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Chronic Pain


Common causes of chronic pain:

  1. degenerative disease, arthritis, Failed back syndrome (after surgery)
  2. stress
  3. cancer

And many other causes which are less frequent, for example collapsed vertebrae in severe osteoporosis.

When it comes to the treatment of chronic pain the focus is less on diagnosis but on treating pain. Quite often patients have undergone surgery, physical therapy, psychological evaluations and are then treated with opioids. These are the most powerful pain medications. Unfortunately they come with major side effects like addiction, suppression of the immune system, tolerance (the dose needs to be increased frequently), respiratory depression, loss of appetite and loss of social contacts. In the US a national crisis occurred because of opioid overdoses of prescription drugs. The combination of sleeping medication and tranquilizers containing benzodiazepine increase the risk of death in opioid treated patients. Nowadays it is not recommended to prescribe opioids Long term for benign conditions.

Therefore the approach to the treatment of chronic pain has shifted. The perception of pain can be modulated by anti-depressants and anticonvulsants (medications which are used in epilepsy). Anti-inflammatories f.e. Ibuprofen , aspirin, Certainly steroids, and paracetamol (Tylenol) work well.

The Key to a long-term treatment of chronic pain is a change in attitude in the patient and in the physician. Once there is an understanding that Chronic pain does not signal deadly gloom and doom, i.e. the underlying condition has been diagnosed and properly treated, then goals for daily life need to be set. Patients need to know that their goals can be realised. Various methods including pain diaries are utilized, so that the patient will gain more control. A mixture of acceptance, reduction of fear and various methods of meditation, Exercise, medication and personal coaching will be employed. Hope and care will help to fight despair i.e. chronic pain.

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