FAQ Category: Pain

People with chronic pain may not be able to find relief, or total relief, from the pain through traditional medical treatments. Sometimes, the medications and therapies available cannot help relieve the pain.

However, research has shown that some people can tolerate their pain better, or manage it better, if they follow some sort of cognitive behavior therapy program. The goals of these programs are meant to help teach the patient how to cope with the pain rather than eliminating it.

If a patient is very afraid of the pain or of reinjuring him or herself, the patient may be behaving in such a way that may cause extra stress, causing the pain to be worse. This is anticipating the worse, or catastrophizing. Another example would be patients who learn visualization or relaxation techniques to use to try and level off the pain.

Receiving psychological therapy or counseling doesn’t take away from the pain – it doesn’t mean that the pain isn’t real, but it is a good tool for many patients who experience the pain.

Addiction to pain medication concerns many people, from those who make the drugs to those who take them. However, some pain can’t be managed without the type of medications, called narcotics or opioids that can be addictive.

Studies have shown that people who truly need pain medications have a very low risk of developing an addiction. Their body knows that they need the medication and uses it accordingly. The key is to use the medications as ordered as often and for as long as they were prescribed.

So, if you are prescribed to take a medication every 6 hours for 10 days, as needed – that means do not take it before 6 hours are up, and after 10 days, stop. You may feel that you still need it and be tempted to take it if you have a few more left. Don’t. If you feel you still need the pain medications, it’s best to speak with your doctor about your options.

If you are concerned with addiction, discuss this with your doctor.

According to some researchers, the Multidimensional Pain Inventory can be used to classify people with pain into three subgroups. Two of the three subgroups are at greater risk for misinterpreting their pain, coping with it poorly, and will likely have chronic pain.

Yes, there is a subgroup of individuals who cope maladaptively by pushing themselves in spite of pain. These individuals can be classified as endurance copers. Studies show that endurance copers may be more prone to chronic pain.

Complex regional pain syndrome (CRPS) is a syndrome that is not yet understood by doctors. When a disease or syndrome is not understood, it becomes more difficult to find a treatment.

That being said, there is on-going research and clinical studies are being done to try to find treatments. Currently, some studies are investigating the use of lenalidomide, a medication used to treat myelodysplastic syndrome, and ketamine, a type of anesthetic. Other studies are also in progress.

Complex regional pain syndrome (CRPS) is a syndrome that has been around for many years but has not always been recognized or diagnosed properly. It has been found as far back as the American Civil War but it was only in 1993 that the umbrella term, CRPS, was decided upon for consistent use.

CRPS is not understood yet. It occurs usually after a trauma to a limb, but it doesn’t have to be severe, it can be just a sprain or a strain. Symptoms of CRPS are pain, skin temperature changes at the site, change in skin color, and abnormal muscle weakness.

People with complex regional pain syndrome (CRPS) vary with the severity of their symptoms. The pain, skin temperature change, and muscle weakness can be mild or become so severe that amputation is required.

Some people find that the symptoms do go away on their own, while some can manage their symptoms with symptom-specific medications. Other treatments that may be tried include physical therapy, nerve blocks, spinal cord stimulation, and drug pumps to deliver opioids (narcotics) and local anesthetics directly into the spinal cord.

Complex regional pain syndrome, or CRPS, isn’t completely understood yet by doctors. Besides not knowing why it happens – usually following what could be a minor injury to an arm or leg – they don’t know how to treat the resulting symptoms and effects.

One effect of CRPS is reduced blood circulation. When the blood vessels constrict or narrow, the blood can’t circulate as it should. This can cause the body part can feel cold.

You are describing perceptual disturbances that are very common among people who have CRPS. Other perceptual changes may include anger or hostility towards the limb, a distorted mental picture of the limb, difficulty in knowing its position in space, and that the limb feels different than it actually looks. Studies show that there is a direct relationship between the severity of pain and the severity of the perceptual disturbances in CRPS.

With CRPS, your brain changes the way it perceives the affected limb. This can occur within a few days of the onset of limb pain. There seems to be a direct relationship between the severity of pain in CRPS and the severity of body perceptual disturbance in the brain. Desensitisation makes you look, think about, and touch the affected limb. This likely reduces the body perceptual disturbance in the brain which then is likely to decrease the pain from the CRPS.

A drug that contains both THC (delta-9-tetrahydrocannabinol) and cannabidiol, CBD, is being studied. It is in a spray form for use in the mouth, either under the tongue, or inside the cheek. One trial, with a relatively small number of subjects showed that it was effective in treating neuropathic pain, sleep, allodynia, and disability.

In a study using Sativex, a spray form of medication that contains both THC (delta-9-tetrahydrocannabinol) and cannabidiol, participants were monitored for intoxication. When used appropriately, even when subjects were allowed to increase the dose until they felt is was beneficial for neuropathic pain symptoms, it did not seem to change their cognitive function when tested.

Pain is a very subjective matter – what may be very painful for one person, may not be so painful for another. For this reason, many healthcare professionals use a number pain scale to rate how the patients are feeling. This pain scale ranges from zero to 10, with zero being no pain and 10 being the severest pain possible.

This approach, however, isn’t always possible with non-verbal patients and needs adapting. One way is to have a visual scale of zero to 10, perhaps a large graph, that the patient can point to in order to tell the nurse of the pain level. Or, the nurse could do it on a scale of zero to five, using fingers to demonstrate pain levels.

Such approaches don’t address the needs of patients who may not be able to communicate at all, though. In this case, the healthcare professionals need to be aware of body language. Assessments need to be made regularly and consistently. One recent article discussed a new rating scale called the Elderly Pain Caring Assessment, which has eight assessments, including facial expression and body posture, to be assessed and rated by the caregivers.

A broken hip is generally quite painful; however, not everyone feels pain in the same way. Some people do “tough it out,” while others truly can stand a higher level of pain than others.

This being said, older people who have painful conditions, such as a broken hip, should be monitored closely for signs of pain. While they may not be saying that they have it, they may be showing it through their facial features, posture, or body movement. When someone is in a lot of pain, they may not be eating as well or moving as well, and this can cause other physical problems.

A lot of research has been done about pain and how people cope with it. One thing that researchers have found is that many people who have chronic pain who do not cope well often have other issues besides just the pain.

For example, some people have a personality trait called Harm Avoidance. While it is perfectly natural to want to avoid situations that might cause harm or pain, some people take it to the extreme. They can worry that certain things may trigger the pain, become very stressed and fearful. This stress and fear can often become more debilitating than the initial pain itself.

This is not to say that people who feel a lot of pain have personality disorders, but it does explain that certain people who have certain personality traits can be more susceptible to the pain and this can result in other issues that also cause discomfort.

Research has shown that some people with chronic pain have personality traits that can make it more difficult to cope with the pain. Whether this means having a pessimistic view of the pain (“I can’t do anything about it, the pain controls me”) or an unnatural avoidance of pain, if this is addressed, the pain levels may go down as well.

The important issue is that the personality traits have to be noticed and dealt with by the healthcare provider. So, if a patient with chronic pain is not feeling relief from the various treatment plans being offered, perhaps some counseling regarding the pain, what causes it, and how to manage it, may be in order for some.

An opioid medication, also called a narcotic, is a controlled drug. These drugs are controlled because of their high potential of abuse and addiction. People who are experiencing pain who need opioids for relief should not have difficulty obtaining them, however, because of problems historically with addictions and diversion of medications, some doctors are reluctant to prescribe opioids.

Opioids differ from other, non-controlled, pain medications because of their action. The medications work by blocking the sense of pain from reaching the brain, while other pain medications reduce swelling, for example.

Many people who take pain medications over a long period of time develop a tolerance of them – their body becomes used to the medication and requires a higher dose to relieve the pain.

If someone needs a higher dose because the medication is no longer as effective as it once was, the only sign should be the presence of pain. Addiction, however, causes the body to crave the medication and other symptoms, other than pain, may emerge. Psychologically, a person who is addicted will do anything to get hold of the drug to relieve the need.

Naprapathy means to correct. It is a form of manual medicine. Manual medicine focuses on the evaluation and treatment of neuro-musculoskeletal conditions. Doctors of Naprapathy are connective tissue specialists.

Naprapathic doctors receive formal training but they are NOT medical doctors (MD). This type of treatment is an alternative to chiropractic care. The focus is the ligaments and connective tissue of the spine rather than the joints.

Some naprapathic doctors also include nutitional counseling and relaxation techniques in their treatment. There is some limited evidence from scientific study that naprapathic care helps with pain, disability, and perceived recovery from neck or back pain. There are no studies specifically reporting on the use of naprapathy and arthritis.

Since providers have been prescribing opioids for chronic, non-cancer pain, the abuse of prescription opioids has greatly increased. There have been many deaths reported from overdose of prescription opioids.

Because of the fear of abuse, diversion, and addiciton even from prescription opioids, many providers are choosing to withhold prescribing opioids. Unfortunately, this means that patients who could benefit from them are being refused.

The companies making opioids are working on abuse-deterrant pills. Hopefully this will reassure providers that they can be used safely.