Thứ bảy, 14 Tháng 8 2010 16:26

What Should You Do With Your Chronic Pain?

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What Happens

In some cases, chronic pain develops after an injury or illness. The pain continues even after you have recovered from the injury or illness. For example, many people who have had a limb amputated report feeling chronic pain in the missing limb (phantom limb pain). Chronic pain can also develop even though you have not had an injury or illness. But the result is often the same-a cycle of sleeplessness, inactivity, irritability, depression, and more pain.

Chronic pain may be mild to severe. You may have pain that comes back from time to time over several weeks, months, or years. Occasional, mild to moderate pain can usually be managed at home. Exercise, good nutrition, regular massages, and pain-relieving drugs-such as acetaminophen or nonsteroidal anti-inflammatory drugs (NSAIDs), for example, ibuprofen or aspirin-may be enough to manage your symptoms.

On the other hand, you may have constant chronic pain that is severe. You may be unable to work, and physical activity may be too painful or exhausting. Sleeping at night may be difficult, resulting in fatigue and irritability. Your outlook on life may change and strain your relationships with family and friends. Prolonged pain may restrict your daily activities and eventually lead to disability. Without specialized treatment, chronic pain syndrome can become disabling.

After treatment begins, many things can interfere with your recovery, such as dependency on drugs or alcohol, overwhelming stress, lack of motivation, depression or other mental health problems, or ongoing litigation because of a workers' compensation claim. If your pain is disabling, you may want to seek an evaluation at a pain management clinic, where a team of doctors work together to treat your pain.

The lives of your family members, friends, or caregivers can also be affected. The people you count on to help you may also need some support. Family therapy or involvement in a caregiver support program may help.  

What Increases Your Risk

Factors that may increase the risk of chronic pain include:

  • Aging. Older adults are more likely to suffer from chronic conditions such as arthritis, diabetes, shingles, and other causes of nerve problems (neuropathy). But chronic pain is not a normal part of growing older.

  • Smoking. Nicotine use can increase pain and decrease the effectiveness of medicines.

  • Health problems. These include:

  • Existing health conditions, such as fibromyalgia, shingles, arthritis, depression or anxiety disorders, or having a limb amputated (phantom limb pain).

  • Past health problems, such as joint injuries. Also, previous surgery may cause new pain or may not work to relieve pain (such as back surgery that does not relieve pain).

  • Overall general health condition. You may have a weakened immune system, which can lead to frequent infections or illness.

  • Conditions that are difficult to treat, such as nerve pain from shingles (postherpetic neuralgia).

  • Lifestyle, such as not eating healthy foods, not exercising regularly, smoking, or having a substance abuse or alcohol dependency problem.

Other factors that may increase your risk for chronic pain include injury, stress, inactivity, relationship problems, or a history of physical, sexual, or emotional abuse 


When To Call a Doctor  

Call a doctor about chronic pain if:

  • Your pain has lasted more than 3 months without a clear reason.

  • You are feeling down or blue or are not enjoying the activities or hobbies that you have enjoyed in the past. You may be experiencing depression, which is common with chronic pain.

  • You are unable to sleep because of the pain.

  • You had an illness or injury that healed, but the pain has not gone away.

  • You have a family member or friend who appears to be suffering from chronic pain, and you would like information about treatment.

Watchful Waiting

Watchful waiting is a period of time during which you and your doctor observe your symptoms or condition without using medical treatment. If you are able to control occasional, mild to moderate pain with exercise, healthy eating, massage, and pain relievers-such as acetaminophen or nonsteroidal anti-inflammatory drugs (NSAIDs), for example, ibuprofen or aspirin-you may not need further treatment from a doctor. But watchful waiting is not appropriate if your pain is severe or if persistent pain interferes with your life. If you delay treatment, the pain may get worse.

Who To See

If you have mild to moderate recurring pain that cannot be managed at home, you may need to consult one of the following health professionals:

  • Family medicine doctor

  • Internist

  • Nurse practitioner

  • Physician assistant

  • Doctor of osteopathy

If your chronic pain is moderate to severe and constant, or if treatment does not control the pain, your primary health professional may recommend that you see a specialist, such as one or more of the following:

  • Pain management specialist

  • Physiatrist

  • Physical therapist

  • Neurologist

  • Obstetrician or gynecologist (for chronic pelvic pain)

  • Urologist

  • Anesthesiologist

  • Psychiatrist, psychologist, or a licensed mental health counselor

  • Orthopedic surgeon

  • Rheumatologist

  • Chiropractor

Often more than one specialist will treat your chronic pain. For example, a primary physician may manage your medicines, and a physical therapist may help you restore function through exercise or other therapies. A professional counselor may help you with coping and depression, and a complementary medicine practitioner may provide alternative therapies such as acupuncture or yoga.

If chronic pain persists and interferes with your daily life despite treatment, you may want to seek an evaluation at a pain management clinic. A pain management clinic is a setting where you receive treatment and learn to cope with chronic pain. Treatment is usually provided by a team of doctors who work together to address all the possible causes of your chronic pain.


Home Treatment  

The following ideas can help you manage your chronic pain.

  • Take your medicines as prescribed.

  • Eat a balanced diet, and consider taking a daily multivitamin that contains vitamin B and vitamin D.

  • Participate in a physical therapy or exercise program that includes stretching several times a day.

  • Keep your appointments with your doctor, especially if you have moderate to severe or constant chronic pain.

Make lifestyle changes, such as:

  • Get enough sleep every night. If you are tired during the day and have trouble sleeping, try to:

  • Set a bedtime and a wake-up time-and stay with these times, even on weekends. This helps your body get used to a regular sleep time.

  • Get some exercise during the day.

  • Avoid taking naps, especially in the evening.

  • Avoid drinking or eating caffeine after 3 p.m. This includes coffee, tea, cola drinks, and chocolate.

  • Treat medical conditions and mental health concerns early, before they get worse and become harder to treat. Untreated health conditions (such as shingles) or mental health problems (such as depression or anxiety) can make chronic pain harder to treat.

  • Exercise regularly with aerobic exercise-such as swimming, stationary cycling, and walking-to build your strength and health. Water exercise may be especially helpful in reducing pain that gets worse during weight-bearing activities, such as walking. Talk to your doctor before you begin an exercise program. Start slowly and increase your efforts bit by bit. If your joints are stiff, try taking a warm bath or shower first to loosen up. Also, do some stretching exercises each day.

  • Schedule your day so that you are most active when you have the most energy. Learn to move in ways that are less likely to make your pain worse.

  • Eat a balanced diet. Good nutrition will help you stay healthy and strong.

  • Stop smoking. Smoking may affect your level of pain and may reduce how well your chronic pain treatment works.

  • Reduce stress in your life. Try a relaxation therapy such as breathing exercises or meditation. For more information, see the topic Stress Management.

  • Other ideas include:

  • Trying assistive devices, if recommended by your doctor, that help you do your daily activities. These devices can help you to be more mobile and independent. For example, use a cane or crutch, braces, splints, or devices such as doorknob extenders or an elevated toilet seat.

  • Joining a support group. A support group is made up of people with similar experiences who can understand your feelings and provide comfort. A support group can keep you from feeling isolated and alone. Being around others who share your problem can help you and your family learn how to accept and manage chronic pain.

  • Doing self-massage or trigger point massage therapy.

  • If you are a caregiver for a person who has chronic pain, your own stress and worry can also cause you to have symptoms of depression, vague body pains, digestive disorders, or headaches. Experts say that it is important to take care of yourself, too, and not to feel guilty about it. For more information, see the topic Caregiver Tips.

Read 3381 times Last modified on Chủ nhật, 12 Tháng 9 2010 12:31

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