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PERSISTENT AGONY

A Closer Look Into Chronic Pain and its


Associated Factors
By Emily Holt
What is pain?
We have all experienced physical pain whether it was that one
time you skinned your knee on the playground, the first time you
touched the hot flame of a candle, every time you stubbed your
toe in the doorway, or if you broke a bone after a nasty fall.
It is that initial experience of sharp, screaming, throbbing, and
uncomfortable pain after an injury to the body, and the eventual
fading of that pain as healing commences and the injury and pain
disappears.
For some types of pain, they fade quickly, while other types of
pain continue for quite some time with the serious injuries. We
define pain as the physical suffering or distress, as due to injury,
illness, etc; or a distressing sensation in a particular part of the
body(Dictionary.com, n.d.)
This definition of pain seems to hold true in all circumstances, but
pain does not always behave the way we would expect.
What is Chronic Pain?

Chronic pain can often be the unfortunate result


after an injury of some kind. After the injured
tissue heals, the pain is supposed to go away
according to most views on pain.
Unfortunately, people who have chronic pain feel
it long after the injury heals.
Some people with chronic pain, however, are
still undergoing some kind of illness or injury that
still adds to their pain.
Or there is no injury that initially triggers the
pain, or nothing seems to be wrong with the
body at all.
Treatable?
Doctors are often unable to treat chronic pain, especially
since it seems to defy all original theories of pain.
Rene Descartes came up with the specificity theory of pain
during the 16th century. He theorized that pain derives from
tissue damage, and increases with the severity of the injury,
and the pain goes away after healing.
In most traditional cases, this has seemed to prove correct.
However, it is not applicable with patients who have
chronic pain, when often, there is no long-lasting injury to
heal.
One of the big issues is that doctors still attempt to treat
chronic pain as though it is a traditional case of finding the
injured or non-functional part of the body, and fix or
remove it. This can often cause more problems as it still
fails to fix the chronic pain itself.
In the medical world, chronic pain is defined
as persistent pain that lasts for longer than 6
months.
And there are different kinds of chronic pain
as well.
According to the article, Chronic Pain
Management,Chronic pain can be mild or
excruciating, episodic or continuous, merely
inconvenient or totally incapacitating
(Chronic n.d.).
According to the article Mastering Chronic
Pain, On average, 15% to 20% of Americans
experience chronic pain each year,
approximately 46 million people (Mastering
2015).
Chronic pain is more common than people
realize, and a greatly unrecognized issue.
Episodic vs. Continuous

Chronic pain can present itself in two


different forms, episodic, or continuous.
Episodic

Some chronic pain is persistent in the sense that it


continually presents itself in episodes. A person
with chronic migraines, for example, will
experience the headaches a few times a week, or
during different times of the day, and prevention
of the headaches is not achievable, therefore,
they continue to resurface for whatever reasons.
Continuous

On the other hand, some chronic pain is


continuous in the sense that it is present from
the moments when a person wakes up and
when they go to sleep. It is ever existent and
never completely leaves. It merely changes in
intensity. Some days it can be rated as low as
a 2 or 3, but never actually reaches a pain rate
of 0.
Levels of Pain
To that end, there are many different levels of pain that
contribute to the overall issue and its difficulties.
Location is an important factor of chronic pain. Typically,
Headache is the most common, followed by back pain,
arthritis pain, and other musculoskeletal pain (Managing
2015).
People will experience different kinds of pain as well as
different levels of intensity depending on where it is located
and what the cause of pain can be identified as.
Different patients will describe their pain as acute,
stabbing, pounding, pressured, throbbing, aching, blinding,
etc. Each style of pain feels different, but is received
similarly in the brain. The main difference is intensity.
Levels of Pain
For a person who experiences chronic pain, it is constant
enough that they can eventually identify the level of
intensity they experience at different given times. Most
patients are asked to rate their pain on a scale of 1 to 10
with 10 being the most intense. They also learn to identify
their average rate of pain, and what variables or
circumstances will improve or worsen their pain in
reference to the ratings.
The intensity of chronic pain is not always predictable or
constant, and can sometimes spike in intensity, or even
drop in force or concentration.
Obviously, the higher levels of pain rating from 8 to 10 are
the worst, but that does not make the lower levels any less
difficult to live with, especially if they are constant.
Tolerance

Chronic pain can be minor for some, and


excruciating for others. And sometimes it can
vary within the patient.
There is a constant correlation between a
persons level of pain, and that same persons
level of tolerance.
Many people believe that minor chronic pain is
not a big deal and easy to deal with.
This, however, is not the case. High or low,
constant or repetitive, the chronic aspect of the
pain is difficult in and of itself.
Tolerance

There are also many misconceptions about


tolerance.
People who experience pain chronically will build
up a tolerance over time. Sometimes a high
tolerance, and sometimes low, normally
dependent on the level of pain of which it is
associated.
However, tolerance is not immunity, a fact many
people forget or misunderstand.
Being exposed to an overabundance of pain does
not give a person invulnerability when it comes
to the negative effects it can have on a person.
Tolerance

If a person has a high tolerance for pain,


usually earned over time, it means that they
can endure high levels of pain and continue
functioning somewhat normally.
It does not mean they feel less pain. Merely
that they can better live with it.
But when a person deals with chronic pain,
even tolerance to pain deteriorates as the
body will grow weaker from being under a
constant battering of pain.
Other difficulties of chronic
pain:
But another thing to keep in mind when considering chronic pain
is that, Pain is not a symptom that exists alone (Deardorff n.d.).
When a regular person gets hurt, and they are in pain, that is
where their focus is. They concentrate on the pain and this desire
and hope to make it stop. And in most cases healing occurs and
the pain goes away.
For someone with chronic pain, this is not the case. If the patient
has been afflicted with it for a long enough period of time, they
know that healing it is not an easy solution, and having hope is
difficult when the pain never goes away.
This kind of pain can stem a lot of other problems people and
doctors can sometimes ignore. Pain that is chronic usually never
appears in just one form targeting a single part of the body. There
are usually other problems linked with it that makes it so difficult
to bear.
Other difficulties of chronic
pain:
In the video Mastering Chronic Pain, Ph.
D. Satterfield says, (Chronic pain) also has
potentially devastating consequences on
mooddepression, anger, anxietyeffects on
social relationships, finances, and self-image
You can think of chronic pain as a chronically
stressful condition that essentially keeps the
stress response turned on all the time
(Mastering 2015).
Emotional aspect

Therefore, pain never exists alone. For instance, if you are


afflicted with chronic headaches, you may also experience
chronic fatigue, muscles soreness, depression, etc .
This helps introduce the emotional aspect of chronic pain.
The article Chronic Pain Management says, The emotional
toll of chronic pain also can make pain worse. Anxiety,
stress, depression, anger, and fatigue interact in complex
ways with chronic pain and may decrease the body's
production of natural painkillers; moreover, such negative
feelings may increase the level of substances that amplify
sensations of pain, causing a vicious cycle of pain for the
person. Even the body's most basic defenses may be
compromised: There is considerable evidence that
unrelenting pain can suppress the immune system
(Chronic n.d.).
Emotional aspect

The difficulties of chronic pain go far beyond the physical


anguish of the pain itself, also incorporating the correlated
physical symptoms, psychological aspects, and emotional
struggles that are linked with the initial affliction of pain.
Chronic pain sets off a domino effect in the body as
different functions are thrown out of balance, weakened,
and disturbed, resulting in several additional problems to
the chronic pain. As the bodys cycles are thrown off, so are
the simple production, management, and influential
functions of the body. Imbalances such as these are not as
easily detected as diagnosed conditions, but could not have
a greater affect on how a body and brain operates.
Causes

Many factors are involved when considering


the different possible causes of chronic pain.
Chronic pain is often caused by ongoing
illnesses or diseases that are persistent in the
body and continue to create the associated
pain symptoms so long as the illness
continues. Arthritis is among the most
common of these chronic pain diseases.
Causes

Chronic pain can be caused by pinched nerves


(especially along the spinal cord).
Along those same lines, nerve damage is also
a common cause of chronic pain, usually
following an injury or accident of some kind.
Chronic pain can also be caused by misfiring
in the nerves and the brain so the body is
constantly sending and receiving pain signals
(even when there is no cause).
Causes
In the article What Causes Chronic Pain, it says, In
many cases, however, the source of chronic pain can
be a very complex and even mysterious issue to
untangle. Although it may begin with an injury or
illness, ongoing pain can develop a psychological
dimension after the physical problem has healed.
This fact alone makes pinning down a single course
of treatment tricky, and it is why health care
providers often find they have to try a number of
different types of curative steps (What n.d.).
Often, an initial cause for chronic pain can not
always be determined, making treating the issue
more difficult.
Other Contributing Factors
Chronic pain can also be linked to psychological factors.
Often the psychological and physical aspects of an illness
go together, but doctors rarely look at both, usually
focusing on just one or the other.
Psychological factors are rarely attributed as the sole cause
of chronic pain in a patient. But often, those factors can
influence and affect the body, opening doors of possibility.
Depression, for example, can lower the immune system,
leaving the body susceptible to viruses which could
potentially harm the body or throw off its necessary cycles
of operation. All of this can lead to conditions that cause
chronic pain.
Psychological factors can also sometimes prevent the body
from recovering, even when proper treatments are under
way.
Treatments
When it comes to treating chronic pain, tactics differ depending
on the determined cause of the chronic pain.
Sometimes surgery, physical therapy, or altered living routines
can help and even eradicate chronic pain that stems from a single
cause.
Most of the time, however, only temporary treatments and short
solutions such as medications can be diagnosed by doctors.
Unfortunately, these temporary solutions only treat the
symptoms of the chronic pain, and often prove to be ineffective.
People with chronic pain that stems from no real bodily injury or
obvious cause, are not usually helped by pain medications and
treatments .
There is also obviously a psychological level of distress that
occurs when a person experiences chronic pain, forming a link
between the two, also making treatment difficult.
Conclusion
Works Cited

"Pain." Dictionary.com. Dictionary.com, n.d. Web. 26 Feb. 2017.

"Chronic Pain Management." WebMD. WebMD, n.d. Web. 26 Feb. 2017.

Mastering Chronic Pain. Perf. Jason Satterfield Ph.D. Kanopy. The Great
Courses, 2015. Web. 24 Feb. 2017.

Deardorff, William W., PhD. "Modern Theories of Chronic Pain." Spine-health.


Veritashealth, n.d. Web. 22 Feb. 2017.

"What Causes Chronic Pain?" WebMD. WebMD, n.d. Web. 24 Feb. 2017.
Works Consulted
Patel, Kim. Chronic Pain and the Self. Therapy Today. Web. 22 Feb. 2017.

Grieve, Kathleen, and Dieter Schultewolter. Chronic Pain: Current Issues and
Opportunities for Future Collaborations. British Journal of Healthcare
Management. 20. 12 (2014):563-67. Web. 22 Feb. 2017.

Living with Persistent Pain. Real Time Health, 2012. Kanopy. Web. 22 Feb. 2017.

Mastering Chronic Pain. Perf. Jason Satterfield Ph.D. Kanopy. The Great
Courses, 2015. Web. 24 Feb. 2017.

Deardorff, William W., PhD. "Modern Theories of Chronic Pain." Spine-health.


Veritashealth, n.d. Web. 26 Feb. 2017.

"Chronic Pain Management." WebMD. WebMD, n.d. Web. 24 Feb. 2017.

"When People Have a High Pain Tolerance, Are Experiencing Less Pain, or Are
They Just Better at "sucking It Up?" R/askscience." Reddit. N.p., n.d. Web.
26 Feb. 2017.
PERSISTENT AGONY
A Closer Look Into Chronic Pain and its
Associated Factors
By Emily Holt

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