Chronic Pain

Medical authorities generally characterize “chronic pain” as any pain lasting longer than six months from time of onset. It is pain that just won’t go away despite medical care and time.

Pain in general is your body’s adaptive response to harmful stimuli. It alerts you to possible injury and tells you to pull your hand away from the flame, to stay off that sprained ankle, to swat at the bee sting. These alerts are examples of acute pain and the types of involuntary reactions they elicit are the responses that have developed over millions of years of evolution to protect you as an organism. So, to put things into perspective, it is useful to think of pain as a positive adaptive response to noxious stimuli that has important implications for your survival.

Chronic Pain is different. The experience of chronic pain persists long after acute pain and long after your body should have gone through a healing process in which the pain gradually subsided. It’s as if the pain signals that triggered your acute pain response won’t quit firing, and this may happen for months or years after the initial pain occurs.

So why does this happen, and why does it happen to some people and not to others? The answer is that we really don’t know. While there are any number of disease processes or injuries that can serve as an initial “cause” of chronic pain, there are also innumerable situations where the initial event that leads to a pain response that turns into “chronic” pain seems relatively insignificant and is out of all proportion to the severity of the pain. This especially occurs in a variety of chronic pain called Complex Regional Pain Syndrome or CRPS.

Researchers are currently investigating biochemical, genetic, nervous system, and psychosocial influences on the development of chronic pain. Based on what we know right now, it is probably fair to say that no one of these will entirely predict chronic pain. The syndrome remains a complex and to some extent an unexplained phenomenon from the point of view of any one determining factor. Despite this however, there are treatment approaches for chronic pain that can provide relief and can help patients to recover the quality of life they enjoyed before pain came to define their lives.

Treatment

There are numerous treatments for chronic pain. These include medications, injections, acupuncture, nerve stimulation, surgery, psychotherapy, behavior modification, exercise, relaxation and biofeedback, and nutritional supplements, among many others. Our philosophy at Centennial Rehabilitation Associates is that all of these can have their place in cases of chronic pain depending on the nature of the pain and patient response, but that no one approach is a definitive cure-all. Just as the cause of chronic pain cannot be pinned down to one factor, neither can the treatment be restricted to one approach.

This is why our treatment is interdisciplinary, involving a variety of practitioners from different areas of medicine and rehabilitation. In our Pain Medicine Center we don’t provide all the possible treatments for chronic pain, but we do incorporate health care professionals from a variety of disciplines in developing and applying a treatment plan. And most importantly, they are all in regular communication with each other so that all the care provided is coordinated and all the providers are on the “same page” relative to the treatment goals and approach.

A similar approach is taken in our Pain Wellness Program which is a part time program modeled after the intensive outpatient programs seen in the world of behavioral medical care. Coming at a complex problem, in this case the problem of chronic pain, without the blinders imposed by one single discipline is, we believe, the optimum way of dealing with this condition. We’re not alone in that opinion either. The Colorado Division of Workers’ Compensation calls interdisciplinary rehabilitation programs such as ours the “gold standard” for chronic pain.

Prognosis

Can chronic pain be cured? The answer is a definite maybe. Depending on the circumstances of individual cases most people can lower their level of pain, reduce their reliance on medications, increase their function, and resume the activities of daily life they enjoyed prior to the onset of their pain. There are many chronic pain patients we have helped at Centennial Rehabilitation who have experienced just these outcomes.

But is there a silver bullet somewhere that will take all the pain away? Probably not. Chronic pain patients can generally expect to have to participate in some form or forms of treatment after they leave us in order to maintain the gains they make while they are with us in treatment. They may also experience flare ups of pain from time to time. But there is no reason to believe that chronic pain is incurable to the extent that any case is unlikely to improve, and in many, if not most cases, the improvement is quite dramatic. You can recover your life after chronic pain. You can control your pain. We can help you.