Chronic pain, or persistent pain, is pain that continues beyond the time expected for a painful condition or injury to heal, usually about 3 months.
Chronic pain occurs because the nerves and spinal cord become over-sensitive and magnify messages when there is no active damaging stimulus. In other words, the nerve messages reach the brain, the brain thinks there is harm and reacts by feeling pain – even when there is no injury.
When chronic pain continues for some time, the brain may start to react to messages from other parts of the body near the site of the now-healed damage and you feel pain in those areas too, this makes the situation worse.
One common type of chronic pain is Neuropathic pain.
Neuropathic pain is a type of chronic pain that occurs following damage to the nervous system itself. It is also called nerve pain or nerve-damage pain. The sensations associated with this type of pain are described as burning or shooting pains. The skin can become numb, tingling or extremely sensitive.
But pain ain't gonna hold us down. Therefore how do you manage chronic pain?
Managing chronic pain
The focus of treatment needs to be on managing your pain and improving your day-to-day function, rather than completely stopping the pain.
Chronic pain is best managed through a multidisciplinary pain management plan with your healthcare professional, covering aspects such as:
- physical fitness and activities
- medication
- mood
- sleep
- relaxation and overall health.
Learning self-management skills is key
Starting to exercise and learning coping skills are important ways to help improve your ability to function and reduce the impact of your pain. Don’t wait for your pain to be completely gone before starting normal activities, including work.
People who are actively engaged in self-management techniques report lower levels of pain-related disability, improvements in mood, better general health and reduced use of medicines.
Opioid medicines for chronic pain
Opioids (eg, morphine, codeine, endone, etc) are commonly used to treat severe acute pain or cancer pain. However opioids are not universal painkillers, and so they are often not very effective in chronic pain. They are better used for such chronic pain that is caused by cancer.
Long-term use of opioids is usually associated with potentially serious harms. This includes both opioid-related side effects, and an increased risk of accidental fatal overdose, dependence or addiction.
When considering opioid use, it is important to note that:
- Opioids are associated with side effects in around 20–30% of people; such as constipation, nausea, dizziness, sleepiness and sleep apnoea.
- Long-term opioid therapy is also associated with a greatly increased risk of fractures in older people.
- Increasing doses of opioids in chronic pain has been repeatedly linked to harm, including death from overdose.
Non-opioid medicines for chronic pain
The goal of treating chronic pain with medicines is to reduce pain to a level that allows you to improve your functioning and quality of life.
Non-opioid pain medicines can be effective at relieving pain, but should generally be used only for a short period and only for as long as they are helping to manage your pain so that you can maintain physical and social function.
All medicines have side effects and before prescribing a medicine for chronic pain, your doctor will discuss its potential benefits and harms, to help decide whether the medicine may be useful for you.
Types of non-opioid medicines for chronic pain
Non-opioid pain relievers that are commonly used as part of a pain management plan are paracetamol and non-steroidal anti-inflammatory drugs (NSAIDs).
Paracetamol
Paracetamol can be effective for mild chronic pain or to supplement other medicines. It is important not to take more than the recommended dose.
Non-steroidal anti-inflammatory drugs (NSAIDS)
In some cases of chronic pain, inflammation may not be associated with it, so anti-inflammatory medicines may not be very helpful. NSAIDS may be able to give short-term relief during a pain flare-up, but generally they should not be used for long-term pain relief because of the risks associated with them. In cases where long-term NSAIDs may be the best option, you will be treated under the ongoing supervision of your doctor. NSAIDS can interact with other medications and you should discuss your medicines with your doctor or pharmacist.
Antidepressants
Low doses of medicines normally used to treat depression (antidepressants) called tricyclic antidepressants can have a pain relieving effect for several types of chronic pain, including neuropathic (nerve) pain. However, these medicines can have side effects (eg, a persistently dry mouth) which can be hard to tolerate.
Anticonvulsants/antiepileptics
A detailed review of clinical research trials shows that some medicines originally developed to treat epilepsy, known as antiepileptic medicines, may provide pain relief in some, but not all, people with specific neuropathic pain conditions such as painful diabetic neuropathy, postherpetic neuralgia and central neuropathic pain.
Antidepressants and anticonvulsants/ antiepileptics are prescription medicines. Do not take them unless they have been prescribed for you. Always follow the instructions provided by your prescriber or pharmacists.
Talk to your health professional about chronic pain
Working with your doctor or pharmacist and other healthcare providers to develop a strategy that works best for you will improve your experience of living with chronic pain.
The more you tell your healthcare providers about your pain, your personal situation and what strategies you have tried to manage your pain, the better. This will help them tailor a pain management plan to suit your individual needs.
Developing a personal pain management plan
Your plan could include setting achievable goals to give you something to aim for. Topics that could be covered in the plan include:
- activity management (eg, pacing of tasks)
- behavioural management (eg, relaxation)
- cognitive therapy to help you think more positively about your ability to manage your pain
- exercise
- medicines management, as needed.
Take a copy of your plan with you each time you visit your health professional. Be proactive and highlight the goals you have reached, or any problems you have faced.
If you are in Nigeria and need help on developing a personal pain management plan, mail us at iyksilver008@yahoo.com.
Your comments are important to us. If you find our topics helpful, kindly drop your comments.
No comments:
Post a Comment