It may seem odd that September is National Pain Awareness Month since you know when you are in pain. This is a time to bring awareness to not ignore your pain, accept it as a valid problem, and seek treatment to maximize your quality-of-life. Pain is the most common cause of disability in the United States, that is more than cancer and heart disease combined!1 Over 100 million people in the United States experience chronic pain or pain that does not completely go away and can result from other chronic diseases like diabetes and arthritis.1 Chronic pain not only affects you physically and can limit your activities, but it affects you emotionally, behaviorally, and mentally. The pain is real and not an attempt to get powerful medications like opioids. Let’s bring the stigma associated with chronic pain!
What is pain?2-4
When you stomp your toe or pull a muscle, your pain receptors in that area send a message to your central nervous system. This message acts as a signal to warn your body of danger. The central nervous system includes the brain and spinal cord. The message is delivered to your spinal cord through many nerves until it reaches your brain. Your brain interprets the signal and sends a message to that area to make you feel pain. This pathway typically ends when the pain is resolved such as when your wound has healed. With chronic pain, your nerves continue to fire to make you feel pain even when the injury is not present.
Acute pain is sudden and results from an illness or injury like cutting your finger or a mild headache. It typically lasts no more than a few weeks and the pain resolves with healing. Sub-acute pain lasts between six weeks and three months.
Chronic pain is persistent and recurring pain that lasts over three months. It can result from an illness like cancer or injury with the pain still being felt in “on” and “off” episodes or continuous long after it. Other examples or conditions that can cause pain include migraines, headaches, nerve damage, arthritis, shingles, osteoporosis, peripheral vascular disease or poor blood flow, and back pain. Back pain is one of the most common health problems that greatly affects everyday functioning. It can also be caused without an illness or injury in the form of its own syndrome. It affects 28% of people between the ages of 46 to 64 years old, and over 65% of those over 65 years old and older. Unlike the other types of pain, chronic pain affects you from your daily activities to your social life. Pain is real and there is a need to bring awareness to its effects on the mind and body!
How does chronic pain affect me?2,5
Chronic pain can make you feel frustrated, depressed, anxious, and stop you from completing your daily activities or things you enjoy like traveling. It is a continuous cycle of pain and uneasy feelings, so it can do more harm than just physical pain. When you feel pain, you may feel depressed or anxious that you are not able to complete your activities as easily. Performing these activities can even make your pain worse. You may feel stressed as you focus on your problem and have trouble sleeping which increase your pain. As you limit your activities, you may feel more depressed and anxious that you can not perform as well or do what you want to do. The pain continues which starts the cycle all over again.
What are the treatment options?1,2,4-6
Acute pain is normally treated with rest, time, and over-the-counter pain medications while chronic pain requires an approach to treat the body, mind, and spirit. Acute pain is resolved upon healing while the pain never completely goes away with chronic pain. Therapies for chronic pain aim to improve you mentally, socially, emotionally, and physically, just minimizing the pain you feel for you to carry out your daily activities. The treatments include self-care, mental health, and pharmacological treatments. The encouraged treatment for chronic pain is self-care which include the following:
Activity and stretching – Participating in workout classes, strength building, physical therapy, or even simply walking helps strengthen your muscles and lowers your pain. If you experience pain during your activities, the activities may be too intense. Just stop before it gets worse and build your way to doing more advanced activities.
Ice/heat – Ice and heat help relieve stiffness and pain, especially with arthritis and other joint conditions. Alternate sessions with ice or heat by applying for 20 minutes, then 20 minutes off a few times a day.
Mindfulness and relaxation – Taking time for yourself to practice mindful meditation requires slowing your thoughts, taking deep breaths, and destroying your negative thoughts. This calms your body and mind down, so you can relax. Yoga is another technique that is used to reduce your stress levels which eases your pain.
Sleep – A lack of sleep affects your mood, relationships, and ability to function. Creating a sleep routine to get a good night’s rest, about seven hours a night consistently can help reduce your stress and pain. This will also make you feel more empowered to tackle your day!
Nutrition – A nutritious diet full of whole grains, fruits, vegetables, and lean meats while limiting your intake of processed/sugary foods, white bread, red meat, and salt gives your body more nutrients that can fight off inflammation and help your pain flares. Some key vitamins include iron, folic acid, and vitamins A, B6, C, and E. These are commonly found in nuts, leafy greens like spinach, berries, and whole grains.
Smoking cessation – Research has shown that smoking increases your risk of back pain and can increase the intensity of neck pain. Those that are smokers have reported that their pain is more intense than those that have never smoked.
Weight management – If you are overweight or obese, gradually losing about 5 to 10% of your weight can lower the amount of pain you are feeling. This is especially true if you have knee or hip pain since more weight adds pressure to the joints and stimulates pain.
Engaging in meaningful activities – Do not let chronic pain stop you – performing activities you enjoy increases your body’s natural painkillers while boosting your overall mood!
Family/friends support – Not only having the support of your family is helpful, but also sharing your experiences and learning from others in group or rehab programs. It may provide you comfort knowing that other people understand your experiences, fears, and discussing your worries.
If these are not enough for pain relief, pharmacological treatments can be started or along with self-care measures. Pharmacological treatments include over-the-counter and prescription medications depending on the type of pain. Opioids are not a first-line treatment. Transcutaneous electrical nerve stimulation (TENS) is an alternative option that involves sending tiny electrical impulses to the painful area, so less pain signals are sent to your brain to make you feel pain. Regardless of the approach, self-care measures should be started to enhance your quality of life and limit the need for medications.
The Dangers of Alcohol For Pain Relief7
From the damaging effects of chronic pain on the mind, body, and relationships, about 28% of people use alcohol as a way to ease their pain. Mixing alcohol with pain medications can increase your risk of liver toxicity, gastrointestinal bleeding, or sedation. Alcohol does not treat the pain. Alcohol only depresses you from feeling the pain temporarily while it actually makes the condition worse. The Dietary Guidelines (2020-2025) recommend that females drink no more than one drink and males drink no more than two drinks daily, regardless of health conditions. Depressing your mind to interpret the pain requires a greater intake, so over time, your body becomes tolerant and requires more to lessen the pain. This increases your risk of developing dependence and experiencing withdrawal when you do not drink. If you misuse alcohol, this can cause peripheral neuropathy. Peripheral neuropathy is a painful neurological condition that causes chronic pain, tingling in the limbs, and disability.
If you are experiencing pain and it does not get better, contact your physician or pharmacist today.
References:
- 10 facts about pain – National pain awareness month. Reinhardt chiropractic website. https://www.reinhardtchiropractic.com/blog/10-facts-about-pain/. Accessed September 19, 2021.
- About chronic pain. PDM healthcare website. http://www.pdmhealthcare.com/HIL.aspx?_se=Ymxlc3N5QGpvc2Vmc3BoYXJtYWN5LmNvbQ%3D%3D&story=HIL918_2. Accessed September 19, 2021.
- Chronic pain. NHS inform website. https://www.nhsinform.scot/illnesses-and-conditions/brain-nerves-and-spinal-cord/chronic-pain. Accessed September 19, 2021.
- September is national pain awareness month. PDM healthcare website. http://www.pdmhealthcare.com/HIL.aspx?_se=Ymxlc3N5QGpvc2Vmc3BoYXJtYWN5LmNvbQ%3D%3D&story=HIL918_1. Accessed September 19, 2021.
- Chronic pain conditions. Metropolitan institute of pain website. https://mipainchicago.com/chronic-pain-conditions/. Accessed September 19, 2021.
- Can diet heal chronic pain? Harvard website. https://www.health.harvard.edu/pain/can-diet-heal-chronic-pain. Accessed September 19, 2021.
- Dangers of using alcohol to dull the pain. PDM healthcare website. http://www.pdmhealthcare.com/HIL.aspx?_se=Ymxlc3N5QGpvc2Vmc3BoYXJtYWN5LmNvbQ%3D%3D&story=HIL918_5. Accessed September 19, 2021.
