Painchronicity: Help Chronic Pain

Frederick Jaccarino, M.D.

Frederick Jaccarino, M.D.

In an earlier column acute pain was discussed.  “Acute” pain is the sensation which tells you the stove is hot, or maybe that you’ll remember the contraceptives from now till menopause.  These are examples of acute pain; acute means that the pain arrived fairly recently, and there good chance it will be relieved in the near future, like when you move your finger away from the hot stove, or when the beautiful baby is finally laying on your chest.  The conversation today is about a different kind of pain called chronic pain, which is a vast subject at the center of much of the demand for medical care.

“Chronic” pain must be understood to be conquered. Chronic means the discomfort has been around for a while, and it is likely to outlast its welcome way too long.  It’s that ache or stab in your lower back that can flare up after a car ride or routine housework. Sometimes it’s that achy elbow which has supplanted your need for a barometer.  Some syndromes or conditions are notable for the chronic pain associated with them; consider the daily morning joint pains of the rheumatoid arthritis patients, or the abdominal cramps experienced daily by people with colitis or malabsorption syndromes.  The pharma and medical communities offer resources that can tame the inevitably recurring symptoms.

The chronic pain sufferer is well served by having a skilled health care provider as an ally and advisor.  Lifestyle and dietary changes may be important to treating the pain symptoms.  Alternative approaches such as massage, acupuncture, yoga, etc have helped many deal with their chronic pain.  Mainstream medical treatments have been miraculously improving the lives (by lessening the discomfort) through advances such as titanium hips, neurosurgical interventions like deep brain stimulators and implantable pumps, and even bioengineered inflammation fighters.  There are therapies specifically targeting causes of pain, such as antidepressants and corticosteroids.  Finally, there are the non-specific analgesics such as acetaminophen and opiate narcotics.

The most predictably problematic side effects accompany the use of opiates.  Itchy skin and constipation affect almost everyone who takes in opiates.  Cloudy alertness is bad for any age, awful in the elderly. Increasing tolerance and addiction is also common, even in household members who have access to the pill bottles of the chronic pain patient.  For chronic pain, the patient should shun narcotic pain relievers, unless there is no other solution for relief.  Too many individuals’ and families’ drierms have drifted away in the daze of a drug’ allure.