Chronic Pain

Chronic pain, which persists for six months or more, is divided into non-terminal pain (such as arthritis pain), and terminal pain (such as cancer pain).

Pain makes the body work harder and causes you to be tired. Fear and anxiety cause tension, which makes a person feel more pain. Chronic pain can disrupt normal sleep patterns. With lack of sleep or interrupted sleep, the problem becomes worse. You can feel angry, irritable, have trouble concentrating and begin to feel helpless. Severe pain leads to an inability to work, reduced income, lifestyle changes, and less attention to loved ones.

The goals of therapy are to increase the pain threshold and to promote or restore healthy behaviour, using medications and non-drug strategies. Everyone has different reactions to things that might help. The following strategies may be useful: exercise, heat and cold (e.g. a hot-water bottle on a sore back or a cold compress on a forehead for headache), acupuncture, or meditation. A positive attitude, while hard to maintain when there's pain, can make you feel more in control and that makes you feel better.

The choice of medication is based on the type of pain, its intensity, the individual's susceptibilities and the pharmacological characteristics of the medication. Medications are most effective when combined with non-drug strategies. For most patients with mild to moderate chronic pain, drugs like acetaminophen, ASA or ibuprofen provide satisfactory pain relief. These non-prescription pain medications are safe to use for chronic pain since they have a low abuse potential, low CNS effects and lack apparent tolerance to effect. Some other pain medication not classified formally as pain killers but found to be helpful in reducing pain in certain intractable pain syndromes include antidepressants such as amitriptyline, anticonvulsants such as carbamazepine and gabapentin, and antiarrythmics such as mexiletine. Narcotics, such as morphine are used for moderate to severe chronic pain, especially cancer pain. The use of narcotics for chronic non-cancer-related pain remains controversial. The right pain medication can usually relieve and prevent even severe pain, if it is taken promptly and regularly.

If you know the pattern of your pain, you are better equipped to do something about it. Daily routines and medications can be changed. Keeping a pain diary can help you find these patterns, record what works and what doesn't. The pain diary can be helpful to your doctor and pharmacist in selecting the best treatment.

Finding an effective way to control pain is not always easy but it can be done.