Chronic pain is the persistent, non-acute, sometimes disabling pain in the body. Any pain that last for more than 3 months can be called chronic pain. It may or may not associated with a previous injury. If so, it outlasts the reasonable healing time of the damaged tissue. It loses its function in protective warning, becomes a health problem and affects the adaptability of the body.
The cause is the overexcited nociceptive pathway in the central nervous system (central sensitization). It occurs in fibromyalgia, osteoarthritis, musculoskeletal disorders with generalized pain hypersensitivity, headache, temporomandibular joint disorders, dental pain, neuropathic pain, postsurgical pain, vulvodynia, multiple chemical sensitivity, and visceral pain hypersensitivity disorders like irritable bowel syndrome, overactive bladder, etc.
The body is constantly sending two types of signals to inform the brain of its current status:
Nociception is an adaptive, protective alarm response. As such, it has to ensure only those nociceptive signals that are linked to actual or potential tissue damage can turn on the siren. To achieve this reliable task, it utilizes the constant input of the proprioceptive signals and the descending control signals from the brain to modulate the transmission.
Brain: National Institute of Health, Wikimedia Commons
Causes of chronic pain:
The main features of chronic pain are:
The patients may complain of any kinds of pain, from joint pain, muscle pain, headache, neck pain, low back pain, shoulder pain, sciatica, fibromyalgia, to "failed back syndrome". They may experience loss of appetite, depression, anxiety, exhaustion and sleep disturbance. The pain subsequently provokes changes in their behavior, and the development of fear-avoidance strategies. As a result, they become physically deconditioned and socially isolated.
The treatment of chronic pain addresses the multifactorial nature of the problem.
The best treatment for chronic pain syndrome is prevention. At any phase of care, patients should be:
Common pains, including chronic pain, have a prevalent cause: the derangement of sensory input for postural equilibrium, which leads to irritational stress and results in sensitization of pain.