CHRONIC PAIN

WHAT IS CHRONIC PAIN?

Chronic pain is said to be persistent pain that lingers on for more than 12 weeks despite intervention with medication or other forms of treatment [6]. Pain can last for months or even years after the body has healed.[9]

RISK FACTORS [9]

Having Chronic and painful conditions such as arthritis.
If you have depression it may change the way your brain processes and receives messages from the nervous system.
Smoking elevates pain.
Being overweight puts strain on your body.
Women are seen to have a greater risk as they are more sensitive to pain. This could be hormonal.
Age: people who are older than 65 are more susceptible to conditions that may produce chronic pain.

POSSIBLE CAUSES

* The exact cause of chronic pain is unknown. It often follows an injury or painful condition. These include: [7] *

Arthritis
Back pain
Headaches
Muscle pains or strains
Repetitive stress injuries
Fibromyalgia: where muscle pain is throughout the body.
Nerve damage
Lyme disease
Broken bones
Cancer
Irritable bowel syndrome
Endometriosis
Surgery
Acid reflux or ulcers

SYMPTOMS

Symptoms may vary, however, may include any or a combination of: [8]

Low back pain
Headaches
Joint pain
Muscle aches
Burning or tingling pain in different parts of the body
Holts of sharp pain

TREATMENT OPTIONS

Medications to control pain such as anti-inflammatories, antidepressants, anticonvulsants or opioids may be prescribed. In addition to these medications other remedies may be included, such as: [8]

Behavioural modification, such as cognitive behavioural therapy.
Acupuncture.
Psychotherapy.
Biofeedback.
Hypnosis.
Occupational therapy.
Physical therapy.
Relaxation techniques such as meditation, deep breathing exercises, yoga, visual imagery, etc.
Nerve blocks..
Surgery to treat underlying conditions.

LIFESTYLE CHANGES [8]

Regular exercise which is of low-impact such as walking, cycling, swimming or yoga. At least 30 minutes a day for at least five days in a week.
Get plenty of sleep. Same hours everyday of about 7 to 9. Try to avoid napping throughout the day.
Quit smoking to improve your general health.
Find techniques to help you manage stress properly. Speak to your doctor about this.
Try keep yourself busy and moving around. Laying down and sitting may cause additional pain and disability.

HOW TO IMPROVE QUALITY OF LIFE LIVING WITH CHRONIC PAIN? [5]

Counselling for emotional and mental problems that you may be facing due to the chronic pain.
Exercise: which releases natural endorphins which help improve your mood.
Managing stressors: if you can avoid stress do so, however, find techniques to relieve stress such as, listening to music which can lift your mood, mental relaxation imagery, meditations, etc.
Socialize more, whether it be with family or friends. Having the support helps you cope emotionally and mentally.
Speak to the doctor about cognitive behavioural therapy which can help with the negative thoughts that may increase emotional problems such as depression, anxiety, etc.

SLEEPING POSITIONS WHICH COULD ALLEVIATE BACK PAIN [1;2]

Sleep on your stomach with your back facing the ceiling. Have a pillow to support your head and neck and one under your lower abdomen.
Foetal position: lie on your side and draw knees to your chest. Have a pillow to support your head and neck and you can also have a pillow between your knees.
Sleeping on your back with you facing the ceiling. Have a pillow to support your head and neck, one under your lower back and one under your knees.
Sleep on your side. Have a pillow supporting your head and neck and one between your feet.
Reclined position: can invest in a bed that reclines or find ways to put your feet higher than your body. This can be done with pillows or blankets.

RELAXATION EXERCISES [3;4]

Breathing exercises: breathe deeply repeatedly for about ten cycles. Breathe in for a count of three, hold breath for a count of three and then breath out for a count of three.
Meditation: this is by sitting or lying down. Block all noises and thoughts and concentrate on your breathing without controlling it. Start with a period of five minutes and increase as you get better at it.
Stretching exercises and muscle relaxation exercise: do simple stretch exercises for the various muscle groups. Focus on also tensing and relaxing these muscles groups after the stretch exercises.
Mental imagery: Close your eyes and focus on an image that helps you feel, safe, comfortable and relaxed. This can be a place, noise, sound, smell, taste, event or memory and can also be a feeling. Focus on this with a period of 5 minutes as a start then increase as you master the technique.

REFERENCES

Gill, S. [Internet]. How should you sleep if you have lower back pain?. United Kingdom: Health Media; [updated 2018 Feb 10; cited 2019 Aug 15]. Available from: https://www.medicalnewstoday.com/articles/320870.php.
Mayo Clinic staff. Slide show: Sleeping positions that reduce back pain. America: Mayo Clinic; [updated 2014 May 21; cited 2019 Aug 15]. Available from: https://www.mayoclinic.org/diseases-conditions/back-pain/multimedia/sleeping-positions/sls-20076452.
Pain Management Network [Internet]. Segment 5- Relaxation techniques and mindfulness. Australia: Agency for clinical Innovation; [updated 2019; cited 2019 Aug 15]. Available from: https://www.aci.health.nsw.gov.au/chronic-pain/painbytes/pain-and-mind-body-connection/relaxation-techniques-and-mindfulness.
WebMD [Internet]. Stress Relaxation and Natural Pain Relief. Atlanta, US: WebMD LLC; [updated 2017 Aug 24; cited 2019 Aug 15]. Available from: https://www.webmd.com/pain-management/guide/stress-relief-for-pain.
WebMD [Internet]. Quality of Life Scale for pain. 11 Tips for Living with Chronic Pain. Atlanta, US: WebMD LLC; [updated 2018 Jun 14; cited 2019 Aug 15]. Available from: https://www.webmd.com/pain-management/guide/11-tips-for-living-with-chronic-pain#1
NHS Inform [Internet]. Chronic pain. United Kingdom: NHS 24; [updated 2019 Jul 09; cited 2019 Sep 04]. Available from: https://www.nhsinform.scot/illnesses-and-conditions/brain-nerves-and-spinal-cord/chronic-pain.
WebMD [Internet]. What is Chronic Pain Syndrome?. America: WebMD LLC; [updated 2018 Nov 28; cited 2019 Sep 04]. Available from: https://www.webmd.com/pain-management/chronic-pain-syndrome-overview#1.
Colombia University of Neurology [Internet]. Chronic Pain Syndrome. Colombia: Colombia University Irving Medical Center; [updated 2015; cited 2019 Sep 04]. Available from: http://www.columbianeurology.org/neurology/staywell/document.php?id=42106.
Christiano, D. [Internet]. What is Chronic Pain Syndrome. America: Healthline Media; [updated 2018 May 24; cited 2019 Sep 04]. Available from: https://www.healthline.com/health/chronic-pain-syndrome.
Divisions of Family Practice [Internet]. Chronic pain. Colombia: Kootenay Boundary; [cited 2019 Sep 10]. Available from: https://www.divisionsbc.ca/kootenay-boundary/our-impact/team-based-care/chronic-pain.
Jungwirth, B. [Internet]. Opioids Are Not a First-Line Treatment for Chronic Pain, Pain Specialist Says. America: Remedy health media LLC; [updated 2016 Oct 06; cited 2019 Sep 10]. Available from: https://www.thebodypro.com/article/opioids-are-not-a-first-line-treatment-for-chronic.
NeuroSpa [Internet]. Chronic pain. Canada: NeuroSpa Brain Rejuvenation Center; [cited 2019 Sep 10]. Available from: https://neurospabrain.com/chronic-pain/.