS). With IBS patients most often turn to gastroenterologists, and often surgeons, fearing that they have a malignant tumor in the digestive tract or some severe, incurable disease.

The fact is that the main manifestation of IBS is pain. Sometimes it is so strong that a person can even lose consciousness. But, regardless of the intensity of the pain syndrome, IBS is not life-threatening.

But while irritable bowel syndrome is not life-threatening, it cannot be called a simple disease. For one thing, IBS can mimic a wide variety of diseases, from dysbacteriosis and chronic constipation to cancer. And, accordingly, it is difficult to confirm this diagnosis - first you need to exclude all other diseases of the GI tract. And secondly, irritable bowel syndrome can significantly worsen the quality of life - with a tendency to diarrhea and severe abdominal pain, people are simply afraid to leave the house.

To establish the cause of chronic abdominal pain, doctors prescribe various studies:

• general and biochemical blood tests;
• stool analysis for hidden blood, coprogram;
• ultrasound of the abdominal cavity;
• irrigoscopy;
• CT or MRI scan;
• colonoscopy and capsule endoscopy - the digestive tract is examined from the inside using an endoscope (it is inserted through the rectum) or a special capsule equipped with a video camera (the patient swallows it and it comes out naturally).

Migraine and headaches

There is hardly a person who has never experienced a headache - it affects both adults and children. Although these unpleasant sensations can occur for a variety of reasons, the most common is tension headache.It is provoked by stress, sleep disorders, problems with the spine, neck muscles, temporomandibular joint, eye strain with constant work with a computer.

However, tension headache usually quickly passes after taking conventional analgesics - for example, based on paracetamol, ibuprofen, nimesulide and other NSAIDs. Relaxation techniques and massage are also very effective.

Unlike tension headaches, headaches associated with impaired venous outflow in the brain (increased intracranial pressure), so simply do not give up. It is often provoked by changes in atmospheric pressure, changes in weather.

To improve blood circulation in the brain and restore venous outflow, it is necessary, first of all, to normalize the tone of the veins. And caffeine helps us in this, and even better - combined analgesics with caffeine in their composition.

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Separately, it is worth mentioning migraine. Like irritable bowel syndrome, it significantly worsens the quality of life - with a prolonged attack, a person can “fall out” of normal activity for several days. This is a serious disease, which is not always possible to cope with pills and injections.

Migraine refers to primary headaches, it is based on neurological disorders. In addition to pain, light intolerance, nausea and vomiting are often noted. In some people, the onset of an attack may be preceded by an aura (as in epilepsy).

Migraine is treated with special drugs - triptans, but in mild attacks can be used combined analgesics containing acetylsalicylic acid and paracetamol (for example, Antinevralgic P, Antinevralgic Forte). Doctors also use beta-blockers.

Neuropathic pain

Neuropathic pain occurs not because of irritation of pain receptors, but because of a disturbance in the nervous system (peripheral or central). The classic example of such pain is postherpetic neuralgia. It develops in response to nerve damage from the Varicella zoster virus (shingles) and can persist for many months after the infection.

Trigeminal neuralgia often results in excruciating neuropathic headaches that are extremely difficult to manage with conventional analgesics and require the use of “heavy artillery” such as pregabalin and gabapentin.

Pelvic pain in women and men

Chronic pelvic pain is another common syndrome that can be encountered by a doctor of any specialty. In women, pelvic discomfort can be caused by:

• Gynecologic diseases (endometriosis, myoma, ovarian cysts, chronic inflammatory process in the ovaries and tubes);
• varicose uterine veins;
• interstitial cystitis and other pathologies of the urinary system;
• spinal problems (osteochondrosis, intervertebral protrusions and herniations, spondylolisthesis);
• irritable bowel syndrome, inflammatory diseases of the digestive tract and other diseases.

In men, prolonged pelvic pain is often caused by prostate lesions - for example, chronic prostatitis.

Chronic fatigue and persistent muscle pain

Constant muscle pain is a characteristic symptom of fibromyalgia. It can be diagnosed in any person regardless of age and gender, but it is much more common in women (7 times more common than in men).

Fibromyalgia refers to pain sensitivity disorders of central origin. It is a non-inflammatory disorder and usually doctors do not find any significant changes on examination. However, the patient experiences constant pain - in the back of the neck and shoulders, head, lower back, neck, chest, thighs.

Fibromyalgia is often triggered by chronic stress and sleep disorders. It can also occur temporarily - for example, against the background of viral or bacterial infections, injuries. In some patients, fibromyalgia is accompanied by chronic fatigue syndrome - a condition in which a person constantly feels a loss of energy, and even a good night's sleep does not bring relief.

How to get rid of chronic pain?

Treatment of chronic pain is a very complex process. It requires a comprehensive approach - lifestyle changes, combination of medication with physical therapy, and if not effective enough - with psychotherapy and alternative methods (for example, therapeutic acupuncture - acupuncture).

Medication treatment of chronic pain

Drug therapy is the most popular option for dealing with chronic pain. Medications usually work quickly and are effective in managing discomfort. But each type of pain requires a different medication, and this should definitely be considered.

What analgesics are used in chronic pain syndrome:

• Nonsteroidal anti-inflammatory drugs(ibuprofen, nimesulide, diclofenac, coxibs) - NSAIDs are indispensable if the pain is caused by an inflammatory process;
• analgesic-antipyretic paracetamol - unlike NSAIDs, it is practically devoid of anti-inflammatory activity, but it copes with the pain syndrome perfectly;
• pregabalin and gabapentin - these are drugs for neuropathic pain. They are used in various neuropathies, diabetes mellitus, as well as in malignant tumors;
• antispasmodics (mebeverine, drotaverine) - without them can not do without them in adhesions, irritable bowel syndrome, some types of headache.

Other drugs can also be used for chronic pain:

• opioid analgesics - morphine-based drugs are the most effective, but also the most dangerous, because they cause narcotic dependence. For chronic pain syndrome, they are usually used only for inoperable malignant tumors;
• antidepressants - effective for psychosomatic pain and fibromyalgia;
• anticonvulsant drugs (carbamazepine);
• triptans - specific drugs for the treatment of migraine.

To enhance the analgesic effect, doctors often use combination drugs - such as Antinevralgic P and Antinevralgic Forte, which we mentioned above.

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Physical therapy for chronic pain

One of the most effective physiotherapeutic methods is considered to be massage. It is an indispensable assistant for tension headaches, as well as chronic pain syndrome in spinal lesions. Massage becomes even more useful if it is combined with therapeutic exercise / kinesitherapy.

Other physical therapy modalities are:

• electrical stimulation;
• heat and cold therapy;
• magnetotherapy;
• ultrasound therapy.

Alternative methods of pain treatment

Alternative methods are used in the comprehensive treatment of chronic pain if analgesics and physical therapy do not provide adequate relief. These include:

• Therapeutic acupuncture;
• yoga;
• meditative techniques;
• biofeedback - assessment of the main indicators of the body with the help of special devices, which allows a person to control his condition and relax in time;
• hypno- and psychotherapy.

When to see a doctor?

A doctor should be consulted for any chronic pain regardless of its type. Even if the pain syndrome is not associated with a serious illness, it can severely diminish a person's quality of life - even to the point of complete social isolation.

But sometimes pain can also be a symptom of really dangerous diseases - for example, cancer. And only a doctor will be able to establish an accurate diagnosis and prescribe the correct treatment.

Comprehensive examination necessarily includes general blood and urine tests, blood chemistry, ultrasound, radiography and other studies depending on the presumptive diagnosis - CT or MRI, Dopplerography of cerebral and/or leg vessels, colonoscopy, consultations of specialized specialists, etc.