Why does it still hurt? Things you should know about chronic pain.

Why does it still hurt? Is the wound still there?

When you recover from an injury, do you have the experience that you still have some pain (pain scale 1–2 out of 10) after a long period of time and start to feel strange/ sore in parts that were not injured?

To answer this question, you must know more about “pain”.

Pain can be classified as acute and chronic.
Redness, inflammation, sharp pain and swelling is often presented in the acute phase. When the pain persist for more than 3 months, it turns into chronic pain.

TMJ (temporal mandibular joint) dysfunction, degeneration joint diseases, pelvic pain, visceral pain and myofascial pain, are common forms of chromic pain.

Chronic pain is common among us, the proportion is as high as 20~25%. There are many who suffer from “pain” all their lives trying to find a solution for recovery. According to studies, people with chronic pain are more likely to develop depression and anxiety; acute pain is more likely to evolve into chronic pain in those with depression family history.

Thus, psychotherapy is as important as taking drugs and injection.

Now, let’s take a look at what pain would do to your body overtime.

How chronic pain affect your body

Do you have the experience that when you feel sick, you feel pessimistic and easily fatigued during that day? It is because pain is highly related with cognition and emotions.

Chronic pain effects widely to your body, mind and daily living, including:

  1. Brain activity: alterations in brain regions involves in cognitive and emotional modulation of pain, increasing pain sensitivity.
  2. Mood: Negative emotions are commonly connected with pain.
  3. Sleep quality: Midnight pain or conceptions such as “the pain might get worse overnight” may influence the sleep cycle.
  4. Concentration: It is hard to focus on a task if pain is constantly “bothering” you.
  5. Quality of life (QOL): Unrefreshing sleep is a major cause of decreased QOL. You may also find yourself unwilling to try new activities or explore outdoors when dealing with pain.
  6. Social life: chronic pain and other symptoms can be predicted by social isolation.

Dealing with chronic pain means dealing with negative emotions and anxiety. If your family members or friends have chronic pain, it is important to understand their feelings.

How to deal with chronic pain?

Chronic pain affects the brain and mind deeply. Thus, apart from following drug prescriptions, there is more to do. Here are some suggestions.

  1. Medication: Pain killers, analgesics and antidepressants are commonly used in treatment.
  2. Behavior/cognitive therapy: Relearning the response when pain occurs. The “coping” mechanism of pain is essential.
  3. Psychological therapy: By seeing a psychiatrist, learning to say your fears out loud is a great way to decrease pressure.
  4. Exercise: Exercise has been suggested to have analgesic effects, the body increase levels of endogenous opioids which decrease the perception of pain. Yoga is a great way to clear your body and mind.
  5. Nutrition: Gluten- or grain- free diets are helpful to alleviate chronic pain conditions.

Keep in mind that the best way to treat chronic pain is to not let acute pain go into chronic. It is better to prevent it than to spend a lot of time trying to fix the problem.

If you are already dealing with chronic pain, treatment from a psychology perspective might be helpful!

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References:
Crofford LJ. Chronic Pain: Where the Body Meets the Brain. Trans Am Clin Climatol Assoc. 2015; 126: 167–83.

Yang S,. Chang MC. Chronic Pain: Structural and Functional Changes in Brain Structures and Associated Negative Affective States. Int J Mol Sci. 2019; 20(13): 3130.

物理治療師 女性運動與姿勢矯正 physiotherapist, MS, CES