Marc Darrow (Physical Medicine and Rehabilitation, Joint Rehabilitation Sports Medical Center, Inc. ) gives expert video advice on: How does chronic pain affect a person psychologically?; Are analgesics effective for managing chronic pain? and more...
How prevalent is chronic pain?
When I lecture to doctors, to students, or to the lay public, I always ask the question, "How many people are in pain today?" Typically, about 40 percent of the people raise their hands. Statistically, I've read that about a third of the American population is in pain.
What methods do doctors use for treating chronic pain?
The best way to treat chronic pain is to do a very good assessment. Find out where the pain is coming from, find out the pain generator and do a very good history. By finding out all the answers to your questions, this will help you figure out where the pain is coming from, how long it's been there and other such issues as what causes more pain and what alleviates the pain. This helps a doctor decide what tools in their arsenal are best to help heal the pain.
Can vitamin D play a role in managing chronic pain?
Vitamin D is very important in order to help reduce chronic pain. The reasons for this are that if Vitamin D is deficient in the body, then of course you can have things like Fibro Myalgia, which is wide spread pain for more than six months with certain tender points in the body. You can have chronic fatigue, and there can be many syndromes like this that are actually caused by a deficiency in Vitamin D.
Aside from physical discomfort, how does chronic pain affect its sufferers?
Chronic pain has many different aspects that can affect the person negatively. Obviously they feel pain in the body; that's the somatic pain in the body, or maybe the visceral pain, which is in the organ systems. There have been studies that have shown that when a person has chronic pain, they experience a downward spiral in consciousness. It works both ways. Once a person's depressed, they typically feel more pain. It's a vicious cycle that occurs: pain, depression, anxiety, anger.
How does chronic pain affect a person emotionally?
We can't distinguish the somatic part, meaning the physical or the body part, from the mental part or the spiritual part. We have to look at all of those things in treating a person. When a person has chronic pain, they often become depressed. When a person is depressed they often experience more chronic pain. So there's many things that we have to look at to deal with the entire person and the word holistically comes up for me because that means that we're dealing with the whole person. We're not looking at a person's hangnail or a person's knee or at a person's pain from an appendicitis that could be chronic, causing abdominal pain, we're looking really at the person and what it is that is affecting their life in many ways. We know that stress causes chronic pain. So when people come in the office that I've had here before, when a patient comes in and I haven't seen them for quite some time, some of the first questions I'll ask are: "Have you just been travelling?" Stress. "Have you broken up with a spouse?" Stress. "Have you had a problem on your job?" Stress. "Are there financial issues going on?" Stress. And when people have an exacerbation of something and it's been inactive for quite some time, meaning that the pain has gotten much worse after it was much better for a while, they will usually have a life incident that takes place that affects their consciousness negatively in such a way that they feel a lot of anxiety and stress from it. And that will affect that part of the body that's sort of like their weak spot.
How does chronic pain affect a person psychologically?
Chronic pain affects a person psychologically very adversely for many reasons. When a person is in chronic pain they feel stress, and when a person is stressed they feel pain; it goes hand in hand. All of these things act very deleteriously or negatively on our psychology or the consciousness inside of us. It depletes our energy when we feel stress or pain. Chronic pain, especially, is very deleterious or negative to the psyche of a person, because a person often feels there's no way out; that they're going to have this for the rest of their life, and they think about the future too much. The future is always a lot of fear; it's always a lot of depression, because if we paint a picture of the future as being very negative and as if there's no way out of it, then we get very discouraged, and that causes more pain.
How does chronic pain affect a persons occupation?
When a person has chronic pain, they're not going to be able to do their job as efficiently or as efficaciously as they did previous to their injury, or when the chronic pain just started. Some of the things that we see emerge are a person becoming depressed. They don't have the same "joie de la vie," or expression of life, that they used to have in their work and their family life, or anything else. So their occupation becomes something that becomes a burden on them, rather than something that's a joy or that they feel creative with.
How does chronic pain affect a person socially?
The social aspects of chronic pain are disastrous for a person. Oftentimes they become drug seekers, meaning that they need narcotics to stay focused in their life and to be able to function; and they feel guilty about that. So, they have this thing going on where they don't want to take pain medicine because they think it's copping out; they should be able to take their pain. At the same time the doctors are saying, "No, you really shouldn't be in pain, so you need to have enough medication onboard so you don't have pain." and many patients become addicted. As a result, their spouses look at them very negatively, their friends look at them very negatively, and it's a very sad thing to see.
Are analgesics effective for managing chronic pain?
Analgesics can be a two-edge sword; they can be very effective in managing chronic pain and at the same time they can be disastrous in the management of chronic pain because of the addiction potential that comes with many of them. Indeed, it's not only because of the addiction potential, but also because of all the negative side effects that can happen from medication.
What is the general prognosis for those who suffer from chronic pain?
There are people in chronic pain that have chronic pain for a lifetime. Then there are other people that are healed immediately by some type of treatment, or some kind of psychological therapy; things that are very efficient that we wouldn't even thing would work to help pain.