On this week’s blog, we share an article from digital media journalist and blogger Smith Willas. Enjoy :-)

Chronic pain is a continuous or intermittent pain that persists for a longer period of time. It affects a person’s life in many ways depending on various circumstances. People grappling with chronic pain experience conflict between what they want to do and what their body will let them do. The most prevalent chronic pains are limb pain, headaches, abdominal and back pain. 

It is generally found that the higher the intensity and frequency of pain is, the lower the self-reporting quality of life becomes. It greatly impacts psychological functioning (feeling less at ease), physical status (increased incidence of other somatic conditions), and functional status (more impediments to leisure and daily activities).

According to a recent report by Indiana University, an estimated 100 million Americans live with chronic pain. Other statistics reveal that pain affects more people in the U.S. than diabetes, heart disease, and cancer combined; of those in pain, 27% suffer from lower back pain, 15% from severe headaches or migraine pain, and 15% from neck pain. Chronic pain, therefore, is associated with distinct pathology, causing changes throughout the nervous system that often worsen over time. As far as remedies are concerned, there are many ways to deal with chronic pain without strong medications. We will see in the subsequent passage, there are certain kinds of pains that do not necessarily require administration of medicine.
 

Types of chronic pain:

Chronic pain is usually referred to as a pain that lasts longer than a few months to many years, which affects people in many ways. It varies in intensity as well as the way of functioning. The following are different types of chronic pains to be aware of:
 

• Nociceptive Pain

Nociception is a Latin term meaning ‘to harm or hurt’; it is the sensory nervous system's response to certain harmful or potentially harmful stimuli. Nociceptive pain is pain detected in either the body's soft tissues (such as muscles and skin) or organs by specialized sensory nerves, known as nociceptors. These nociceptors detect painful stimuli and send information to the spinal cord and brain for interpretation and response. Examples of nociceptive pain are headaches, pelvic pain, arthritis etc. 
 

• Somatic pain

Somatic means relating to the body as opposed to mind, and somatic pain is basically detected by sensory nerves in the muscles, skin and soft tissues. This type of pain is often easy to locate, as sensory nerves are well-distributed throughout ​ the soft tissue. It can be either superficial or deep. Superficial pain is felt due to nociceptive receptors, while deep somatic pain arises from structures such as joints, bones, tendons, and muscles.
 

• Visceral pain

Visceral pain refers to pain in the trunk area of the body that includes the heart, lungs, abdominal and pelvic organs. It represents a major clinical problem yet difficult to localize the internal organs are not as widespread as they are in the body's muscles and skin. It may be accompanied by nausea, vomiting, changes in vital signs (heart rate, blood pressure, temperature), and emotional manifestations.
 

• Neuropathic pain

Neuropathic pain is nerve-related pain caused by nerves that do not function normally- they may be damaged, dysfunctional or injured. It is a complex pain because damaged nerve fibers send incorrect or confused signals to other pain centers. Its intensity can vary throughout the day and a patient experiences feeling like stabbing, pricking, burning, and tingling. Examples of neuropathic pain are Phantom limb pain, peripheral neuropathy (diabetic neuropathy), post-mastectomy pain, and sciatica. 
 

• Psychogenic pain

As the name suggests, psychogenic pain is associated with psychological factors such as depression and anxiety. Other factors may include certain beliefs, fears, memories or emotions that lead to the initiation or worsening of pain. People grappling with psychogenic pain often have a history of unresolved psychological issues that can resurface at any point in time, resulting in symptoms of pain. Patients report stark pain of high intensity, such as a knife in the back or hot iron wounds. Headaches, muscle pains, back pain, and stomach pains are some of the most common types of psychogenic pain.
 

• Idiopathic pain

Chronic idiopathic pain syndrome is basically a pain of unknown origin. It may involve both cerebral and peripheral physiological mechanisms, and often associated with depression. It can last around 6 months or longer. Some experts suggest that brain sends pain signals despite there not being any actual tissue damage. Idiopathic pain is usually treated with a wide range of medications. It’s almost like a shotgun approach of throwing everything we can find at it until we learn what works. These disorders include TMJ disorders and fibromyalgia.
 

• Complex regional pain syndrome (CRPS)

CRPS is a type of neuropathic pain that may result from a major injury, but it can also be caused by a relatively minor trauma. Though its origins are largely unknown, it is associated with severe and debilitating pain. The pain can be so intense that even lightest touch can be excruciating. Diagnosing CRPS may often be difficult because a patient's symptoms and physical findings can mimic other disorders.
 

How chronic pain affects your life:

Chronic pain can cause serious physical and mental conditions. Cancer pain, for instance, progresses rapidly, so treatment has to be administered frequently, and opioids (like morphine) may need to be prescribed at higher and higher doses. It may also result in toleration for these medications, which is why interventional techniques such as spinal pain pumps or destroying pain nerves may offer significant relief. On the other hand, mental conditions may include depression, anxiety, and post-traumatic stress disorder. 

During chronic pain, a person’s body continually sends signals to the brain, even leading to a heightened level of threat perception. According to some stats, in fibromyalgia (muscle pain and tenderness) patients, over 62% will experience depression, and 56% have increased anxiety as compared to 7% and 18%, respectively, in the general population of the U.S. 

Chronic pain can fundamentally change the way brain processes emotions and the pain itself. People having chronic pain are more likely to experience depression because the pain affects the part of the brain that controls emotions and sleep. When sleep becomes unsatisfying, feelings of depression, anxiety, and pain become more intense. This is a situation when the energy is drained out quickly from your body and leaves you feeling unable to face the challenges of the day. 

Furthermore, if a person is feeling unmotivated, depressed, or exhausted due to pain, his or her social life suffers a lot. It is often seen that such people often avoid get-togethers and gatherings, or friends. Social isolation can lead to further depression and poor mental health, creating a vicious cycle. Therefore, it all comes down to the fact that psychological aspects of chronic pain can be far more debilitating than the pain itself.
 

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