Information on Chronic Pain for Patients
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INFORMATION ON CHRONIC PAIN FOR PATIENTS f1! Compiled for EFIC by: ~ .,,.... ) Beotrice Sofoer, Dov d Nlv ond Morshall Devor Tab te 01 contents Introduction Why am I in pain 7 There is more to chronic pain than ju st hu rting Chronic pain dese rve s special attention as a di sease in its own ri ght Where can I get help and advi ce? What trea tments ma y be offered to me 7 Are there some thing s I could do to help my self? Master ing the "system"--- patience and communic at lon between the health profe ss ional and patient About EFIC About the Artist: Baruch Elron: "Don't Suffer In Silence" Barucll Elron is a well-known I!gure In Ihe art scene in "-.=",...==:0 Israel. He recenlly underwenl amputation 01 a leg an d knolVS chronic pain personally. In lilis palFlling, Mied "Sharp PalFl", Elron uses autumn COIO UfS to express defoiJation of body and spirit due 10 unremlttmg phantom limb pain. lVi th the scream helpll1g hin) 10 share his suftering ,\ ill> hl5 surroundings. The palFltmg wa s selected from among 250 submiSSIOns al a competltion fointly sponsored by Ihe Israeli pharmaceutical company Ra/a Laboralofl(ls Ud. and the Israel Pain Associa tion al ils annual meeting in Halfa 11/2000. The piece lias ~come Welf known amongst researchers, physiclans ilnd other caregivers In I he (,eid of pa In a5 weil as the publlc al farge slnce il was selec ted by the Europ ean Feder. ticlll oliASP Chapters IEFIC ) as a central illus l ra l lOn lor Ihe 151 [ ulopear. W~ ek Agams l Palll 10cl. 8- J3 2001). to express I he idea: "Oon't Sulfer In Si/ence. The pam l mR also graces Ihe home page of EFl C's web si te ww w fElC.org and , erves JS iJ banner for EFIC's overall iniliallve "Europe Agalnst Pain". 3 Introduction Why am I in pain? This booklet has been written to help you understand the This is a question frequently asked by people who suffer pain, nature of chronic pain and to assist you to find the be st and on e that is sometimes not so easy to an swer We advice and treatment. You are not alone in suffering ehron ic know that pain is usually a warnin g from the bOdy that pa in. Everybody exper ienees short term pa ln from time to something is wrong. But sometimes the warning system time , but there are surprisingl y man y people , like yourself. itself fa ils and issues an alert that is unneeded, or that is out who hav e experieneed pain over a long period with little or of proportion. Indeed, a pain alarm is somet imes sounded no relie f. when there is no aetual illness or injury at all . Over the last dec ade or so the re have been many advan ees in the world of medieine. Unf ortunately, there are still no specific 'eures' for many types of ehronic pain. We do, Pai n ean be friend or foe. The most common cause of pain ho we ver, have severa l treatments which may offer part ial is when the body detects tissue injury or some sort of disease. relief (and In some eases eomplete relief), and certain For eommon aches and pa ins the intensity rou ghly matches treatments whieh are only available from health professionals who have particular skills in the treatment of chronic pa in. the physical disorder. If the pain is relieved by eommon pain killers, it is a safe be t tha t it will go away on its own in a Pa in is a eomplex individual experienee wi th sensory, matter of hours or days . If the pa in is alarmingly severe, emot ional and soel al as peets. It is important to un der stand it's a good idea to seek medi eal help as soon as possible. tllat no two people will experience the same pain in the So me people have ree um ng pains, like headaches or sa me way. This is becaus e the mess age s that pain gives to menstrual era mps , that they have learned to recognize as our brain may not be interpreted by one person in the same non-threatenin g. if unpleasant. When the pain alarm ring s way as another person, and beeause our indivi dual experience loud, especially when you're not sure why, the alarm 01 life colours the way we experienee and express our pain. system is doing its job .. tak e it seriously. We intend that this short booklet be of so me help to you in understandin g the nature of your pa in problem, and hope that It may aid in your search for a measure of relief. Simple in juries ean beeome inflamed or infec ted, and this tends to prolong the pain. Deep tissue injuries like a sprained ankle , also te nd to last day s or weeks rather than hours. Simple pain killer s, like aspirin, are usually safe and effective aga in st these pa ins. Ho wever , when tak en for weeks at time Beatrice Sofaer, Ph_D., RN these medieations carry an ace umulating risk of serious David Niv, M.D . EFIC President 1999 . 2002 side effects, particularly stomach and intestinal troubles. Marshall Devor, Ph.D., EFIC Committee on Sa f er alternatives are available, and you should eonsult Publications 1999 . 2002 your doctor. 4 5 There is more to chronic pain than just The bigge st probl em is with pain s that shoul d go aw ay but hurting ! don'!. There is no specific time after whi ch a short term The actual pain we feel is bad enough. Bu t when you live pain becomes chronic . This depends on the specific condition. with pain for a lon g time thi ng s can go from ba d to wor se . A simple rule of thum b is that if the pai n has las te d a lot Pa in fre que ntly li mits the ab ility to work, to enJoy one se lf longer than you had ex pec ted it to at l he outset, then you and even to take care of oneself. Ma ny people with ch roni c may have a chronic pain problem. pain le ave th eir jo bs, addi ng a fin anc ia l burden. As ti me drags on with out relief, peop le ten d to t urn inward and get depressed. They may appear self -abs orbed to fa mi ly, Iriends and othe r care rs whic h only in cre ases loneli ne ss and so cial isolation. When pa in and disab il ity app ear to be out Chronic pain som etimes mea ns that there is a persis t en t of proportion to inju ry , a Irequent eve nt with chroni c pain, tissue disorder, such as arthritis. However, sometimes it results carers may withdraw , fe elin g that they ar e being taken Irom a di sorder in the pain al arm sy stem itself. This can ad vantage of. What began as a medical pr oblem freq uently happen, for example, if there has been injury to the nerves ...Iike develops into a problem that engulls the sufferer and everyone a noisy tel ephone line. Some medical conditions are frequen t arou nd. causes 01 nerve pain, sugar diabetes, for example, or shingles. Surgery, particularly in the ehest area , or amputation 01 a body part, may leave you with persisten t burni ng and electric Chronic pain deserves special attention shock-like pa in. as a disease in its own right It is qui te logica l to assume tha t by repa iri ng the injur y that caused our pain, or curing the precipitating disease, the pain will automaticall y wear off. Spine surgery for the removal 01 The am ount of pain that different people have fOllowing a herni ated disc can sometime s re solve ba ck pain pro blem s. seemingly identical injuries can vary a great deal. One person Howe ver, what if it does not? And what about pain may suffer greatly, while another does not even ne ed minor con ditio ns whe re nothin g ca n be don e to fix the pr obl em pain relievers. A particul arly distressing, yet not uncommon that ca use d th e pa in, or where no pr oblem ca n be l ound ? si tuation , is when a seemingly minor injury, perhaps just a In thi s all- too-comm on situation treatin g and eliminating pain paper cut, leads to severe persisten t pa ln. We do no t know tak es over as the f irst goa l. Bu t wh en even thi s ca nn ot be for sure why this happens. So me people app ear to be do ne , or ca n only be partly do ne , there still re ma in things predispose d to pain while others seem to be immune. In tllat can be done to improve th e overa ll quality of lile for the part these individual differences may rellect upbr inging or pers on suf l er in g pa in. cultural traditions. Ho we ver, there are more and more indications that pain res po nse may aiso be al fec ted by ou; A lew examples 01 painlul conditiolls wh ere not mu ch can genes.