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National Pain Awareness Week aims to bridge gaps in care for people with chronic pain

Acute pain can save a life by alerting us to injury and help us recover by forcing us to protect the injured area. But chronic pain – the kind that continues after injuries have healed or is caused by other nervous system disorders – can lead to a life that many of those who suffer say doesn’t feel like it’s worth living at all.

National Pain Awareness Week is aimed at creating greater support and resources for the estimated one in five Canadians with chronic pain. Research shows that people with chronic pain are chronically under-treated and underserved: A 2014 study found that the average wait time for more than a third of publicly funded pain clinics was longer than a year. People in many parts of the country have no access to pain clinic services, while a directory for pediatric pain clinics lists only seven in Canada.

About half of people waiting for treatment of chronic pain also suffer from depression, with almost 35% reporting suicidal thoughts. More than 70% say the pain interferes with their work.

Treatments

Pharmaceutical drugs used to treat chronic pain include opioids, muscle relaxants, anticonvulsants, antidepressants and Nonsteroidal Anti-Inflammatory Drugs (NSAIDs) such as ibuprofen. While only your doctor can prescribe these treatments, your pharmacist can help ensure that medications prescribed to you for pain management do not harmfully interact with other medications (prescribed or over the counter) that you may be taking.

    Read: Canadian pharmacy’s proactive approach creates better health outcomes.

Alternative treatments such as physiotherapy, acupuncture and exercise may also be recommended. The AWARE study, funded by the Canadian Diabetes Association, measured the effects of mindfulness-based stress reduction on pain, as well as cortisol production and blood glucose. After a nine-week, mindfulness-based stress reduction program, participants reported significant improvement in their experience of pain. The reason, said Dr. Howard Nathan, the study’s lead researcher, is that the severity of pain doesn’t necessarily increase with the severity of injury. Pain triggers a “fight or flight” stress response, and the greater the stress response, the greater the patient distress. Mindfulness practice allows people to feel safe even in the presence of pain, which lessens the severity of their experience of pain.

Another study by Northwestern Medicine published by Nature Neuroscience in late 2015 offers a new source of hope, a new treatment strategy that – in rodents – restores the part of the brain that is reconfigured by chronic pain. By combining a Parkinson’s drug, L-dopa, and a non-steroidal anti-inflammatory drug and administering the two drugs together early after an injury, researchers were able to completely eliminate chronic pain. A clinical trial is now underway to investigate the effectiveness of these treatments in humans.

Common causes of chronic pain

  • Neuropathy, a form of nerve damage that results in pain in parts of the body that otherwise feel normal. This type of pain tends to be chronic, and may be a result of injury, infection, or other diseases such as diabetes or cancer. (Read: World Health Day 2016: Beat diabetes.)
  • Amputations (phantom limb syndrome), burns and scars.
  • When acute pain from surgery or back or neck injury is under-treated or lasts more than one or two months, changes can occur in the nervous system and brain that changes the way people experience pain, leading to long-term chronic pain that isn’t linked to an obvious injury or other cause.
  • Post-herpetic neuralgia, a complication of shingles, can result in disabling, long-term pain. (The risk is reduced if antivirals are taken within 72 hours of the first symptoms of shingles onset.)
  • One in five children suffer from recurring or chronic pain, most commonly caused by headaches, abdominal and back pain, and general muscular-skeletal pains.
  • Migraine or other regularly recurring headaches.
  • Cancer and HIV.
  • Fibromyalgia – a common cause of chronic widespread musculoskeletal pain.
  • Other forms of nerve damage or disorders.

 

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