Chronic Pain Disorder - Causes, Symptoms, and Treatment

Introduction

Pain is the body's normal reaction to illness or injury. But for some people, the pain continues for an extended period, even after the cause is gone. When the pain lasts for more than three to six months, it is chronic. However, more than 25 percent of people with chronic pain develop chronic pain disorder. In chronic pain disorder, the individual may have other symptoms like anxiety and depression that impact daily life. Sometimes the pain will be severe and interfere with everyday activities. The management of chronic pain disorder involves the involvement of multiple specialties like physicians, psychologists, pain specialists, and physical therapists to provide treatment, proper education, and therapy and monitor the progress.

What Is Chronic Pain Disorder?

Chronic pain may last for months or years and can happen in all body parts. It interferes with daily activities and may lead to anxiety, irritability, and depression. It is a common condition, and nearly 25 percent of people in the United States experience it. It is one of the most common reasons why people seek medical assistance. Chronic pain syndrome can occur due to various factors such as psychological trauma, physical trauma, recurrent infectious conditions, autoimmune conditions, and chronic diseases. The affected individuals describe their pain in different ways.

They are:

• Throbbing pain.

• Aching pain.

• Shooting pain.

• Stinging pain.

• Burning pain.

• Squeezing pain.

What Are the Causes of Chronic Pain Disorder?

The root cause of chronic pain disorder is both physical and mental factors. However, the common conditions that cause long-lasting and widespread pain are considered the main etiology of chronic pain disorder. They are:

• Rheumatoid arthritis - An autoimmune disease that causes inflammation and joint pain.

• Fibromyalgia - A neurological condition that causes tenderness and pain in various body parts.

• Osteoarthritis - Arthritis occurs due to wear and tear of the protective cartilage between bones.

• Back pain may occur due to nerve compression, muscle strain, and spinal stenosis (arthritis of the spine).

• Cancer.

• Surgery.

• Irritable bowel syndrome - Chronic digestive tract inflammation and intestinal pain and cramping.

• Nerve damage.

• Stress injuries.

• Lyme disease.

• Endometriosis.

• Inflammatory bowel disease.

• Bone fracture.

• Chronic headache.

• Trauma and abuse.

What Are the Symptoms Associated With Chronic Pain Disorder?

Chronic pain disorder affects the physical and emotional health and even the individual's social life. Chronic pain can lead to the following symptoms.

• Depression.

• Anxiety.

• Irritability.

• Poor sleep.

• Fatigue.

• Guilt.

• Suicidal thoughts.

• Drug abuse.

• Tiredness.

• Family problems.

• Mood problems.

• Loss of stamina.

• Muscle aches.

• Inactivity.

What Are the Risk Factors for Chronic Pain Disorder?

Studies show that some people are susceptible to a chronic pain disorder. Several risk factors have been identified for chronic pain disorder. They are:

• Obesity - Being obese can lead to health complications and certain conditions (arthritis) that may cause chronic pain.

• Genetics - In some people, chronic pain may occur due to certain genetically related conditions like migraine.

• Age - Chronic pain disorder is more likely to be seen in older people due to the incidence of arthritis, joint defects, and certain medical conditions after 50 years of age.

• Previous Injury - People with a history of traumatic injuries are at risk of developing chronic pain disorder.

• Stress - Chronic pain disorder is highly related to post-traumatic stress disorder and frequent stress.

• Smoking - Chronic smoking may cause adverse health effects and resultant chronic pain.

• Gender - Females have more pain sensitivity due to hormonal factors and are at risk of developing chronic pain.

How Can We Diagnose Chronic Pain Disorder?

Chronic pain disorder can be diagnosed based on a detailed medical history and diagnostic tests. Pain is considered chronic if the affected individual is facing it for more than three months. People experience pain as a result of any underlying health condition. Thus identifying the reason behind the pain is also essential. Pain is a subjective sensation, and there is no specific method to determine the severity and duration of pain. Thus a set of questionnaires is used by the specialist doctor to identify the type, severity, and duration of chronic pain.

• Location of the pain.

• Intensity on a scale of 1 to 10.

• Frequency of pain.

• Effect of pain on social and work life.

• Previous pain treatment.

• Type of pain (shooting, throbbing, sharp, shooting, stinging, pinching, and burning).

• History of anxiety and stress.

• History of traumatic experiences.

• History of illness and surgeries.

Other than medical history, specific tests are also used to diagnose chronic pain disorders. They are:

• Blood tests.

• Urine tests.

• X-rays.

• Magnetic resonance imaging (MRI).

• Electromyography.

• Computed tomography (CT).

• Nerve conduction studies.

• Reflex and balance tests.

What Are the Treatment Options for Chronic Pain Disorder?

Identifying the exact cause of pain is the primary step in treating chronic pain disorder. Treatment for chronic pain disorder involves various strategies like medications, therapies, and lifestyle changes. Chronic pain disorder can be managed with a multidisciplinary approach.

1. Medications - Certain medications are used to relieve chronic pain and improve the symptoms of chronic pain disorder. They are:

• Corticosteroids.

• Anticonvulsants.

• Antidepressants (tricyclic antidepressants).

• Nonsteroidal anti-inflammatory drugs.

• Topic pain relievers.

• Opioids.

• Sedatives.

2. Therapies - Ceratin therapies also manage chronic pain disorders. They are:

• Counseling.

• Physical therapy.

• Occupational therapy.

• Cognitive behavioral therapy.

3. Nerve Blocks - Nerve blocks can be used to treat chronic pain, post-surgical pain, and severe acute (short-term) pain. Nerve blocks alleviate pain by providing rapid relief. They can also provide long-term relief since some injections minimize nerve irritation and allow them to recover.

4. Lifestyle Modifications - Chronic pain disorder can be minimized with lifestyle changes. They are:

• Reducing stress.

• Practicing low-intensity exercises.

• Getting enough sleep.

• Following a healthy diet.

5. Regenerative Orthobiologics - Orthobiologics uses biological material to aid in the healing of musculoskeletal injuries. They are generated from naturally occurring compounds in the body and enhance the recovery of fractured bones, injured muscles, tendons, and ligaments. Orthobiologics can be used to treat the musculoskeletal causes of chronic pain.

Conclusion

Pain is the body's normal reaction to illness or injury. Chronic pain disorder is characterized by continuous pain, leading to specific symptoms like anxiety, tiredness, depression, irritability, and suicidal thoughts. Chronic pain lasts more than six months and results in anxiety and depression in the affected individual. In some cases, the pain may last longer than usual and affects emotional and physical health. Chronic pain disorder is hard to treat, and management involves medications, counseling, and therapies.