Chronic pain can have many causes. dr Tara-Lin Hollins from the Cleveland Clinic (USA) explains the causes of chronic pain, how it differs from normal pain and what treatment options are available.
With chronic pain, according to Dr. Hollins generally distinguish two categories: peripheral pain and central pain. The causes and treatment options are very different.
What is peripheral pain?
Peripheral pain refers to local pain or stabbing pain. This type of pain is caused by nerve injuries, infections, or exposure to toxins, for example.
Peripheral pain is usually a warning signal from the body that there is a health problem, says Dr. hollins This type of pain can often be relieved with over-the-counter medications.
How does central pain arise?
Central pain, on the other hand (also known as neuropathic pain), is caused by damage to the central nervous system, such as in the brain or spinal cord. This type of pain results from nerve damage that stops sending pain signals properly, resulting in chronic pain, Hollins explains.
According to the expert, it used to be assumed that centralized pain only occurred in the case of nerve injuries such as spinal cord injuries or strokes. In the meantime, however, it is known that there are a number of other diseases that lead to such chronic pain.
Typical causes of chronic pain
For example, diseases such as fibromyalgia, arthritis, irritable bowel syndrome and endometriosis are known causes of chronic pain. According to Hollins, chronic pain in the lower back and chronic headaches or migraines are also particularly common. And chronic fatigue syndrome is often accompanied by pain.
Determine the type of pain present
However, determining what type of pain you are suffering from is not always easy. A study by pain professionals can help determine whether you have peripheral or central pain (or a combination of both).
How is pain treated by professionals?
Peripheral pain can be treated with anti-inflammatory drugs, injections or surgery, explains the expert. For example, osteoarthritis is treated with anti-inflammatory drugs.
However, there is the problem that anti-inflammatory drugs are often not able to combat the pain problems caused by the central nervous system. “We are finding more and more that treating only peripheral pain is not enough when patients also have centralized pain,” adds Dr. Hollins in a recent press release.
What to do with centralized pain?
For centralized pain, drugs are available that act on the brain or spinal cord. In addition, it may be advisable to seek psychological treatment (although a pain psychological treatment would be ideal) to address the so-called central sensitization. Learning stress management techniques and treating anxiety are also effective treatments.
Pain scale not always suitable for chronic pain
In the past, people in pain were often asked to rate their pain on a scale from zero to ten. According to Hollins, however, this method of determination is not suitable for every person, especially not for those with chronic pain.
For example, one person may have a pain score of eight and sit on the couch all day while another person with a pain score of eight goes shopping and performs other daily activities, Hollins reports.
Today, therefore, it is often first determined how much existing pain influences everyday activities. The expert explains that suggestions for functional improvements can then be made.
That’s how it is dr. According to Hollins, it is advisable to see a pain specialist if you have years of spinal pain, knee pain, headache, arthritic pain or persistent pain after a successful surgery.
The pain can often be relieved so that those affected can be more active in everyday life again and their quality of life improves significantly. (as)