Managing Chronic Pain

 Every day, there are people from all over the world that deal with chronic pain. People deal with this type of pain for a few weeks to a few decades. Chronic pain is no joke. First, let's start with the basics: what is chronic pain? Chronic pain is a long-standing that persists beyond the usual recovery period or occurs along with a chronic health condition (i.e. arthritis). The pain can be caused by inflammation or dysfunctional nerves. This severe kind of pain can affect your everyday life, making you feel miserable and alone at times. So many people do not really know how to deal with chronic pain, which is why I am here writing to you ways how to manage this type of pain so you can go back to your daily living, enjoying life. 

There are some people in this world that do not like to take the pharmacological approach to deal with pain, which I wholeheartedly respect. There are therapeutic interventions that studies have shown have helped patients deal with chronic pain, such as cognitive-behavioral therapy and meditation. According to Ashburn and Staats, "Cognitive-behavioural therapy is widely used in the treatment of the chronic pain. This psychological method attempts to change patterns of negative thoughts and dysfunctional attitudes to foster more healthy and adaptive thoughts, emotions, and actions in the patient" (1999). Relaxation techniques (i.e. meditation) help the body and mind calm down so that one can recognize sensations in one's body, including pain. In an article from Cleveland Clinic, Miller explains "Observing and accepting discomfort may help increase your tolerance of pain. This is because when you meditate, you are relaxing your mind and body, and that leads to the release of endorphins or ‘feel-good’ hormones” (2022). I do believe that cognitive behavioral therapy and meditation are necessary for our mental health when dealing with pain because pain can take a toll on our brain, making us humans, feel depressed and isolated from the world. These types of therapies allows us to rewire our brains from going into these negative thoughts and emotions and instead create a positive attitude which can lead the chemicals in the brain to release hormones, possibly relieving some pain in the body. 

Sometimes therapy might not be enough for relieving chronic pain, which is why there are pharmacological approaches. The most common drugs that chronic pain patients use are NSAIDs (Non-steroidal anti-inflammatory drugs). They are the most frequently used drugs for pain. According to the author, "Non-steroidal anti-inflammatory drugs (NSAIDs) are used extensively in the management of chronic pain and inflammatory conditions, such as rheumatoid arthritis (RA) and osteoarthritis (OA), as well as acute pain due to trauma, surgery, headache, musculoskeletal injuries, and cancer" (Wehling, 2014). However, long-term use of analgesics can cause peptic ulcer disease, acute renal failure, and stroke/myocardial infarction. You should not be taking NSAIDs if you already have or had these conditions. Other drugs used for chronic pain are opioid analgesics, tricyclic antidepressants, and anticonvulsants. Common adverse side effects of opioid analgesics (oxycodone, hydrocodone, morphine) are constipation, sedation, rebound pain, and impaired cognition. However, one should monitor drug use to ensure that it is being used correctly. Tricyclic antidepressants "can be helpful in several chronic pain states, especially in patients with head pain (including headache), central pain, and neuropathic pain" (Ashburn and Staats, 1999). Common side effects include dry mouth, dry eyes, dizziness, blurred vision, and constipation. One should be careful when taking these specific antidepressants since they can cause life-threatening cardiovascular effects. Common anticonvulsant drugs used for chronic pain are carbamazepine and gabapentin. Side effects include weight gain, tremors, dizziness, drowsiness, fatigue, and nausea.

While there are pros and cons to each medication, when it comes to chronic pain, these are the most common medications for dealing with it. You should talk to your provider when choosing which type of medication works best for you because everyone's body is different. Nonetheless, I do believe that anyone dealing with chronic pain should be in some kind of therapy whether it is relaxation therapy or any kind of therapy is a must since pain, in general, can have a huge impact on our mental health. 

References: 

Ashburn, M. A., & Staats, P. S. (1999, July 7). Management of chronic pain. The Lancet. Retrieved April 22, 2022, from https://www.sciencedirect.com/science/article/pii/S014067369904088X?casa_token=JEi0Q-ESx4QAAAAA%3A1Fuv0ypGoloSYY3lDhWxJrtYTy7ED6t78fHKy5ArqXoqXk4MxkJn77_Ajab6MoG7VFSY7EcZWoU

Wehling, M. (2014, August 28). Non-steroidal anti-inflammatory drug use in chronic pain conditions with special emphasis on the elderly and patients with relevant comorbidities: Management and mitigation of risks and adverse effects . SpringerLink. Retrieved April 22, 2022, from https://link.springer.com/article/10.1007/s00228-014-1734-6

Miller, T. (2022, April 8). Meditation for pain relief: How to do it. Health Essentials. Retrieved April 22, 2022, from https://health.clevelandclinic.org/how-you-can-ease-your-aches-and-pain-with-meditation/