Chronic Pain Conditions
Chronic pain: IASP (International Association for the Study of Pain) defines Pain as:
Chronic Pain is any pain that has persisted beyond the expected illness or injury, arbitrarily defined as lasting beyond the expected time course, or “3 months”. Any chronic pain that persists despite several interventions is called Persistent pain.
Chronic pain is better explained by a biopsychosocial model rather than a biological model which is more useful in acute pain. That is why for managing chronic pain we need to have a strategy in place which looks into and addresses all the factors responsible for giving rise to chronic pain, whether these are biological due to the underlying pathology, psychological or social. Therefore a multidisciplinary approach is a prerequisite for the efficient management of chronic pain.
A multidisciplinary chronic pain management team comprises of medical doctor (a Pain Physician), a Psychiatrist and Psychologist for managing the psychological comorbidity and a Physical medicine professional for physical therapy. While dealing with a patient in chronic pain apart from the physical basis or underlying pathology giving rise to chronic pain, factors which suggest psychological comorbidity or physical disability should be specifically sought and should be addressed while making the overall treatment plan.
The role of Pain Physician lies in the proper assessment of the chronic pain condition in order to pinpoint its cause and its management by interventional pain procedures if not responding to conservative management. The interventional pain procedures are minimally invasive procedures (injections), mostly done on day care basis which are meant to either deposit a drug (local anaesthetic/ steroid) near the pain generator, ablation of nerves or implantation of intrathecal pumps or spinal cord stimulators. Interventional pain procedures are used for therapeutic pain relief as well as to confirm the diagnosis.
There is ample evidence that the psychological factors play a significant role in the experience, maintenance and exacerbation, if not the cause of pain. Since there are no cures for chronic pain and some level of pain will persist in most pain sufferers regardless of treatment, psychological approaches are useful complements to more traditional medical and surgical approaches.
A comprehensive pain management program should include the services of a Physiatrist, who can offer various physical modalities such as therapeutic heat and cold, hydrotherapy, ultrasound, electricity, TENS, manual techniques in addition to active exercises. Physical techniques benefit the patients by causing functional restoration, maximizing and maintaining pain relief for long and a feeling of control of one’s own pain.
A multidisciplinary approach is certainly of benefit in chronic pain patients to help them relieve their pain and bring them back to functionally active life.
- Low Back Pain
- Cervical/Neck Pain
- Upper & Mid Back Pain
- Joint Pains
- Arm/Leg Pain
- Neuropathic/ Nerve Mediated Pains
- Orofacial Pains
- Cancer Pains
- Whiplash Associated Pain
- Spinal Cord Injury and Other Central Pains