Pain is a normal, almost essential part of life. Every once in a while we stub a pinky toe against the bed, or cut a finger while making dinner, or pull a muscle when we’re working out. If it wasn’t for pain, we wouldn’t recognize a minor injury that needs to be treated, which would open the door to that minor injury becoming major. Pain is necessary. Pain is our warning light.
But pain isn’t always a fleeting and temporary sensation. Sometimes it can go on for many days, weeks—months, even. Chronic pain often makes people gradually wither and fade away, depriving them of all their passions, hobbies, and the little joys in life. Moreover, the approach to treating such a condition is much different from that of dealing with acute pain from a common injury.
So where’s that fine line between sharp pains, a casual ache and chronic pain? When should you start sounding the alarm? How do you identify chronic pain?
Let’s find out!
Chronic pain: know the enemy
The simplest and most accurate definition of chronic pain was stated in 2004 by the International Association for the Study of Pain (IASP): it’s just pain that continues when it should not. Easy as that.
The American Chronic Pain Association describes chronic pain as continuous or intermittent pain that lasts for more than 3 to 6 months, or for an unusually long period of time after the initial injury or condition, and significantly impairs the person’s quality of life and general well-being.
In other words, if everything indicates that the pain should have already ceased, yet it’s still there, it’s likely a case of chronic pain. Regardless of whether it is a scratch, a fracture, a major trauma or a minor post-operative scar, if the pain is still there in a couple of months after everything else has been fixed and healed, it’s chronic pain.
What is the cause of chronic pain?
In layman’s terms, chronic pain happens when a pain signal “gets trapped” in the body. Normally, after the cause of pain is resolved or healed, the said signal gradually fades away, but during chronic pain, it goes on firing long after everything is objectively healed.
Sometimes that’s due to a nerve trapped in the scar or regenerated bone tissue. In other cases, it’s more a looped electrical impulse in the brain, like a snake biting its own tail. All in all, there’s no common medical opinion on the matter, and it doesn’t matter much in the end anyway: chronic pain isn’t a matter of why, but an absolute, overwhelming, and never-ending list of HOWs:
How to live on. How to be happy. How to be active.
The good news is that putting chronic pain behind you is absolutely possible—always, and for anyone. And the first step in that direction is always in identifying the condition.
Chronic pain: a quick checklist
In 2013, a group of Danish researchers published the results of a pilot study on the matter of chronic pain symptoms. One hundred and twelve patients with the condition were asked to fill in a survey with 53 possible related and accompanying symptoms, resulting in the following list of most common manifestations of chronic pain ranged by their impact on the patients’ quality of life and general comfort:
- Rather severe or very severe pain (89%)
- Reduction in physical activity (67%)
- Fatigue (66%)
- Sleep disturbance (53%)
- Feeling of not managing/coping (36%)
- Disturbed touch or sensation on body (34%)
- Sadness (34%)
- Reduced self-esteem (33%)
- Impaired memory (30%)
- Dependency on others (29%)
If you feel like this resembles you even vaguely, you may be dealing with a case of chronic pain. Here are several other factors that might also speak in favor of the diagnosis:
- You can recall when the pain started, and what was its initial cause.
- All other components and manifestations of your injury or disease have long healed, but the pain has remained.
- You often notice you no longer expect the pain to cease for good. Maybe you can't even imagine your life without pain anymore.
- Either you or your doctor have considered trying opioids to manage the pain on a regular basis.
Common misconceptions about chronic pain
You can cure it with drugs alone, such as powerful painkillers (including opioids).
This is the most common, and perhaps the most dangerous myth about chronic pain. Quoting the American Chronic Pain Association: “Imagine a car with four totally flat tires, going nowhere. That’s what life can look like for someone whose life has been totally changed by chronic pain. Medical treatment only puts air in one of our tires. We still have three flat tires and can't move forward.” (ACPA Resource Guide to Chronic Pain Treatment, 2016). Chronic pain management needs so much more than just medications. You’ll need: psychological support, education, self- management, self-discipline, and possibly even alternative medicine practices if they prove to be effective for you. Painkillers alone won’t solve your problem.
Here are more common misconceptions:
Chronic pain is impossible to overcome. You can’t live an active/happy life with chronic pain.
This is the second most popular misconception about this condition. The potential of humans to adapt and heal themselves is virtually endless, and you can overcome absolutely everything that you choose to overcome. It’s a long-known fact that people can learn to block at least part of the pain from being perceived through such practices as meditation, distraction, as well as psychotherapy. If one wants to lead a happy and active life, chronic pain will not stop him or her from doing so. It’s all a matter of determination, times, and efforts required.
Chronic pain is a natural component of being old.
Aging was never meant to be painful, uncomfortable, and displeasing in general. As such, chronic pain is not an essential component of aging, nor it is a natural manifestation of growing old. The explanation here is that older people usually have (or have had in the past) more injuries or conditions that could potentially result in chronic pain syndrome later.
Chronic pain is not real pain, because there is nothing to hurt when all has long healed.
A person suffering from chronic pain or phantom pain is hurting as much as a person with an open wound or a fractured bone. Both kinds of pain are just as real both from the personal point of view, and from the physiological aspect of the matter. After all, according to the IASP, pain is “an
unpleasant sensory and emotional experience associated with actual or potential tissue damage,
or described in terms of such damage.” In other words, if you feel it – it IS real.
Chronic pain: How to live with it and still be happy
The next step after identifying chronic pain is to see realize the multitude of approaches to its treatment, both conventional and alternative. As soon as you learn how many things are there to alleviate your condition, you’ll already feel much more empowered to smile and keep going. Finding the best solution becomes then a matter of time, and keeping a positive attitude gets so much easier.
This is the first article in a series dedicated to living a happy and active life with chronic pain. A reassurance, a piece of support, almost a promise: you can do it. You can always be happy, and no kind of pain, acute or chronic, will ever negate that.
Look forward to all the articles in this 5-part series! And for another awesome point of view on pain, our own Dr. Grissom recommends "The Gift of Pain" by Dr. Paul Brand and Philip Yancey.
Order it HERE from Amazon!