What is Chronic Pain?
When it comes to pain, most people know about acute pain. That is the type of pain that you feel right after an injury, whether it's a cut, broken bone, or a burn.
Chronic pain is any pain that last 45 days or longer, or longer than expected for the type of injury. I consider chronic pain to be defined as pain lasting longer than 3-6 months or more.
We now know that chronic pain is different and needs to be treated differently than acute pain. Medications are not the answer to chronic pain. In fact, there is no perfect answer to treating chronic pain. Medications are just one of the tools that we can use. Each patient needs to have a personal treatment plan and personalized goals. Treatment needs to include a multimodal approach; physical therapy, chiropractic care, massage therapy, exercise therapy, and OTC medications including Tylenol and/or ibuprofen for mild pain.
Prescription pain medication does have its place in the treatment of chronic pain. It should be used in conjunction with other modalities (i.e., physical therapy). Pain medications does not just include narcotic medications but includes a variety of medications for different types of pain. Often, we use nerve medication to help with pain, such as Gabapentin, other times, a muscle relaxer is needed to reduce muscle spasms. This is why the patient and provider need to work together to define the pain and create a specific and specialized treatment plan.
There is also a psychologic factor to chronic pain that many people do not consider. Having pain chronically changes how each person perceives pain and how their body/mind handle pain. Other psychologic issues such as depression can alter how someone may respond to chronic pain. It is important to consider these conditions when evaluating and treating chronic pain. There are medications that serve a dual purpose to treat both the psychologic aspect and the physical aspect of pain, such as, Amitriptyline, Nortriptyline, Venlafaxine, or Duloxetine.