Whelehans Pharmacy:Chronic Pain Part 1

Chronic Pain Part 1

We often associate pain with some direct cause. It could be from a sports injury, or toothache, perhaps an accident which has resulted in a broken limb. For most of these there is a standard action and recovery process, with no pain once healed. For many though, pain is something for which there is no simple “cause and effect” making it more difficult to fix the problem. Pain is a constant factor in the lives of many.

Types of Chronic Pain

 

Nociceptive Pain :Nociceptive pain is the type of pain which results from physical injury or damage to body tissue. This may be due to a fracture, injury or burn, or following surgical treatment such as following an operation. It can present as a sharp or stabbing type of pain, or as an ache.

Neuropathic Pain :Neuropathic pain is caused by damage of the nerves, spinal cord, or brain. Typical effects are felt as a burning or tingling type of pain. Causes of neuropathic pain include nerve compression such as carpal tunnel syndrome and nerve damagefor example from peripheral neuropathy due to diabetes or post-herpetic neuralgia following shingles infection.

 

Psychogenic Pain: Psychogenic pain is physical pain that arises from psychological factors, and is much less common as a stand-alone condition. Psychological factors and symptoms of psychogenic pain often complicate pain related disabilities although the pain has a physical cause, the psychological factors exacerbate or enhance the pain to be more severe than found in most individuals with a similar physical cause of pain.

Causes of Chronic Pain

A general classification of the 4 main categories for pain are:

 

Causes of Musculoskeletal pain include Osteoarthritis; Rheumatoid arthritis; Osteoporosis; Ankylosing spondylitis; Polymyalgia rheumatic; Fractures; Chronic or repetitive overuse; Carpel Tunnel Syndrome and Muscular strains and Mechanical low back pain.

Causes of Headache and/or Migraine includeCluster Headaches; Migraine; Trigeminal neuralgia; Glaucoma; Smoking; Alcoholand Drug or Substance overuse or misuse.

 

Causes of neurological pain include Diabetic nerve damage (up to 25% of diabetics); Shingles; Multiple Sclerosis; Alcoholism; Thyroid disease and Pernicious anaemia; Infections (e.g., HIV)

 

Psychological causes of pain include Depression; Anxiety; Personality disorders and Sleep disturbances.

To be continued…next week I discuss treatment options

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