Chronic pain: Strategies for improvement | Allen and Allen

Chronic pain: Strategies for improvement

According to the Centers for Disease Control and Prevention (or CDC), about 20% of American adults – 50.2 million people – live with chronic pain. The most common type of chronic pain is back pain (41% of adults), with hip, ankle, and foot pain closely behind.

woman at her desk experiencing back pain

Chronic pain is one of the most frequent conditions prompting adults to seek medical care. Chronic pain can seriously impair a person’s ability to handle the functions of daily life, including work and sleep. The United States loses roughly $80 billion a year in lost wages, and nearly $300 billion a year in lost productivity, all due to chronic pain.

Diagnosing chronic pain: MRIs don’t tell the whole story

Medical science has traditionally regarded chronic pain in one of two ways:

  1. A structural problem caused by damage to discs in our spine, muscle strain, or torn tendons.
  2. A complex problem without any known or apparent cause.

Interestingly, chronic pain is not always caused by a structural problem within the body, and imaging studies are not a good way to evaluate pain. At least two studies of MRIs show that there are many people with structural problems that do not experience pain:

  • A 2012 study of the MRI scans of the knees of 710 people that were 50 years or older found that 90% had some feature of osteoarthritis, without regard to whether they had knee pain or not.
  • Similarly, a recent study of MRI scans of the backs of 98 people with no back pain showed that 64% had disc abnormalities. Indeed, discs in our spine deteriorate as we age, with 90 percent of us showing degeneration of our discs by age 60. But of course, not all folks over the age of 60 experience persistent back pain.

man receiving a back massage

Treatment for Chronic Pain

The most common treatments for chronic pain are physical therapy or massage, followed by medication and surgery. Other options include exercise and even keeping mentally engaged with social activities.

Exercise

Physical therapy is the main treatment for traumatic and chronic pain. Many people mistakenly think that exercising a joint will only make the pain worse. They believe that only rest can alleviate pain.

On the contrary, physical activity does not lead to more degeneration, and moving the joints promotes blood flow and can lubricate the joint. A study tracking nearly 500 runners over a period of 14 years found that there was “no progressive increase in musculo-skeletal pain in older adults who participated in vigorous exercise,” compared to those who did not. People with arthritis who exercise regularly report less pain and maintain function longer than people who do not exercise.

pile of pain medication

Drug Options

Nonsteroids like ibuprofen and naproxen are the drugs of choice for managing arthritic pain.  When they don’t work, or stop working, other effective options include corticosteroid injections can be helpful.

A surprising but controversial newcomer to the list of medications that can help are cannabinoids. These compounds are derived from the cannabis plant and can be highly effective, safe, and well-tolerated by patients. Indeed, the NFL has begun a study of using cannabinoids to treat the chronic pain experienced by many of its players.

Surgical options

Surgery is often the last option after more conservative efforts have failed. Joint replacement can be life-changing, but it is not without its own difficulties and patients should not expect a return to complete normalcy after a joint replacement. Further, the replacement joints can themselves need to be replaced. Jason McDougall, a professor at Dalhousie University in Canada advises delaying joint replacement surgery: “The recommendation is that you should try to put it off as long as possible.”

depressed male covering his face

The mental health aspect of treatment

Regardless of the treatment option that you might choose, do not ignore the psychological aspects of chronic pain. Pain is not imagined, but it is a mind-body phenomenon and is sometimes a brain-directed response. For example, research conducted before the recent pandemic showed that social isolation can increase chronic pain for many people. As would be expected, during the pandemic, nearly half of 1000 respondents with chronic pain reported that their pain and stress had increased.

Keeping busy and engaged is an important aspect to controlling chronic pain, according to Jacqueline Winfield Fincher, immediate past president of the American College of Physicians: “It’s easy to just get down in the chair or bed, and not want to move because it hurts.  But it’s basic human psychology that when you have something to look forward to, you have a goal that motivates you to want to get better.”

If you are experiencing pain from an accident that was not your fault, you should contact a lawyer to explore your legal rights.  Treatment, regardless of which you chose, is not cheap. Call Allen & Allen today for a free consultation at 866-388-1307.