Common Causes of Chronic Pain
Although chronic pain is surprisingly common, it’s also a mysterious condition. Experts estimate that between 42 and 50 million Americans know the agony and disruption of chronic pain, but many don’t know where it’s coming from. This is more than a cut or broken bone – chronic pain continues for long periods of time, and runs so deep that almost half of all sufferers find little relief with painkilling medications.
Unfortunately, you will be at a disadvantage until you can find the source of your pain, since your only defense is to treat symptoms rather than resolve the underlying problem. If you’re uncertain or confused about why you’re struggling with pain, consider whether your body may be burdened by another damaging condition.
How Chronic Pain Works
Pain is your body’s way of telling you that there’s a threat to your health, and you need to take care of it right away. When you hit, squeeze or puncture a specific area of your body, there is a sudden, powerful reaction (or acute response) from your nervous system, and as you fix the problem with rest or treatment, the pain sensation usually goes away. But chronic pain tends to involve a nervous system malfunction: pain signals continue to cycle between the nerve endings and the brain instead of stopping there, resulting in an agonizing loop.
The Most Common Causes of Chronic Pain
There are many causes of chronic pain. In some cases, one major event disrupts the normal nerve impulses, but in many other cases, it’s an ongoing condition that’s causing the ongoing pain. You will likely need to work with your doctor to uncover the answer, but begin by investigating these common causes:
Trauma. A traumatic event can lead to nerve damage, tissue damage and arthritis, all of which could result in chronic pain. Physical trauma – like a car accident, serious fall, or other injury – can permanently injure nerves or nerve reactions, and mental trauma – such as emotional or sexual abuse – can cause condition like post-traumatic stress disorder or anxiety, which can alter your pain threshold.
Infection. In some cases, bacterial or viral infections will have long-lasting effects on the body, which may continue for weeks or even years. Shingles, Lyme disease, ear infections and prostatitis (infection of the prostate) often bring persistent, severe pain. Chronic neck pain can be traced to meningitis, viral throat infection, or osteomyelitis (infection of the spine bones in the neck).
Disease. Multiple sclerosis, cancer, migraines, fibromyalgia, inflammatory bowel disease (IBD), endometriosis, and chronic fatigue syndrome are some of the most common diseases that lead to chronic pain. In these cases, treating the root condition will undoubtedly have an effect on the pain; the extent of relief will depend on a variety of other factors.
Anxiety. Many anxiety disorders can bring muscle tension, widespread soreness, and headaches. To make matters worse, anxiety (especially generalized anxiety disorder) often goes hand in hand with other chronic pain conditions, like fibromyalgia or arthritis. In fact, it can be difficult to tell which comes first, the musculoskeletal condition or the anxiety disorder.
Chronic pain can occur in any area of the body, and sometimes many areas at once. The way you experience the pain has to do with the type of condition that’s causing it, and the amount of nerve damage you have. For instance, sometimes a single back injury can cause pain to radiate into other areas of the body because of a pinched nerve, or a systemic disease like MS will affect the spinal cord, and in turn, interfere with a number of nerve pathways.
Targeting Treatment to the Source of the Pain
For some, the source of pain is clear: cancer, arthritis, a serious back injury or another memorable event that has damaged the nerves and tissues. However, emotional trauma, generalized anxiety, fibromyalgia or psychogenic pain (pain that isn’t linked to any past injury, disease or tissue damage) are more difficult disorders to diagnose – and more difficult to treat.
But no matter the source, the problem is the same: the never-ending loop of pain signals between the nerves and the brain. You need to find a way to disrupt this cycle, and for many people, that will demand a few different approaches:
- Distracting the nerves. An outside stimulus can interfere with the painful nerve impulses racing through your body, which is why massage, electrical stimulation (TENS), acupuncture, or heat and cold therapy can be so helpful for pain management.
- Blocking the pain signals. You can also control your pain by controlling the chemicals (neurotransmitters) that help pain signals reach the brain. Prescription medications, injections, or biofeedback therapy can reduce the amount of certain neurotransmitters linked to pain (like substance P), or prevent them from functioning properly.
- Boosting endorphins. Endorphins are naturally-occurring chemicals that trigger specific receptors in the brain to stop the pain sensations. Opiates have a similar effect, but exercise, positive emotions, and positive beliefs and expectations can build up natural endorphin levels without artificial means.
Chronic pain is easy to define, but difficult to predict. That is, most sufferers can agree that the pain is deep and distracting, but they don’t always agree on which strategies are most effective. Not surprisingly, having two or more underlying conditions will make the pain more difficult to manage, but physical problems aren’t the only factors in effective pain treatment.
Studies show that your emotional state and outlook can make a big difference in how you feel pain, and how much it interferes with your quality of life. Those who tend to dwell on their pain may become more sensitive to painful stimuli, will likely experience more anxiety, and are less able to lead a productive daily life than those who try to focus on other, positive goals. It follows that cognitive behavioural therapy (CBT), relaxation training, an increase in exercise – treatments that can improve your mood and restore emotional control – should play a role in any strategy to manage chronic pain.