Chronic Pain
Introduction: The Universal Disorder
You know it at once. It may be the
fiery sensation of a burn moments after your finger touches the stove. Or it's a
dull ache above your brow after a day of stress and tension. Or you may
recognize it as a sharp pierce in your back after you lift something heavy.
It is pain. In its most benign form, it warns us that
something isn't quite right, that we should take medicine or see a doctor. At its worst, however, pain
robs us of our productivity, our well-being, and, for many of us suffering from
extended illness, our very lives. Pain is a complex perception that differs
enormously among individual patients, even those who appear to have identical
injuries or illnesses.
In 1931, the French medical missionary Dr. Albert
Schweitzer wrote, "Pain is a more terrible lord of mankind than even death
itself." Today, pain has become the universal disorder, a serious and costly
public health issue, and a challenge for family, friends, and health care providers who
must give support to the individual suffering from the physical as well as the
emotional consequences of pain.
A brief history of pain
Ancient civilizations recorded on stone tablets
accounts of pain and the treatments used: pressure, heat, water, and sun. Early
humans related pain to evil, magic, and demons. Relief of pain was the
responsibility of sorcerers, shamans, priests, and priestesses, who used herbs,
rites, and ceremonies as their treatments.
The Greeks and Romans were the first to advance a theory
of sensation, the idea that the brain and nervous system have a role in
producing the perception of pain. But it was not until the Middle Ages and well
into the Renaissance-the 1400s and 1500s-that evidence began to accumulate in
support of these theories. Leonardo da Vinci and his contemporaries came to
believe that the brain was the central organ responsible for sensation. Da Vinci also developed the idea that
the spinal cord transmits sensations to the brain.
In the 17th and 18th centuries, the study of the
body-and the senses-continued to be a source of wonder for the world's
philosophers. In 1664, the French philosopher Rene Descartes described what to
this day is still called a "pain pathway." Descartes illustrated how particles
of fire, in contact with the foot, travel to the brain and he compared pain sensation to
the ringing of a bell.
In the 19th century, pain came to dwell under a new
domain-science-paving the way for advances in pain therapy. Physician-scientists discovered that opium,
morphine, codeine, and cocaine could be used to treat pain.
These drugs led to the development of aspirin, to this day the most commonly
used pain reliever. Before long, anesthesia-both general and regional-was
refined and applied during surgery.
"It has no future but itself," wrote the 19th century American poet
Emily Dickinson, speaking about pain. As the 21st century unfolds, however,
advances in pain research are creating a less grim future than that portrayed in
Dickinson's verse, a future that includes a better understanding of pain,
along with greatly improved treatments to keep it in check.
The two faces of pain: acute and chronic
What is pain?
The International Association for the Study of Pain defines it as: An unpleasant
sensory and emotional experience associated with actual or potential tissue
damage or
described in terms of such damage.
It is useful to distinguish between two basic types of pain, acute and
chronic, and they differ greatly.
- Acute pain, for the most
part, results from disease, inflammation, or injury to tissues. This type of
pain generally comes on suddenly, for example, after trauma or surgery, and
may be accompanied by anxiety or emotional distress. The cause of acute pain
can usually be diagnosed and treated, and the pain is self-limiting, that is,
it is confined to a given period of time and severity. In some rare instances,
it can become chronic.
- Chronic pain is widely believed
to represent disease itself. It can be made much worse by environmental and
psychological factors. Chronic pain persists over a longer period of time than
acute pain and is resistant to most medical treatments. It can-and often does-cause
severe problems for patients.
Pain management is an integral part of treating chronic pain.
Next: The A to Z of pain »
- ibuprofen, Advil, Children's Advil/Motrin, Medipren, Motrin, Nuprin, PediaCare Fever, etc. - Explains the medication ibuprofen (Advil, Motrin, Nuprin, Medipren) a drug used for the management of mild to moderate pain, fever, and inflammation. Article includes descriptions, uses, drug interactions, and side effects.
- Cortisone Injection - Read about cortisone injection treatment for inflammation, allergic reaction, sciatica and arthritis. Learn about side effects and complications of a cortisone shot.
- Rheumatoid Arthritis - Learn more about rheumatoid arthritis, an autoimmune disease that causes chronic joint inflammation, which has symptoms that include stiffness, fever, muscle and joint aches, loss of appetite, and fatigue. Treatment of rheumatoid arthritis incorporates the use of first-line drugs (aspirin and corticosteroids for pain and inflammation) and second-line drugs (methotrexate and hydroxychloroquine to prevent joint destruction and promote remission).
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