What is Chronic Pain?

Chronic pain is defined as longstanding pain lasting more than 3 to 6 months and persisting past normal healing time. It is an overwhelming physical, mental, and emotional burden for about 100 million Americans. Beyond the personal costs, the Institute of Medicine of the National Academies research estimates that chronic pain costs the American economy an estimated $560 - 635 billion in healthcare spending and lost productivity every year. Here are 10 facts about chronic pain.

1. It can be the result of many  conditions including degenerative neck or back pain, cancer-related pain, painful neuropathy, headaches and migraines, nerve pain, spinal injury, pelvic pain, peripheral vascular disease, phantom limb pain, post-surgical and scar pain, fibromyalgia, among others and lasts for months or years, even after your body has healed from the injury or illness. Sometimes chronic pain arises for no obvious reason or from more than one source at a time.
2. Chronic pain can feel like aching, burning, shooting, squeezing, stiffness, stinging, and throbbing. It can be continuous or can come and go. It can interfere with daily life and can lead to loss of work, loss of mobility and energy, depression, and anxiety.
3. Some people are at higher risk of chronic pain, like those who have genetic conditions that cause it, obesity, advanced age, injury, a labor-intensive job, repetitive motion, stress and post-traumatic stress, and smoking.
4. The first step to relieving chronic pain is finding and treating the cause, if possible. If you have long-lasting pain, your doctor will want to know where you are feeling the pain, its intensity on a scale from 1 – 10, how often it occurs, the nature of the pain, whether it is affecting your life or work, what makes it better or worse, any recent illnesses or surgeries, and any sources of stress or anxiety in your life.
5. When it’s not possible to treat the cause, patients can try to manage or treat the pain itself using medications, traditional and integrative therapies, lifestyle changes, and interventional pain management. Your doctor may recommend a plan that includes more than one treatment method depending on the type of pain, the cause (if known), your age, and your overall health.
6. Long-term use of some medications, like opioids, come with potentially serious side effects, including tolerance, dependence and even addiction.
7. Therapies, including cognitive behavioral therapy, counseling, occupational therapy, and physical therapy many help reduce pain and maintain or restore function. Also alternative treatments like acupuncture, biofeedback, hypnotherapy, mindfulness training, arts therapy, pet therapy, Reiki, and meditation are some options to try.
8. In some cases, classes and support groups, like the Chronic Pain Management class through https://www.myhealthyvt.org/, help participants make important lifestyle changes. Through lessons about stress, exercise, diet, and sleep, the classes help participants build strength, increase energy, and improve mobility in ways that help them improve their outlook and feel better. The class is free and occurs over 2.5 hours one day a week for 6 weeks. 
9. Sometimes primary care doctors refer patients to Interventional Pain Management, which can be a useful alternative for patients who have exhausted other treatment methods. Pain management doctors use a host of different minimally invasive techniques—often using image guidance, such as x-ray (fluoroscopy), CT scan, or ultrasound—to target the culprit areas.
10. Some interventional pain management techniques include epidural steroid injections, during which anti-inflammatory medicine is injected into the epidural space of the spine, near the  spinal nerves, to treat irritation and inflammation of spinal nerve roots; trigger point injections, in which local anesthetic can be injected into pain myofascial tender points, often in the neck or back; nerve blocks, where a provider injects an anesthetic near the site of the pain to reduce feeling in that area; and facet joint injections, where anti-inflammatory medication is delivered into the joints of the spine; and nerve ablations, where heat is used around a nerve to thwart its growth or reduce its ability to generate a pain signal. New technology involves using electromagnetic fields with small electrodes to mask the signal coming from a chronically injured nerve(s).

If you are experiencing chronic pain, ask your doctor about some of the treatment options available to you and visit https://svhealthcare.org/Services/Pain-Management for more information. 

Radiologist Andrew Shedden, MD, and Anesthesiologist Joshua Tobe, MD, co-lead the Southern Vermont Interventional Pain and Treatment Center, part of Southwestern Vermont Medical Center and Southwestern Vermont Health Care, in Bennington.