Pain and Chronic Illness

Chronic pain is pain that continues after your body has healed from an illness or injury. It can occur anywhere in your body, and can range from mild, annoying pain to severe pain that interferes with your mood and ability to function.

Chronic pain is generally different from acute pain. Acute pain signals are due to actual or impending tissue damage that normally subsides after the injury that caused it. Chronic pain is pain that lasts for longer periods, usually more than three months. This three-month interval is normally long enough for acute pain to ease completely.

Chronic pain often develops after a major injury or illness such as shingles, back problems, or after a limb has been amputated (phantom limb pain). Chronic pain is common in older adults as they are more likely to suffer from medical conditions linked to ongoing pain (such as arthritis). Chronic pain may also occur without clear-cut injury or illness. Although the reason is not clear, in these cases pain signals are somehow triggered by the nervous system, and continue to fire for months or even years. It is also possible that certain brain chemicals that suppress pain may not work properly.

Pain is caused when the nerves send pain signals through the spinal cord and into the brain. Once one has healed from an injury or illness, the nervous system normally stops sending pain signals to the brain. In those with chronic pain, the nervous system continues to send pain signals, resulting in prolonged pain.

The symptoms of chronic pain include mild to severe pain that does not go away and pain that may be described as shooting, burning, or aching, with discomfort, soreness, tightness, or stiffness. Fatigue, depression, and withdrawal from social and physical activities, weakened immune system, and functional disability may also occur.

Treatment of chronic pain usually includes behavioral therapy and a combination of medications (such as pain relievers or antidepressants) and exercise (which, in most cases improves --and would not be expected to worsen-- the pain). Complementary therapies such as acupuncture or yoga and physical therapy -- including hot and cold therapy to relieve painful areas of the body, or stretching and range-of-motion exercises to maintain strength, flexibility, and mobility -- may be used as well.

Treatment may be needed for conditions related to chronic pain; professional counseling for depression, for example. In such circumstances cognitive-behavioral therapy (CBT) is the treatment of choice. This approach recognizes the role of physical, psychological, and social factors in chronic pain.

Cognitive-behavioral therapy teaches relaxation techniques, stress management, and other pain-coping strategies. These techniques increase the person's coping strategies and sense of control. Furthermore, by modifying both thought and behavior in ways that help sufferers become healthier, CBT focuses on changing destructive thoughts about illness and helping individuals adopt positive ways of coping with their physical condition.