How to Manage Chronic Pain

By Don Williams

Our clinic has been interested in how to manage chronic pain through treatment and management pain for many years and, generally speaking, we have had good success. However, as a category of patients, it is a fascinating and highly varied group of people.

What is Chronic Pain?

Pain is essentially a perception of a sensory and emotional experience that is unpleasant and associated with tissue damage. This can be described as burning, aching, tingling, shooting, pricking, stinging, or compressing sensations.

“Chronic” is merely a time measurement. It means the pain has persisted for a long period of time.

Commonly, the terms “acute” and “chronic” are used incorrectly. Chronic means long-term, while acute means short-term. However, patients often use these terms to describe the severity of pain, with statements like, “I hurt my back yesterday; it’s really chronic.” By definition, a back injury yesterday would be considered an acute injury. More correctly, it could be referred to as severe.

What Causes Chronic Pain?

This is the $64-million question. There are a multitude of theories about why people end up with long-term or “chronic” pain. It is often multifactorial.

Pain is a perceptual phenomenon. Essentially, if we poke your leg with a finger, we stimulate a receptor. It transmits an electrochemical message to the brain through the distal nerve branches, the nerve root, and the spinal cord, eventually reaching the brain. The brain then decides how to interpret that signal.

At the brain/sensory experience level, we have thresholds for experiencing pain. If your threshold is a level 5 and you receive a level 4 stimulus, the body will interpret this as irrelevant, and you will dismiss the stimulus. However, if the stimulus is a level 6, it is interpreted as noxious, and we have a pain experience. There is a release of neurotransmitters and hormones, and we “experience” pain.

We know that psychosocial factors can impact this interpretation. For example, if we are stressed, anxious, or depressed, our threshold might be altered or lowered. This means that the previously irrelevant level 4 stimulus will now be perceived as painful. This triggers the cascade and release of neurotransmitters, and we experience pain.

The important thing to recognize here is that the response might not be appropriate for the stimulus. However, the pain experience is very real.

This perceptual phenomenon is often poorly understood and can lead to misdiagnosis and mismanagement. Patients are sometimes told, “It is all in your head,” leaving them feeling unheard, unsupported, and hopeless.

We often see patients presenting with feelings of loss and hopelessness. But, alas, it’s not all bad news.

Why Does Chronic Pain Persist?

Conditions often persist for three main reasons:

1. The pathology either hasn’t or can’t be addressed.
2. People continue to engage in activities or behaviors that exacerbate the pain.
3. Weaknesses and imbalances exist in the system, allowing the problem to repeat or continue.

Fortunately, the last two points are often very manageable.

How We Treat Chronic Pain

When we see chronic pain cases, we systematically assess the system to:

• Identify weaknesses and imbalances.
• Correct behaviors and activities that cause the pain.
• Address the pathology where possible.

We tailor a system or approach to determine what load or exercise you can tolerate without triggering pain. We then work to gradually build this up over time to increase strength, control, and resilience, ultimately progressing out of the painful state.

Chronic Pain Management FAQs

Can chronic pain be cured?

While not all chronic pain conditions can be fully cured, many can be effectively managed to significantly improve quality of life. Tailored treatment plans often lead to remarkable progress.

What are the common treatments for chronic pain?

Common treatments include physical therapy, exercise regimens, stress management techniques, and addressing underlying conditions. In some cases, medications or interventional procedures may be used.

How long does it take to see improvement?

The timeline for improvement varies depending on the condition and the individual’s response to treatment. Many patients begin to see positive changes within weeks to months with a consistent approach.

A Hopeful Outlook

Chronic pain management is a journey, but it’s one that can lead to significant improvements in daily life. By addressing the root causes, correcting imbalances, and building resilience, you can move beyond the limitations of chronic pain and reclaim your normal.

If you’re struggling with chronic pain, contact our clinic today. Let’s work together to create a plan that helps you live your best life.