Chronic Pain Management in Brighton
The definition of chronic pain is pain lasting longer than 3 months. In practice, the term “chronic pain” is used to refer to pain that continues beyond the time normally expected for healing of a torn ligament or broken bone. There are a few examples of chronic pain that occur frequently and usually resolve by themselves. Tennis elbow is one such condition. Usually it is brought on by an overload of muscle tendon junction from either knocking it or repetitive strenuous use. For reasons poorly understood it is common for this condition to last for one to two years.
Spinal pain, in particular low back pain, is not always equally accepted. There may be a similar pathological process occurring, where all tests may be completely normal and yet pain persists. There may be a stigma associated with pain and in certain circumstances there may be insinuations about the legitimacy of the complaint.
Pain is a very subjective phenomenon and there are still many unanswered questions. For instance, two people with identical pathologies in their spines shown on X-ray may have totally different pain experiences. In both cases the back problem may be sending out a moderate amount of pain signals, but one person may have a higher threshold or tolerance of pain. Factors that affect pain tolerance include sleep disturbance, fatigue, depression, stress, worry, previous pain experience, family/work pressures and medications.
Even when pathology can be seen on an X-ray, frequently it does not cause pain.
What we do know is that the longer you have pain, the more it tends to spread to nearby areas – in medical terms we call this sensitisation of the nervous system. Over time it can even spread from one side of the body to the other side and up and down the spine. Once it spreads to wider areas of the body it is often termed Fibromyalgia.
Risk factors for increasing pain include smoking and obesity. Certain occupations can mildly increase the risk of developing pain, but in general there is little correlation with general level of activity or strenuous work.
The most important person that can help you is you! If you smoke or are overweight – you need to take control and do something about it… today! There is no point in making excuses or putting things off till next week. You only get one chance at life and we must make the most of it.
Having trouble coping or need some one to help you through the stresses – our trained psychologists can help with sleep problems, stress and over-eating in response to pain.
You’ve heard the term “use it or lose it”. It is true – if we just lie around and rest all day our muscles wither away, our bones become brittle and our joints stiffen up. Regular exercise is important for the back, even if you are feeling sore. The discs and other joints gain their nutrition through small regular movements of the spine. Our bodies tend to stiffen up with age and often it is the stiffness or cramping of the muscles that hurts the most – we need to stretch these. Initially it will hurt but with time it should gradually get easier. Our physical therapists can assist with an exercise program that is achievable. Sometimes the pain is just too great to move much and injections may be needed to reduce the spasm. The injections are rarely a cure – they just reduce the pain and spasm and allow movement which in-turn stimulates the body to heal itself. The bottom line is that the body naturally tries to heal itself, and by remaining positive and active, we can help.
Treatment and Management of Chronic Pain
If you are feeling overwhelmed by your pain, it is likely that a multidisciplinary approach is needed. A comprehensive assessment from one of our medical specialists is likely the first step.
Dr’s Kal Fried and Nathan johns have specific interests in chronic pain management, and will co-ordinate referrals to other members within our team, such as Psychologists and Physiotherapist, for an overall program. Call the clinic for more information.
For specific conditions, such as disc protrusion or spinal facet joint arthritis, there are focal interventional injection therapies performed by Dr Victor Wilk, that may be performed in conjunction with a rehabilitation program.