Chronic Pain Management
Dr. Born has over 22 years experience with pain patients. He provides
evaluation and treatment services to pain patients and frequently works
in conjunction with local medical pain specialists. He provides
pre-surgical evaluations as requested for spinal cord stimulator or
intrathecal pump implantation. He provides a variety of treatment
approaches to pain patients, including psychotherapy, biofeedback,
relaxation training, cognitive therapy, and training in a variety of
other behavioral chronic pain management skills.
Chronic Pain
The prevalence of physical
pain in the general population is staggering, with estimates of 30 – 40%
of Americans experiencing pain on a daily basis. Pain is perhaps the
most frequent reason for making physician visits and is a common reason
for missed workdays and lost productivity. Although estimates vary, it
is safe to say that pain-related disability produces costs of more than
$150 billion annually.
The term ‘Chronic Pain’ refers to pain that continues beyond the time
considered normal for healing and recovery from an injury or illness.
In general, pain that continues for longer than about three months
following an injury would be considered chronic pain. Pain that is
experienced directly after the injury and during the healing period is
commonly referred to as ‘acute’ pain. In general, chronic pain is
more challenging to treat effectively than acute pain and can produce
many secondary problems including loss of productivity, inability to
engage in normal lifestyle activities, development of depression,
increased stress, and loss of physical conditioning. There is also
growing evidence that the presence of chronic pain may lead to physical
changes in the body’s functioning, including neurochemical,
neuromuscular, and hormonal functions.
The person experiencing chronic pain will often require
further medical assistance from health care providers. Generally, the
most effective approach in managing chronic pain is a
‘multi-disciplinary’ approach. Simply put, this means that the most
effective help may come from a ‘team’ of health care providers from
different disciplines. Some of the most common healthcare disciplines
that are helpful to people with chronic pain include family physicians,
medical pain specialists, chiropractors, neuromuscular massage
therapists, physical therapists, and psychologists.
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The Chronic Pain Cycle
Sometimes you will hear the term ‘Chronic Pain Cycle” used in referring
to the challenges involved with chronic pain management.
This refers to the self-perpetuating nature of chronic pain.
There are probably multiple ‘chronic pain cycles’ that are
involved. For instance:
As a result of pain the muscles in the area around the site of
the injury become tense, or
‘brace’. Then, if these muscles
remain tense for a period of days, weeks, or months they begin to
produce additional pain as a result of the tension.
This additional pain can then lead to yet more muscle tension,
perhaps in the accompanying muscles, which, in turn, produces yet more
pain.
Here is another
example of a chronic pain cycle:
A person is injured and as a result develops chronic pain as well as
significant activity interference.
As a result of the pain and physical limitations the person is
not able to perform normal work or personal activities.
As a result of these changes a person can begin developing a
clinical depression. The
clinical depression causes additional problems such as sleep
disturbance, inability to concentrate, and inability to relax (among
others). The development of a
clinical depression causes changes in the nervous system that not only
can increase sensitivity to pain but also make coping with pain and
stress much more difficult. The
person has increased pain and they are less able to cope with it.
Then the cycle continues.
There are
numerous other examples of chronic pain cycles, and they can be
different for each individual.
Learning to manage the Chronic Pain Cycle is key to developing better
control over not only the pain , but your life.
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Psychologists and
Chronic Pain
Psychologists can provide help in several ways to patients suffering
from chronic pain. It is not uncommon for medical pain specialists to
require patients to undergo psychological consultation or evaluation to
help determine the best treatment approaches for the patient, or to help
determine the patient’s readiness for certain surgical procedures.
Pain psychologists can also provide treatment assistance by helping
treat the depression and anxiety that frequently develop with chronic
pain. Specially trained psychologists can also counsel with and train
the patient in a variety of behavioral chronic pain management skills.
Examples of topics and skills that the psychologist may focus on with
the patient include relaxation training, control of negative thinking,
and stress management.
Managing chronic
pain is challenging, and the patient with pain needs emotional support.
Learning about your condition, and developing coping skills are very
important. There are many web-based support resources. Below are
listed a few good resources for information on pain and coping:
The American
Chronic Pain Association
The ACPA, PO Box 850, Rocklin, CA 95677
Phone: 1-800-533-3231 - Fax: (916) 632-3208
http://www.theacpa.org/
The American
Pain Foundation
201 North Charles Street,
Suite 710
Baltimore, Maryland 21201-4111
1-888-615-PAIN (7246)
http://www.painfoundation.org/
American
Academy of Pain Management
American Academy of Pain
Management
13947 Mono Way #A
Sonora, CA 95370
Office: (209) 533-9744
Fax: (209) 533-9750
http://www.aapainmanage.org/
The American Pain Society
4700 W. Lake Ave.
Glenview, IL
60025
Phone:
847-375-4715
Fax: 866-574-2654, 847-375-6479
http://www.ampainsoc.org/contact/
For a further listing of
these and other recommended pain management cites, you can check the
following web address:
http://pain-topics.org/related_websites/ |