| What is chronic pain? Chronic pain is when a person | | | | difficulties. Sexual desire is reduced causing more |
| suffers from pain in a particular area of the body (for | | | | stress in the patient's relationships. Understandably, |
| example, in the back or the neck) for at least three | | | | these symptoms may lead to feelings of despair, |
| months. Chronic pain can be caused by many things | | | | hopelessness and other symptoms of a major |
| and lasts beyond the normal amount of time that an | | | | depression or clinical depression. People with chronic |
| injury takes to heal. Some people get chronic pain | | | | pain report a wide range of limitations on family and |
| such as arthritis or carpal tunnel syndrome from | | | | social roles leading to changes in the family, |
| normal wear and tear of the body or from aging. | | | | depression and anger among the patients and to |
| Others have chronic pain from various types of | | | | stress, resentment and strain in family relationships. |
| medical illnesses such as cancer or diabetes. In some | | | | So what can you do? When you realize the |
| cases the chronic pain may be from an injury that | | | | biopsychosocial nature of the problem, you can see |
| happened during an accident or an assault. Some | | | | that there are many things you can do to start |
| chronic pain has no physical explanation. Our bodies | | | | feeling better. Talk with your doctor about getting a |
| and minds work together. When we are stressed, | | | | TENS (Transcutaneous Electronic Nerve Stimulation) |
| we often feel muscle tension in our necks and backs, | | | | unit. These units send tiny electrical impulses that feel |
| stomach problems and/or headaches. This pain is | | | | like a tingling sensation and essentially block the nerve |
| very real and, in addition to impairing sleep, leisure | | | | impulses to the area, thus relieving the pain. Look into |
| activities and potentially causing depression and/or | | | | massage or physical therapy. Many of the shiatasu |
| anxiety, it can also cause people to carry themselves | | | | back massagers available now help alot for people |
| differently leading to real physical changes and | | | | who "store" their stress in their upper to mid-back. |
| ultimately physical pain. Approximately one in three | | | | While not a panacea, they are much cheaper than a |
| Americans suffer from some kind of chronic pain in | | | | massage therapist. Consider exercise. Many people |
| their life, and about 25% of them are not able to do | | | | actually begin experiencing fatigue, aches and pains |
| day to day activities because of their chronic pain. | | | | when they are too sedentary. Talk with your doctor |
| How is pain evaluated? Providers generally assess | | | | about swimming, walking, stationary biking or just |
| pain during a physical exam, but how much pain | | | | stretching. Many malls open early so people can walk |
| someone is in is hard to determine. Every person is | | | | in the air conditioning. Work with your physician to |
| different and perceives and experiences pain in | | | | address any side effects of the pain medication. Get |
| different ways. There is often very little consistency | | | | out of bed and get dressed each day by 9am. Even |
| when different doctors try to measure a patient's | | | | if you cannot go far, try to at least get out on your |
| pain. Many practitioners will evaluate the type of pain | | | | porch so you can get some fresh air. Evaluate your |
| (i.e. sharp, dull, throbbing), the duration or the pain | | | | diet. While chocolate and pizza may feel like comfort |
| (constant, 2-3X/day etc), the intensity of the pain on | | | | foods, they also will add to your depression (and |
| a scale of 1 to 5 and what makes the pain better or | | | | weight). Join a support group. There are many online |
| worse. Sometimes the care provider may not believe | | | | if you cannot get out to one. Finally, evaluate the |
| the patient, or might minimize the amount of pain. It | | | | ways your stress, depression, PTSD and pain might |
| is important to remember that when you are | | | | be causing a self-perpetuating cycle. The pain reminds |
| depressed or have PTSD, your pain tolerance is | | | | you of the incident that caused the PTSD which |
| often much lower; therefore, what would only mildly | | | | causes more stress and increases the pain which |
| bother you at other times might cause significant | | | | continues to remind you of the PTSD. In these |
| distress when you have other mental health issues | | | | cases, a short-term course of antidepressant and/or |
| going on. This kind of experience often makes | | | | anti-anxiety medication might be very helpful while |
| patients feel helplessness and hopeless, which in turn | | | | you work through the trauma in therapy. |
| increases tension, depression and pain. If you do not | | | | Opiate-based pain medication can increase your |
| feel like you are being taken seriously or if you do | | | | depression so it is important to discuss treatment |
| not feel empowered to control your trreatment, | | | | options with your doctor and maybe limit strong |
| seek a second opinion. Some people's chronic pain | | | | painkillers to one dose at night if possible Ultimately, if |
| stems from a traumatic event. Under these | | | | you think of your problems as a woven blanket, if |
| circumstances the person may experience both | | | | you start to pull one thread, the rest of the blanket |
| chronic pain and PTSD. Approximately 15% to 35% | | | | starts to disintegrate. The same is true for your pain. |
| of patients with chronic pain also have PTSD. One | | | | If you start to do one positive thing, then it will have |
| study found that 51% of patients with chronic low | | | | a positive impact on all other areas and exponentially |
| back pain had PTSD symptoms. For people with | | | | reduce your pain. For example, just starting to do |
| chronic pain, the pain may actually serve as a | | | | some simple doctor prescribed stretching or very mild |
| reminder of the traumatic event, which will tend to | | | | exercise will help not only reduce weight, increase |
| make the PTSD even worse. Survivors of physical, | | | | mood and self-esteem, improve sleep and reduce |
| psychological, or sexual abuse have a greater risk for | | | | aches and pains. They key is to pick something you |
| developing certain types of chronic pain later in their | | | | are willing to change and start there. Patients with |
| lives. People with chronic pain are less able to function | | | | PTSD will need at some point to engage in counseling |
| in daily life than those who do not suffer from | | | | to deal with the trauma. Many patients find that once |
| chronic pain. They may have trouble with things such | | | | they start physically feeling a bit better, they have |
| as walking, standing, sitting, lifting light objects, doing | | | | the strength to face the trauma. During this period |
| paperwork, standing in line at a grocery store, going | | | | though, patients need to take extra good care of |
| shopping, or working. Many patients with chronic pain | | | | themselves. Recovery from PTSD is a full-time job. |
| cannot work because of their pain or physical | | | | Most patients will find that they have a hard time |
| limitations. People who also have PTSD often have | | | | working or even keeping up with household chores. |
| difficulty concentrating, problems sleeping, are | | | | Prepare for that ahead of time so it does not add to |
| hypervigilent (startle easily) and have to deal with | | | | your stress. PTSD is real and as you start to face |
| things that trigger flashbacks. These things culminate | | | | the trauma, you might experience crisis symptoms |
| to increase depression and anxiety which further | | | | again such as confusion, difficulty making decisions |
| limits their ability to lead a quality life. Because the | | | | and depression. These symptoms will subside, but |
| pain and disability are always there and that may | | | | you need to be prepared to encounter them and |
| even become worse over time, many of people | | | | deal with them one more time. There is no easy |
| think suicide is the only way to end their pain and | | | | answer for patients with chronic pain and PTSD. |
| frustration. They think they have no control over | | | | They are extremely interrelated and debilitating. Life |
| their life. This frustration may also lead the person to | | | | will never be exactly the same. Nevertheless, with |
| use drugs or have unneeded surgery. Depression is | | | | comprehensive treatment, many people can regain |
| common for those with chronic pain. The reasons are | | | | their prior quality of life. |
| as follows: Pain causes sleep difficulties, leading to | | | | Dr. Snipes received her Masters in Rehabilitation |
| fatigue and irritability Since chronic pain often causes | | | | Counseling and her PhD in Counseling and Education |
| problems with mobility, many people are home-bound. | | | | from the University of Florida. She is an ordained |
| This leads to social isolation and a lack of enjoyable | | | | Christian minister . Currently she runs two online |
| activities. Due to the inability to work, there may also | | | | continuing education sites Continuing Education for |
| be financial difficulties Stomach pain may also be | | | | Engineers and online continuing education for |
| present and caused by the stress of the chrinic pain | | | | rehabilitation counselors, addictions professionals and |
| and by the pain medications themselves. The pain is | | | | social workers. |
| distracting, leading to memory and concentration | | | | |