What is chronic pain and how can it be treated?


Pain is a signal that the nervous system sends to indicate that something is wrong or that there is a risk of injury.

The objective of this warning is to avoid or reduce the impact of possible damage and to prevent the stress that this situation triggers. Although pain is often used as a single term, there are different types. Here we will review what chronic pain is, how it differs from acute pain, and how it can be treated.

What is chronic pain?

Broadly speaking, pain is defined as an unpleasant sensory and emotional experience. It can be differentiated into two types:

  • Acute: Lets you know there is an injury or problem that needs to be addressed. It usually comes on quickly, is intense, and doesn’t last long. This pain disappears once the person recovers from the injury that caused it.
  • Chronic: It is a serious condition, which can cause complications that go beyond the physical symptoms that it initially presents. This pain can last several months or years, and interfere with the development of daily activities.

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Chronic pain can affect anyone, although it is more common among women and older adults. It can also affect any part of the body, its main symptoms are:

  • Burning.
  • Discomfort.
  • Palpitations.
  • Intense pressures.
  • Stitches.
  • Rigidity.

Many times, people with chronic pain experience other signs of discomfort as a result of the limitations that this injury causes in their daily activities:

  • Anxiety.
  • Depression.
  • Mood swings.
  • Disorientation.
  • Frustration.
  • Irritation.
  • Trouble sleeping.
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Unlike acute pain, which occurs after a blow or injury, chronic pain can be caused by an old injury, previous surgery, an infection, or a disease, such as arthritis, cancer, or fibromyalgia.

How to treat chronic pain

Due to its serious consequences, difficulties to carry out the routine and its presence for long periods of time, treating chronic pain is essential. However, it is a complex process that will depend on many aspects, such as biology, personal history, or the context in which one lives.

Health professionals often make diagnoses and recommend different types of medications:

Antidepressants and anticonvulsants

As the name implies, they are medications that are prescribed to control depression or prevent epileptic seizures, although they also appear to be effective in treating causes of chronic pain, such as back pain, fibromyalgia, or diabetic neuropathy.

precautionsSide effects of these medications are usually mild, and include headache, dizziness, or nausea. However, if you experience changes in your behavior patterns, you should consult a health professional as soon as possible to prevent possible complications.

Trademarks: amitriptyline and nortriptyline (Pamelor), duloxetine (Cymbalta), milnacipran (Savella), or venlafaxine (Effexor XR), among others.

Nonsteroidal anti-inflammatory drugs (NSAIDs)

These drugs inhibit certain enzymes that release damage to the body’s tissues, called cyclooxygenases.

precautions: Although they reduce pain and inflammation, if they are not taken properly and the recommended doses are exceeded, they can cause side effects, such as high blood pressure, nausea, ulcers, and kidney problems.

Trademarks: Ibuprofen (Advil or Motrin IB), naproxen sodium (Aleve), among others.

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Selective COX-2 inhibitors

These drugs seek to reduce the side effects of NSAIDs, since they work only by blocking the enzyme COX-2, which is more likely to cause pain and inflammation.

precautions: Despite their beneficial effects, it is advisable to take the lowest effective dose of selective COX-2 inhibitors, for the shortest time possible, and follow up with a doctor, since taking too much can cause certain side effects, such as pain headache, or fluid retention.

Trademarks: Celecoxib (Celebrex).

opioids

These are medications usually prescribed to relieve acute pain, although in some cases they can be used against chronic pain. They work by mimicking pain-relieving chemicals called endorphins produced by the brain.

They also dampen other nerve cell functions, such as heart rate, alertness, or breathing.

precautionsOpioids currently cause the largest number of overdose deaths in the U.S. This is because over time, the body develops tolerance, meaning it needs more and more of a drug to achieve the initial level of effect that eased the pain. This can eventually lead to dependence, addiction, and abuse of opioids.

Trademarks: fentanyl (Actiq, Duragesic, or Fentora), Hydrocodone (Hysingla ER or Zohydro ER), oxycodone-acetaminophen (Percocet or Roxicet), among others.

Paracetamol

Although this medication is often recommended to treat mild to moderate pain, it is also used to relieve chronic pain. It does not treat the inflammation, only the pain.

Currently, it is not known how paracetamol works, although it is believed that there could be a third type of cyclooxygenase, COX-3, that this drug blocks.

precautions: It is safer than other non-opioid pain relievers because it does not cause side effects, but if taken in excess for a long time, it can cause liver or kidney damage.

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Trademarks: Paracetamol (Tylenol).

Therapies and complementary medicine

Due to the risk of side effects or addiction that some of the previously developed medications can cause, many experts tend to favor other types of treatments for chronic pain:

  • Acupuncture: It is a technique that consists of penetrating the skin with small needles at specific points on the body. It seeks to stimulate certain nerve endings in the body to relieve pain.
  • Exercise: It is recommended to opt for low-impact physical activities, such as swimming, walking or cycling, although you can gradually increase the intensity. Your body will determine which exercise and intensity is effective and which is not.
  • Physiotherapy: It is a discipline that offers non-pharmacological therapeutic treatment, that is, it does not use drugs. Exercises, elongations, stretching or application of physical agents such as water, electricity, cold/heat, laser, or ultrasound are used.
  • behavioral therapy: includes methods that seek to relax the body and reduce stress. Some recognized practices or techniques within behavioral therapy are meditation, tai chi or yoga.
  • The intensity and presence over time of chronic pain is difficult to determine. Therefore, it is important to take care of our body.

    A good way to do this is to get enough sleep, at regular times, maintain a healthy diet, control emotional disturbances, and give up harmful habits, such as smoking.

    Sources consulted: US National Library of Medicine, Mayo Clinic, National Institute of Neurological Disorders and Stroke.

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