Pain Management - Chronic Pain
Chronic pain afflicts approximately 10-20% of the adult population. Advances in research and development have greatly enhanced our ability to treat both acute and chronic pain disorders. However, while the number of treatment options – including antidepressants, anticonvulsants, opioids, nonopioid analgesics, local anesthetics, and alpha adrenergic agents – for such conditions as polyneuropathy, postherpetic neuralgia, low back pain, soft tissue injuries, and arthritic conditions has expanded, many patients – particularly those with persistent pain – continue to experience inadequate pain relief and/or intolerable adverse effects.
Pain control is essential because, even when the underlying disease process is stable, uncontrolled pain prevents patients from working productively, enjoying recreation, or taking pleasure in their usual roles in the family and society. Chronic pain may have a myriad of causes and perpetuating factors, and therefore can be much more difficult to manage than acute pain, requiring a multidisciplinary approach and customized treatment protocols to meet the specific needs of each patient.
Forms of chronic pain include:
- Neuropathic pain
- Musculoskeletal pain
- Rheumatoid arthritis
- Cancer pain
Neuropathic pain includes a variety of conditions such as diabetic neuropathy, post herpetic neuralgia, post mastectomy pain, phantom limb pain, reflex sympathetic dystrophy (RSD or Complex Regional Pain Syndrome), and pain caused by blunt trauma or crushing injuries. Symptoms of neuropathic pain may not be evident for weeks to months after the injury. The likelihood of effective management worsens as the symptom duration increases; therefore, prompt evaluation and treatment are vital.