Guide to Chronic Pain Treatment
 
A guide to chronic pain and its treatment.

Guide to Chronic Pain Treatment

If you've been living with chronic pain, you know the struggle.

You might hurt, throb or sting in one place or all over. You might feel soreness in your muscles or an ache deep down in your bones. The worst part? It can be hard to describe to your doctor, because it just hurts, and it has for a long time.

Such are some of the symptoms of chronic pain, a disease that happens when you hurt — sometimes inexplicably — for six or more months or longer than would generally be expected for recovery to a specific disease, injury or surgery. Other symptoms of chronic pain include:

  • Burning feeling.
  • Headaches.
  • Stabbing or burning pain.
  • Tingling or numbness.
  • Sharp pricks or pinching sensations.
  • Dull aches or discomfort.
  • Tenderness.

Sometimes, chronic pain stems from an injury that may have been corrected with surgery but continues to ache long after it heals, according to the Mayo Clinic. Some people have prolonged joint or back pain, while others experience chronic pain from underlying problems, such as arthritis or cancer. Still for others, the pain just appears with no notice or good reason.

Typically, chronic pain falls into one of two categories. Causes and treatments depend on which of the two types you experience.

Pain Caused by a Chronic Issue

Most of the time, pain serves an important purpose: To protect against peril. Think of it as a messenger, sending a signal through the nerves to the brain when you're injured: "Hey, something's wrong here!"

But when you have a chronic issue, the signal gets sent over and over again. That's the type of pain experienced by people with chronic diseases like these:

  • Headaches: People who experience headaches or migraines for at least 15 days each month have chronic headaches, a disease that itself has a number of causes ranging from infections to blood vessel problems, says the Mayo Clinic.
  • Cancer: While cancer doesn't always hurt, sometimes it does — for different reasons, says the American Cancer Society. A growing tumor might put pressure on other parts of the body. Cancer treatments themselves might cause pain.
  • Arthritis: The joint inflammation caused by arthritis can hurt anywhere your bones meet, but common culprits include the hands, knees and hips. For those genetically prone to arthritis, previous injuries can make it worse, says the National Institutes of Health.
  • Lower back pain: Some eight in 10 people will have lower back pain at least once, often caused by conditions like sprains, ruptured discs or even pregnancy, the NIH reports. For many, the pain goes away in three months, but sometimes it lingers long after the conditions heal.

Even though underlying issues are the cause, pain that lasts longer than 12 weeks is a disease — not just a symptom. That's because when the hurt evolves from acute to chronic, it often becomes its own diagnosis, study authors recently noted in the Journal of Pain Research.

Pain Caused by Nerve Damage

When someone is living with chronic pain caused by nerve damage, the cause is less clear. Sometimes, the pain messenger service has a glitch and sends a signal about a danger that's not really there. Maybe it did exist long ago, from a previous injury perhaps, but the nerves never got the memo that you're healed. They still fire warnings to the brain, which in turn causes the perception of pain. Causes of this tough-to-crack pain can include:

  • Neuropathic pain: Sometimes caused by diabetes, neuropathic pain happens when the nerve fibers become damaged. It generally feels like an electric shock or a "pins and needles" sensation, according to the Cleveland Clinic.
  • Complex regional pain syndrome: Similarly, this culprit often sends shooting pain down a single limb, like your foot, arm or leg. Injuries cause more than nine in 10 cases of this nerve-related pain, estimates the NIH.
  • Fibromyalgia: This disease, linked with widespread pain, acts in a similar way, says the Mayo Clinic. It causes people to feel pain more intensely because of the messages received in the brain. It can even be triggered by a memory of a painful event.

Make no mistake, though; "mystery pain" is not entirely psychological. People who live with these kinds of inexplicable pain have likely heard at least once that they have a "made-up disease," as one author wrote for Harvard Medical School. While some mental disorders like depression or anxiety can make pain worse, nerve disorders trigger real, physical responses to pain stimuli.

Chronic Pain Treatment: How to Manage the Pain

Pain can vary from person to person, so treatments do, too. And though many types of chronic pain can't be cured, they can be treated or managed. This means that while drugs or therapies — such as neurostimulation — may not eliminate the pain forever, they can reduce the pain for a better quality of life with continued treatment.

"Sitting at home disabled because of your condition is no way to live. If there's an alternative, you may still be able to get out and experience life," said Debby Triplett, a 62-year-old Louisiana woman whose doctors tried several treatments aimed at relieving her foot pain.

Seven years after trying a spinal cord stimulator that delivered traditional tonic stimulation failed to give Debby adequate relief, her doctor replaced the system with a neurostimulator that deliver's Abbott's BurstDR therapy. BurstDR™ stimulation is a physician-designed therapy form of SCS clinically proven to provide superior outcomes for patients with chronic pain over traditional SCS therapy1.


"I haven't looked back since my new stimulator has been implanted," Debby said. "It's like going back to being a normal person again. It can change your life; it changed mine."

Always consult with your doctor before beginning any treatment program.

Life Beyond Pain

An estimated 100 million Americans live with chronic pain, according to the American Academy of Pain Medicine. While their path forward may be difficult, new technologies and treatments mean that plenty of them live happy, fulfilling lives while keeping their pain in check. It's entirely possible — chronic pain be darned.

 

1Deer T, Slavin KV, Amirdelfan K, et al. Success Using Neuromodulation With BURST (SUNBURST) Study: Results From a Prospective, Randomized Controlled Trial Using a Novel Burst Waveform. Neuromodulation. 2017.

This story reflects one person's experience; not everyone will experience the same results. Talk to your doctor about the benefits and risks of your treatment options. St. Jude Medical does not provide medical services or advice as a part of this website.

Rx Only

Proclaim™ SCS System

Brief Summary: Prior to using these devices, please review the User's Guide for a complete listing of indications, contraindications, warnings, precautions, potential adverse events, and directions for use. The system is intended to be used with leads and associated extensions that are compatible with the system.

Indications for Use: Spinal cord stimulation as an aid in the management of chronic, intractable pain of the trunk and/or limbs, including unilateral or bilateral pain associated with the following: failed back surgery syndrome and intractable low back and leg pain.

Contraindications: Patients who are unable to operate the system or who have failed to receive effective pain relief during trial stimulation.

Warnings/Precautions: Diathermy therapy, implanted cardiac systems, magnetic resonance imaging (MRI), explosive or flammable gases, theft detectors and metal screening devices, lead movement, operation of machinery and equipment, postural changes, pediatric use, pregnancy, and case damage. Patients who are poor surgical risks, with multiple illnesses, or with active general infections should not be implanted.

Adverse Effects: Painful stimulation, loss of pain relief, surgical risks (e.g., paralysis). User's Guide must be reviewed for detailed disclosure.