Chronic pain and its impact

Pain is everywhere

Majority of clinic visits in to a general physician are for longstanding headache, backaches, joint pains, chest discomfort; pain anywhere in the body. Pain is a neurological symptom, that has a medical cause and it demands specific medical treatment. Many varieties of arthritis, degenerative illnesses, migraine and muscle spasms; all are associated with longstanding pain. However, any pain that lasts for more than 3 months certainly has some psychological contributions to it. Such pain is medically well understood as chronic pain.

Facts about pain

A very interesting medical fact about pain (which also makes it complicated) is that all physicians feel that patients tend to exaggerate their complaints of pain. This again has a strong subjective emotional component. Thus, any pain can never completely somatic or psychic, it is always psychosomatic. A soldier on the battlefield does not feel the pain of 5 bullets in his abdomen, until the time he has reached the hospital bed. Then the pain is excruciating, unbearable and unreal (and rightly so). The nerve fibers that carry pain signals to the brain are filtered through the emotional centers. That is how emotions modulate pain. When one is happy, the pain of arthritis or neuralgia doesn't hurt too much.

Symbolic pain

Empirically it has been observed that specific areas of the body have symbolic correlations with pain that arises in them. A housewife, who is feeling bogged down by her daily routine, several hours of household work, pressures from the family, worries about the children and financial stressors; commonly develops a chronic tension headache. She has the worldly stresses on her ‘head’. This pain is localized to the area above the forehead and is expressed a constant heaviness (like all the pressures of the world thrown over her). Likewise a 19 year old boy who has just broken up with his girlfriend, feels a constant pressure and tightness in his chest, giving him restlessness, fear of a heart problem; and chest pain. His heart is truly ‘broken’ and gives him unexplained pain. The office executive working for 11 hours on his seat, bearing the load of his family responsibility may feel over stressed and develops a chronic backache. He is the beast of burden who has the world’s load on his back that unquestionably gives him pain.

Pain and Emotion

Pain signals get influenced by emotions and thoughts, which in turn affect neurological transmission and alter the pain experience. Internal analgesics in the body include endorphins that are released in times of pleasure and happiness. That explains why one feels less pain when one is happy. The cycle is true in reverse too. Sadness accentuates physical perception of pain while pain precipitates depression.

Pain and psychopathology

Any chronic pain condition triggers irritability, anger, frustration and resentment. It leads to a complete change in one's outlook towards things because it is enduring and constant so it ends up becomes nagging and irksome.  The person in pain becomes ‘painful’ to have around. The bitterness of the pain spills into the individual’s personality.

Pain management

Pain is agonizing and ought to be treated delicately. Medications can control inflammation, however pain pathways are pretty complex and medications fail to act in many of these. Yoga or meditation for instance can release endorphins that block the pain signals in the spinal pathway. Scientific evidence has endorsed this repeatedly. Psychotherapy techniques can be used to manage chronic pain and the negative emotional experience associated with it. Systematic relaxation techniques and biofeedback help in easing muscle tension and lactate buildup that is responsible for accentuating pain. One needs to learn how to alleviate one’s own pain a cope with it. Life ought to be beautiful and pain free.