What causes chronic pain, and what can we do about it?
Some cases of chronic pain can be traced to a specific injury that has long since healed — for example, an injury, a serious infection, or even a surgical incision. Other cases have no apparent cause — no prior injury and an absence of underlying tissue damage. However, many cases of chronic pain are related to these conditions:
Low back pain
Pain in the low back can be a result of conditions affecting the bony lumbar spine, discs between the vertebrae, ligaments around the spine and discs, spinal cord and nerves, muscles of the low back, internal organs of the pelvis and abdomen, and the skin covering the lumbar area.
Arthritis, especially osteoarthritis
This condition is brought on by wearing of the cartilage that lines the joints due to age, injury, overuse or obesity resulting in pain, limited movement and inflammation. it often starts in the fingers and affects weight bearing joints of the hips, knees and spine.
Headache
Although many people use the term “migraine” to describe any severe headache, a migraine headache is the result of specific physiologic changes that occur within the brain and lead to the characteristic pain and associated symptoms of a migraine.
Cancer Pain
The majority of people with cancer will experience pain at some time or another. The pain can result from the cancer itself, or from the cancers treatment. In addition, some people who have been cured of their cancer can continue to suffer from pain.
Fibromyalgia
The main symptom of fibromyalgia is pain that is believed to derive from an increased sensitivity to pain stimuli. The pain can be brought on by different situations, including noises, weather changes, or stress, but it may also occur without any relation to external stimuli.
Toothache
The pain usually comes from within a tooth or the surrounding gum and bone structures. The pain can be from more than one tooth. Toothache pain is usually felt as a constant or intermittent ache that does not go away.
Nerve damage (neuropathy)
When the sensory system is impacted by injury or disease, the nerves within that system cannot work to transmit sensation to the brain. This often leads to a sense of numbness, or lack of sensation. However, in some cases when this system is injured, individuals experience pain in the affected region. Neuropathic pain does not start abruptly or resolve quickly; it is a chronic condition which leads to persistent pain symptoms.
Understanding the Psychological Impact of Chronic Pain
At a fundamental level, chronic pain is a matter of biology: Errant nerve impulses keep alerting the brain about tissue damage that no longer exists, if it ever did. But complex social and psychological factors are also at play, and they seem to help determine who fares well despite even severe chronic pain — and whose lives quickly unravel.
Negative emotions, including sadness and anxiety, seem to aggravate chronic pain. For example, people who dwell on their discomfort tend to be more disabled by chronic pain than people who try to take their pain in stride. And among people with chronic pain stemming from a work-related injury, those who report poor job satisfaction fare worse than those who say they like their jobs.