Chronic Pain-the Paradox and the Approach

by Nicole Murray, L.Ac.

Every day at Beach Community Acupuncture, we treat many patients for chronic pain, a phenomenon that is widely misunderstood. Pain specialist Elliot Crane explains in this TED talk that most of us think of pain as a symptom of an injury or disease, which is correct-for some people. He goes on to tell us that in about 10 percent of cases, the pain persists after the patient has recovered from the injury or event. In this case, pain becomes a distinct disease with measurable changes to nerves that get worse over time.

With acute pain, chemical and electrical signals relay information from nerve endings to the brain. This helps to ensure that we are aware of injury and the need to take care of ourselves, as well as to avoid harm (if you get burned once, you probably won’t intentionally put your hand in the fire again). With chronic pain, these “pain signals go on for weeks, months, or even years.” (NIH). The signals continue to go off after the injury is resolved-it’s like malfunctioning circuitry. This is different from cases in which there is a direct cause of the pain, such as arthritis, or overuse- where a job demands too much of the body (for example, hairdressers with wrist pain).

The National Institutes of Health provides some facts about chronic pain:

Due to its persistence, chronic pain can cause major problems in every aspect of a person’s life, and is frequently resistant to many medical treatments. A person may even have two or more coexisting chronic pain conditions. Among the most common pain challenges for Americans are headaches, low back pain, arthritis pain, cancer pain, and nerve and muscle pain.

More than 76 million people in the United States live with chronic pain, but surveys show that almost half of them receive no treatment.

Research shows that almost 60 percent of older adults with pain have had it for more than a year.

The annual economic cost of chronic pain in the U.S. is estimated to be $100 billion, including healthcare expenses, lost income, and lost productivity at work and at home.

Other health problems, such as fatigue, sleep disturbance, decreased appetite, and mood changes, often accompany chronic pain. Chronic pain may limit a person’s movements, which can reduce flexibility, strength, and stamina. This difficulty in carrying out important and enjoyable activities can lead to disability and despair.

With chronic pain, the goal of treatment is to reduce pain and improve function, so the person can resume day-to-day activities. Whatever the treatment plan, it is important to remember that chronic pain usually cannot be cured, but it can be managed.

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Treatment for chronic pain includes:
* medications
* acupuncture (see this Harvard Medical School article)
* local electrical stimulation
* brain stimulation
* surgery
* massage
* meditation
* psychotherapy

How we treat chronic pain
We treat chronic pain at the clinic every day. We ask people to try to come 2-3 times a week for a few weeks and see what has changed-sometimes we get the pain to reduce, but also can help with energy, mood, and sleep. If people find acupuncture helpful, they usually stay in treatment weekly for as long as they are suffering.

Here are some helpful links and resources:
American Chronic Pain Association
Local chronic pain meetup group
Fascinating story on NOVA about a new approach to chronic pain
The National Institute of Neurological Disorders and Stroke
Cleveland Clinic primer on pain

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