Back On Track Health: Regular or intense pain

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Regular or intense_back

By Warren Heggarty

Do you experience regular or intense pain anywhere in your body? Or do you have an old injury that can sometimes cause pain?

According to Pain Australia, everyone, including medical practitioners, could benefit from a better understanding of chronic pain. Like mental health issues, there is stigma associated with it, a sense that person with chronic pain is somehow making it all up. Pain is invisible to others and this can add to the frustration when it interferes with your day-to-day living. 

Chronic pain is usually defined as lasting for more than three months. Most regular aches and pains are easily fixed with analgesics or anti-inflamatory medicine. However, chronic, intense pain is often difficult to treat. According to Professor Philip Siddall, Director of the Pain Management Service at Greenwich Hospital, medicines for nerve and other chronic pain have only a partial effect at best. “People have asked me to amputate their leg, just to get rid of the fire that never goes away. With this desperation and distress, it is tempting to try anything in the hope that it will give relief.” (Siddall, 2018)

Another form of chronic pain is “phantom limb pain.” Because our brains carry a “map” of our bodies, even if part of the body is no longer there (following an amputation) the part of the brain onto which it is “mapped” still is. It is thought that this generates the sometimes excruciating pain that people feel after an amputation (Stephenson, 2013, Stephens, 2014)

According to Michael Nicholas, director of pain education and management programs at the Royal North Shore Hospital in Sydney says that opioids have “very limited utility” for chronic pain. This is partly because their effectiveness reduces over time. And while they might initially dull the pain, “they dull you, too.” They merely mask the pain without doing anything about it (Powell, 2018).

Living with pain 

This raises the related issue of opioid addiction (see ACTION Recovery Conversations May page 3) which is an increasing problem, especially in rural and remote areas where there is not the same accesses to alternative pain management methods. Nicholas says that people need to work out other ways to live that don’t involve trying to avoid or escape from pain. “Unfortunately, you have to accept living with pain.” (Powell, 2018)

The Australian Pain Management Association recommends that patients be involved in all decision-making about their treatment. According to Australian Pain Management Association, there are four main approaches to pain:

• Psychological strategies, for example acceptance therapy and cognitive-behavioural therapy

• Physical strategies, for example avoiding pain triggers and pacing your physical activity (bearing in mind that the idea is not to avoid living!)

• Medicinal strategies with regular reviews

• Social strategies, for example support groups, family and friends. 

This is just a general discussion of some types of chronic pain. Always consult your doctor to get qualified advice.

References

Australian Pain Management Association. (n.d.). Helping Patients Live with Neuropathic Pain. Retrieved September 25, 2018, from NPS Medicinewise: https://www.nps.org.au/medical-info/clinical-topics/neuropathic-pain

Powell, S. (2018, February 14). A fine line between relief and craving. The Australian.

Siddall, P. (2018, March 6). Neuropathic pain: diagnosis and treatment today. Retrieved from Medicinewise News: https://www.nps.org.au/news/neuropathic-pain-diagnosis-and-treatment-today

Stephens, C. (Director). (2014). How to do Mirror Therapy for Phantom Pain [Motion Picture]. Retrieved from https://www.youtube.com/watch?v=HMIparaWrUo

Stephenson, C. (Writer), & Stephenson, C. (Director). (2013). Discussing phantom limb sensations and pain with amputation [Motion Picture]. Retrieved from https://www.youtube.com/watch?v=-P5S0ayEp08

Find more on Flourish Australia’s Physical Health microsite

https://both.flourishaustralia.org.au/

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