Chronic pain is by nature a condition that affects many aspects of a patient’s life.
Pain is a natural alarm system for us to know there is a harm that needs to be addressed. But when the acute pain persists and continues for more than 3-6 months, it becomes chronic. There are many changes that happen in our nervous system for a chronic pain to develop and continue. Normally pain signal travels through pathways from different parts of our body to our spinal cord and all the way up to different parts of our brain including parts related to our emotions and sensory perceptions. There are many gates that the pain signals need to go through in this path. In return there are pathways that send signals back down through our nervous system to reduce or dampen the incoming pain signals.
In summary there are pathways that facilitate the ascending pain signal transmission to brain and there are descending pathways from brain that try to inhibit the pain signals. We have many of these balancing or control systems in our body. If for any reason the balancing effects of these systems become dysfunctional, diseases can emerge. As for chronic pain, it appears that the gates that pain signals have to go through become more open than usual. Also the inhibiting effects of the descending pathways become less effective. This results in an ongoing facilitated flow of pain signals to brain.
Over time many normal sensory signals may start to be perceived as pain signals. For example a migraine or chronic headache patient may not tolerate bright light or a fibromyalgia patient may feel pain with any pressure or even touching the skin. These are normal sensory signals that we feel and perceive in our daily life but in chronic pain they can be perceived as pain signals. This ongoing chronic pain can be episodic or persistent in time and can be mild, moderate or severe depending on how bad we feel it.
Because of many different physiological reasons including it’s ongoing nature, chronic pain affects almost all aspects of patient’s life. It becomes very difficult to have a good quality restful sleep with chronic pain. Severe pain may lead into inactivity and body deconditioning. Less mobility leads into losing muscle and bone mass which in turn lead into more pain and less mobility. Lack of sleep and mobility leads into less energy. Ongoing pain reduces threshold for irritability that over time changes behaviour and can affect relationship with others. Ability to work can be impaired that affects financial and social status of patients. Making poor choices on diet and medication uses can further complicate this picture. Deterioration of quality of life in all aspects leads into sad mood and worries (Depression and Anxiety). The combination of these factors can lead into set backs in the care of other underlying health condition that the patients may have.
In short, chronic pain is human’s unseen enemy that can affect all aspect of human’s life. Chronic pain is not a symptom, it’s an illness that needs a comprehensive approach for management.
There are many different treatments available for chronic pain but in many cases these treatments are only based on one modality and address only one aspect of treatment.
The current body of scientific evidence shows that because of the multiple aspects of chronic pain treatments that are integration of different disciplines lead into better outcomes. This approach looks at the whole person and integrates different treatments to deal with different needs. That is why we call it Integrative Chronic Pain Management.
This Integrative Pain Management Program addresses patient’s needs in following areas:
- General health assessment and individualized treatment planning
- Nutrition and Healthy Eating
- Activity centered care
- Sleep Hygiene
- Mental wellness skills and resiliency building, individual and group
- Proper Medications use
- Proper use of pain procedures
- Proper use of health supplements, vitamins and assistive devices
- Biofeedback techniques
- Self Management Education
The ultimate goal of this program is to improve and elevate general health, develop advanced health management skills and improve management of pain. Improving activity and ability to function with improved overall quality of life are essential points in this program. Return to work or other activities of daily life are promoted.
Dr. Kevin ROD
