Is Chronic Pain Forever? Can Chronic Back Pain go away?

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Written By Dr. Marcus Yu Bin Pai

MD, PhD. Physical Medicine & Rehabilitation Physician from São Paulo - Brazil. Pain Fellowship in University of São Paulo.

Will Chronic Pain Last Forever? Understanding Pain and Its Role in Our Lives

What characterizes the pain?

The International Association for the Study of Pain (IASP) defines pain as an unpleasant emotional and sensory experience associated with actual or potential tissue damage.

We will all feel pain at some point, but do you know what pain is? Pain is nothing more than a warning signal sent to the body to warn that something is not going well. A nerve stimulus is sent to our brain, which responds to the sensation of pain through the cortex.

Despite being a common problem, pain needs medical attention and guidance. In addition, each organism reacts to pain differently, thus being able to say it is an individual and subjective sensation.

Chronic pain is a common concern that affects millions of people around the world. The patient affected by chronic pain may experience a loss of quality of life, reduced productivity at work, decreased self-esteem due to limitations, and even be affected on several occasions in social and personal life.

From a therapeutic point of view, a correct diagnosis is essential for appropriate treatment measures to be adopted, seeking to improve quality of life in all aspects.

You may have heard that chronic pain can be managed but not cured. As science has developed, we have learned that this is not the case. While pain management is a big part of living with a chronic pain condition, many effective treatments can reduce chronic pain symptoms and even help an individual overcome their chronic pain.

So can chronic pain be cured? In essence, the simple answer is usually no, but it can be managed, it can be refractory.

This article will delve into the complexity of chronic pain and how changing our perspective can help us manage and even overcome it.

Chronic doesn’t mean forever

chronic-and-acute-pain

Many pain patients (like myself, until I learned about the science of pain) are under the impression that chronic means their pain will last forever.

Chronic pain is long-lasting, but that doesn’t mean it has to last forever.

Acute vs. Chronic Pain: Understanding the Differences

A. Acute Pain

Acute pain is a transient, nociceptive response that arises from direct tissue injury or inflammation due to various factors such as surgery, trauma, or infection. It serves a vital physiological purpose, alerting the body to potential harm and prompting appropriate protective actions. Acute pain is typically characterized by its rapid onset and relatively short duration, generally subsiding within days or weeks as the underlying cause resolves.

B. Chronic Pain

In contrast, chronic pain persists beyond the expected healing time, usually lasting for three months or more. It is a pathological condition involving complex interactions between the peripheral and central nervous systems. Unlike acute pain, chronic pain often lacks an identifiable cause, and its persistence may not be associated with ongoing tissue damage or inflammation. Instead, chronic pain may result from maladaptive changes in the nervous system, leading to an amplified or prolonged pain response.

Understanding the Mental and Emotional Toll of Chronic Pain

Having worked with individuals experiencing chronic pain for over two decades, I have witnessed firsthand the psychological turmoil that accompanies constant discomfort. The unpredictable nature of pain can instill a perpetual state of fear and anxiety, causing people to feel uncertain about when they might experience a sudden flare-up.

Moreover, the limitations chronic pain imposes on a person’s life can lead to feelings of vulnerability and incapacity. For instance, someone with chronic pain might have to miss out on enjoyable activities, such as attending art fairs, playing golf, or hiking, due to their physical limitations.

They might also find themselves squirming in pain while sitting through dinner or unable to watch their child’s entire baseball game, fearing the consequences of prolonged discomfort.

Doctors’ hopelessness

chronic-pain-forever

Often, the impression that chronic pain cannot be treated comes from medical professionals. Unfortunately, chronic pain training and education for medical professionals are generally lacking: they may need to be made aware that there are scientifically proven methods to help patients regain their quality of life.

It is a common experience among pain patients to be told that they need to stay positive and live with the pain. We may be given ways to self-manage our pain, but we’re rarely referred to treatments that can reduce our symptoms.

Many of us leave the doctor’s office feeling hopeless about the future. This feeds the pain cycle by perpetuating negative beliefs about pain, contributing to stress, and leaving us without guidance.

Giving hope to patients with chronic pain can be extremely powerful. We all want to get our life back! None of us want to live in pain! When we know there is a chance to make things better, we are more likely to seek treatment, actively engage in it, and proactively self-manage our symptoms.

False hope

People may have suggested all sorts of ‘magical cures’ for their chronic pain. Many of us who live with chronic pain have experienced people saying that if we eat this type of food, do this particular exercise, or try this one magical remedy, our chronic pain will be cured.

This can understandably make you feel very skeptical about the concept that you can recover from chronic pain. However, once you understand the science behind treatments for chronic pain, it becomes much easier to regain that sense of hope.

Looking at Muscles and Nutrition

One argument against the “wait and see” approach to pain is that we should examine the role of muscles in causing discomfort. The idea that pain resolves on its own doesn’t mean there isn’t a process involved in the recovery, and understanding these processes could help us find ways to alleviate pain more effectively.

For instance, our muscles’ function is highly dependent on how we use them, similar to how our nutrition affects our overall health. If you’ve been consuming unhealthy food for years, you may start experiencing various health issues. By changing your diet, you can gradually improve your health and resolve these issues, even if the improvements seem to happen randomly.

Similarly, addressing muscle function and proper training can gradually improve pain and joint function. This requires viewing pain not as a sign of disease or a permanent problem but as an indication that there’s a process at play that needs adjustment.

The Importance of Viewing Pain as a Process

When dealing with chronic pain, it’s crucial to think of it as a process that can be improved over time. Like nutrition, it’s unrealistic to expect instant results. Instead, we should focus on gradually rebuilding and adjusting muscle function and joint health.

By viewing pain as a corrective sign rather than a sign of disease, we can better understand how to adjust our training, use our muscles differently, and work towards a healthier body. This perspective is empowering and allows us to take control of our own pain management.

  1. Seek Medical Advice: If you are experiencing ongoing, persistent pain that interferes with your daily life, consult a medical professional as soon as possible. Your doctor will likely develop a treatment plan that includes medication, therapy, and lifestyle modifications to help you cope, manage, and live with your pain more effectively.
  2. Avoid Addictive Pain Relief Medications or Substances: When it comes to treating chronic pain, avoid using addictive medications or substances like opioids, alcohol, and illicit drugs. Instead, opt for over-the-counter pain relief medicines or follow your doctor’s recommendations for safe and effective pain management.
  3. Try Cognitive Behavioral Therapy (CBT): CBT is a psychological intervention that can help you develop skills to identify and change negative thoughts, emotions, and behaviors surrounding your pain. Speak to your doctor for more information on how you can integrate CBT into your treatment plan.
  4. Reduce Your Stress: Chronic stress can exacerbate chronic pain. By regularly practicing stress management techniques, such as yoga, tai chi, or meditation, you can learn to disarm your body’s stress response and reduce your pain. Discuss suitable stress management techniques with your doctor.
  5. Consider Alternative Medicine: Your doctor may recommend alternative medicine, such as acupuncture or deep massage therapy, as part of your treatment plan. These therapies can provide additional benefits for managing chronic pain, including reducing inflammation and improving blood circulation.
  6. Exercise Regularly: Despite the challenges of chronic pain, regular exercise can help maintain muscle strength and tone, release endorphins, and prevent muscle deconditioning. Consult your doctor to incorporate suitable exercises, including hydrotherapy, into your treatment plan.
  7. Shift Your Focus Away from Your Pain: Engage in activities that bring you joy and make you happy to reduce the focus on your pain. Stay connected with friends, family, or join a chronic pain support group to maintain a healthy social support system.
  8. Be Open to Trying Medications Recommended by Your Doctor: Finding the right medication for chronic pain management can take time. Keep an open mind and work closely with your doctor to identify the most effective medications for your unique situation.

Recovery is different for everyone

Since it is possible to retrain the brain, chronic pain can be cured in theory. However, it’s more complicated. There is no quick cure or just one solution.

Some treatments may work for one person rather than for another. It’s about finding what works for you.

Crucially, it can be a long and complex journey trying to retrain your brain and overcome your pain, and there are many factors to consider. It’s an ongoing commitment to techniques that you must learn and use for the long term.

Recovery can mean different things to everyone. For some, treatment will allow them to regain some functioning and lessen some of their symptoms: this can make a big difference in their quality of life.

For others, they may be able to significantly reduce their symptoms to the point where they can regain most of their functioning and control any remaining pain. Some people will be able to overcome their chronic pain and be pain-free.

Breaking Free from the Chronic Pain Cycle

For those living with chronic pain, it’s important to know that help is available. A comprehensive assessment from a pain management specialist can provide valuable insights into the root causes of pain and offer personalized solutions.

From teaching you how to get out of bed differently to providing advice on simple tasks such as loading the dishwasher, a tailored approach to pain management can help you regain control of your life and alleviate the mental and emotional distress caused by chronic pain.

Conclusion

Chronic pain doesn’t have to last forever. By shifting our perspective on pain and understanding the role of muscles and proper training, we can take control of our health and work towards a pain-free life.

Remember, pain is not a sign that you are broken; it’s an indication that there’s a process at play that requires attention and adjustment. So, embrace this empowering perspective and work towards a healthier, pain-free life.

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MD, PhD. Physical Medicine & Rehabilitation Physician from São Paulo - Brazil. Pain Fellowship in University of São Paulo.

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