More than 35% of Americans suffer from Chronic Pain Syndrome



"Pain has two general categories; acute and chronic. Acute pain signals injury and generally resolves itself in less than 30 days as a person heals.  Chronic pain refers to pain persisting longer than three months.  It can last months to years.  Chronic pain can be mild to severe, annoying to debilitating, and continuous to intermittent. Chronic Pain Syndrome (CPS) is a common problem that presents a major challenge to patients and health-care providers because of its complex nature. Approximately 35% of Americans have some element of CPS.  Nearly 100 million people are affected directly or indirectly and are partially disabled or totally disable due to Chronic Pain. 

The cause of CPS can be injury, infection or ongoing disease.  In many cases, the cause of the pain is idiopathic, or unknown. Some of the major causes of CPS include arthritis, headache (especially migraines), low back pain, cancer, joint pain, and neuropathy or nerve pain.  Various musculoskeletal, neurological, urologic, gastrointestinal and reproductive disorders can contribute to or lead to CPS.  Risk factors for CPS include stress, anxiety, fatigue, depression and anger.

A detailed physical examination is essential for pinpointing the potential causes of chronic pain.  Attention should be given to Waddell signs, which refer to disability that is out of proportion to physical impairment and objective findings on examination. Imaging studies such as x-ray, computed tomography (CT), and magnetic resonance imaging (MRI) can also be used in the assessment of chronic pain.  

Symptoms associated with CPS include fatigue, difficulty sleeping, suppressed activity and disability. Also, mood changes such as depression, fear, hopelessness, irritability, stress and anxiety can be linked to CPS.  The emotional toll it takes can make the pain worse.  

CPS can be treated with medications, procedures, surgeries and various forms of therapy.  Classes of medications used to treat CPS include over-the-counter analgesics, opioids, anti-inflammatories (NSAIDs), anti-depressants and medical marijuana. Procedures used that can be extremely helpful include trigger point injections, steroid injections, facet injections, nerve blocks, intrathecal morphine pumps, radiofrequency ablations, spinal cord stimulator implants, other neuro modulatory procedures, and other minimally invasive spinal procedures. Hyaluronic Acid Injections, Platelet Rich Plasma, (PRP) and Stem Cell injections are also highly effective.  Various forms of therapy include physical therapy, chiropractic, occupational, recreational and vocational.  Psychological therapies include reassurance, counseling, biofeedback, relaxation meditation, acceptance and commitment therapy, cognitive behavioral therapy and stress management. Acupuncture, Reiki, Essential Oils, massage, magnetic field therapy, Aromatouch therapy, art therapy, sound/music therapy, dance therapy, yoga therapy, myofascial release, acupressure, heat therapy, ultrasound therapy, pool therapy and other Holistic Therapies can be instrumental as alternative therapies for CPS.  Nutritional Counseling is essential as many food groups contain inflammatory ingredients and toxins that contribute the symptoms of chronic pain.  Medical Marijuana has shown to be an effective remedy for CPS if prescribed by a knowledgeable provider and taken properly. Medical Marijuana has also been shown to decrease the need for opioid medication management and lessen the dependency issue associated with opioids.  

Overall, CPS can take an extensive toll on a person's quality of life.  It can affect activities of daily living and tremendously disrupt quality of life and day-to-day functioning of an individual.  The condition is best treated with a multidisciplinary, integrative approach including health-care professionals such as Physicians, Nurse Practitioners, Physician Assistants, Psychologists, Physical Therapists and Holistic Practitioners".

NorthernArizonaPainInstitutes.com
Prescott Office: 1.928.458.7343
24/7 at 1.877.388.9050

Written by:
Robert J. Brownsberger, MD, 
Whitney James, MD
Dorian Lange, PharmD

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