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Sunday 9am – 10pm

What is chronic pain?

Chronic pain (pain lasting six months or longer) can be excruciating, mild, debilitating, it might just cause you discomfort, be continuous or intermittent.
Your chronic pain may have originated from a previous trauma, initial injury or infection, or there may be an ongoing reason behind your chronic pain. Some individuals can suffer chronic pain without past injury or evidence of physical damage to their bodies.
Chronic pain has an emotional cost that can worsen your chronic pain. Anxiety, stress, depression, anger and fatigue interact with your chronic pain and might act to decrease your body’s natural painkiller production and increase those substances in your body that amplify the pain sensation, leading to a vicious pain cycle. Chronic-pain sufferers’ basic defences can be compromised by their chronic pain, with substantial evidence for immune-system suppression from unrelenting pain.

Your IPSA Medical chronic pain consultation

By taking your detailed medical/lifestyle history, your skilled IPSA Medical pain specialist will work alongside you, respecting your assessment of the intensity, level and timing of your pain, in order to develop the most suitable pain-management plan. Your IPSA Medical pain physician will carry out your confidential pain consultation in IPSA Medical’s conducive, client-focused and professional setting.

What symptoms are there with chronic pain?

The chronic pain symptoms can include:

  • Pain that ranges from mild to severe where the pain does not go away
  • Pain that is electrical, aching, burning or shooting in nature
  • Feelings of stiffness/tightness, soreness or of discomfort

The chronic pain symptoms do not usually exist in isolation but produce other associated issues:

  • Fatigue
  • Sleeplessness
  • Mood changes (e.g. fear, irritability, hopelessness, anxiety, depression and stress)
  • An increased desire to rest
  • Withdrawal from activity
  • Disability
  • A weakened immune system

The different types and treatments for chronic pain at your IPSA Medical clinic

General somatic pain (pain from your ‘outer’ body):

  • Pain in your muscles/skin is localised by your brain because this kind of pain is quite common, with everyone experiencing ‘general somatic pain’ at some point following a fall or when having been hit by a person/object and the pain usually goes in a matter of days.
  • Some people, however, can develop somatic pain that does not go away (e.g. fibromyalgia/chronic back pain).
  • General somatic pain is often treated with non-steroidal anti-inflammatory drugs (NSAIDs) (e.g. ibuprofen/naproxen and/or with paracetamol). Opioids might sometimes be required (e.g. codeine/morphine).

Visceral pain (pain from your internal organs):

  • Pain from your internal organs is more difficult for you to locate because your brain has less experience of visceral pain: the connections between pain sensors in your brain and internal organs are less sophisticated.
  • Visceral pain, as with acid indigestion or constipation, is common and easily treated. Visceral pain usually improves quickly on its own or with non-prescription medication.
  • Some types of visceral pain such as chronic pancreatitis (pancreas inflammation) or chronic active hepatitis (liver inflammation) can last for extended periods and be difficult to treat.
  • Some types of visceral pain (gallstones/appendicitis) can be treated surgically. Other types require non-opioid pain medication, while others will require opioids.

Bone pain:

  • Pain in your bones following a fracture or a bruise is of a temporary nature. However, pain from bone cancer, a spinal fracture, osteoporosis (bone weakening, often in older individuals), osteomyelitis (a bone infection) and also arthritis (joint inflammation) can last for extended periods.
  • Throbbing and gnawing bone pain might require long-term treatment with NSAIDs (e.g. ibuprofen) and/or opioids. Hormone therapy or bisphosphonates (to strengthen your bones) can be used to treat osteoporosis.
  • Severe pain (often in your back) from muscle spasms requires pain medication but, in addition, muscle relaxants (e.g. baclofen) might be needed to relax your muscles.

Neuropathy (pain from nerves leading from your extremities, head, face or trunk to your spinal cord):

  • All pain ‘comes’ from your nerves as your nerves transmit pain impulses to your brain. With neuropathy, these pain impulses come from irritation occurring along the length of nerves rather than from the ends of nerves.
  • Neuropathy-causing pain from sciatica occurs when your sciatic nerve (a nerve running from your spine to leg) is ‘pinched’. The pinching is near your lower spine but your brain ‘believes’ it is from your leg’s nerve endings because your sciatic nerve transmits feeling from your leg
  • Infections such as shingles can produce nerve irritation, as can ruptured spinal discs pinching nerves or cancers growing in your nerves. Peripheral neuropathy can be caused by AIDS and diabetes.
  • Nerve pain eliciting ‘pins-and-needles’ type sensations can be treated using ‘tricyclic antidepressants’. More severe pain can feel like a sharp/stabbing/electric feeling and is treated with seizure medicines (anticonvulsants).
  • Nerve pain from the loss of a limb (phantom-limb pain/deafferenation) where the individual feels the limb is still present and hurts is often treated with blood pressure medicine (clonidine).
  • Herpes zoster (shingles) infects nerve endings and the skin near your nerve endings. A local application of capsaicin (prescription-strength pain ointment) helps, but tricyclic antidepressants, opioids and/or anti-convulsant medication may also be required.

Circulatory problems:

  • Poor circulation can cause chronic pain. Poor circulation can be due to diabetes, tobacco use or due to some autoimmune diseases (lupus/rheumatoid arthritis).
  • Partial artery blockage due to fatty deposits (plaques) also results in poor circulation. Poor circulation leads to pain because the areas of your body that do not get an adequate blood circulation are deprived of oxygen and of nourishment causing damage and, consequently, pain.
  • Poor circulation-related pain can be treated surgically with artificial arteries to bypass clogged arteries and improve blood circulation. If bypass surgery is not possible, blood thinners and/or pain-control opioids may be required.
  • Complex regional pain syndrome (CRPS), which is fairly common, involves both circulation and nerve transmission where painful nerve transmissions cause your blood vessels to narrow, preventing oxygen and nourishment reaching the affected areas. CRPS can sometimes be surgically treated (sympathectomy) to prevent nerve impulses narrowing your blood vessels. Non-opioid medication (with/without surgery) is often required and opioids may also be required.

Headaches:

  • Headaches (e.g. migraines, cluster or tension) can result from many illnesses and different health conditions (e.g. sinusitis, brain tumours, giant cell arteritis, trigeminal neuralgia).
  • The treatment differs depending on headache type and pain severity. Non-opioid medicine can be used but opioid therapy is required in some instances.
  • Migraines (that often occur on only one side of your head) can be associated with nausea, vomiting, photophobia (light hurts your eyes) or phonophobia (sound hurts your ears), and also ‘scintillating scotomata’ (parallel lines vibrate at object edges mostly at the light/dark border between objects). These ‘auras’ appear prior to onset and alert you to the upcoming migraine, where the pain intensity can vary from mild to severe. Many migraine medications exist. Triptan drugs seem to be particularly beneficial.
  • Cluster headaches (which occur in groups, perhaps several times each day) can last for days and even weeks and can produce severe and intense pain. Oxygen therapy can be helpful.
  • Sinusitis, often producing facial pain that is worse in the morning, can respond well to anti-inflammatory medications and decongestants. Sinus surgery or antibiotic treatments are sometimes required.
  • Trigeminal neuralgia, severe peripheral neuropathy, occurs only on one side of your face/head, with a ‘trigger point’ mostly on the side of the face, and this produces intense pain when touched. Anti-convulsants (anti-seizure medications) are often found to be beneficial.

To book your same-day IPSA Medical chronic pain consultation, book online or call your nearest IPSA Medical clinic.

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