A certain amount of pain is expected after injury or surgery, but under normal circumstances the body heals and the pain is resolved — a process often assisted by medication. Chronic pain is different and something of a mystery. Tests and examinations may uncover nothing abnormal, but the body’s distress is real. Chronic pain patients have typically suffered a failed surgery or unresolved condition of some kind and have experienced pain that has not been alleviated by treatment for more than a year. In some cases, chronic pain develops out of the blue, with no link to trauma or disease. Over time, the condition takes a physical as well as an emotional toll on patients — persistence of pain, poor response to treatment, sleep disruption and emotional fallout are all hallmarks of chronic pain.
Chronic pain can affect all parts of the body, but is especially prominent in the lumbar or cervical regions of the back. Discograms and pain management injections are two methods often used to address chronic back pain conditions, but may also cause pain of their own. A discogram involves first injecting a spinal disk with contrast dye material to facilitate examination under an X-ray (also called fluoroscopy). The disk is then injected with enough fluid to pressurize it. A disk that is unable to be pressurized is potentially ruptured. Pain management injections involve the direct delivery of steroids or anesthetic to nerve, joint or epidural space. Injections are typically prescribed after a course of medications and/or physical therapy is completed, but before surgery is considered. Also referred to as blocks, injections are useful for providing pain relief and as a diagnostic tool for identifying the source of back pain.
Complex regional pain syndrome (CRPS), formerly referred to as sympathetic dystrophy reflex (RSD), is a chronic, painful and progressive neurological condition that affects skin, muscles, joints and bones. Physicians are unsure of the cause. Symptoms include continuous, intense, burning, pain that is disproportionate to the severity of the injury, excessive sweating, swelling and sensitivity to touch. The syndrome usually develops in an injured limb or following surgery; however, many cases involve only a minor injury or no precipitating event at all. CRPS/RSD most often affects one of the arms, legs, hands or feet, then may spread to other limbs. There have also been cases where symptoms eventually recede, only to reappear with a new injury.
Fibromyalgia is a widespread musculoskeletal pain and fatigue disorder for which the cause is still unknown. The term itself means pain in the muscles, ligaments and tendons — the soft fibrous tissues in the body. More women than men are afflicted with fibromyalgia and it appears in people of all ages. The condition is characterized by fatigue, widespread pain in the muscles, ligaments and tendons, aching all over and multiple tender points. Other symptoms may include premenstrual syndrome and painful periods, chest pain, morning stiffness, cognitive or memory impairment, numbness and tingling sensations, muscle twitching, irritable bladder, the feeling of swollen extremities, skin sensitivities, dry eyes and mouth, dizziness and impaired coordination. Changes in weather, cold or drafty environments, infections, allergies, hormonal fluctuations, stress, depression, anxiety and overexertion may all be contributing factors.