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WILDERMAN MEDICAL CLINIC
What is chronic pain?
We are all familiar with pain and have all experienced it at one point or another in our lives. You cut your finger and feel an instantaneous jolt of pain; your brain is signaling that something is wrong, and when you look down at the source of the pain, you can see a physical, measurable injury that is causing this uncomfortable sensation.
This is called acute pain; it is a temporary discomfort caused by an injury that will resolve when the injury heals.
Chronic pain, however, is pain that lasts beyond the normal, expected recovery time and, often, exists in the absence of physical findings. Chronic pain can develop as the result of physical trauma, such as a motor vehicle accident, or due to a pathology, such as cancer or arthritis.
Others develop chronic pain due to psychological causes, such as ongoing stress, depression, or anxiety — this is referred to as psychosomatic pain, meaning that a psychological disorder results in physical symptoms.
What are the symptoms?
Chronic pain can have a wide range of symptoms from one individual to the next. Symptoms can vary in quality, severity, and duration; some individuals have constant, unrelenting pain while others experience symptoms that are intermittent. Pain can be described as:
- Achy
- Throbbing
- Sharp
- Shooting
- Burning
Chronic pain can also lead to other symptoms, including:
- Anxiety
- Depression
- Other mood changes, such as irritability
- Poor sleep quality, resulting in fatigue
- Impaired memory or concentration ability
What are the risk factors associated with developing chronic pain?
There are numerous factors that can increase the risk of developing chronic pain, including “socio-demographic, psychological, clinical, and biological factors” (Mills et al. 2019). Some of these risk factors include:
- History of physical injury causing pain
- Past surgical or invasive intervention
- Co-morbidities, either physical or psychological
- Smoking
- Alcohol consumption
- Sedentary lifestyle
- Nutritional deficiency
- Poor sleep
- Family history
- Socioeconomic factors, such as poverty, unemployment, and lack of social support
How is the condition diagnosed?
Chronic pain syndrome is a very complex issue, with subjective rather than objective, or tangible, findings. As a result, there can be differing opinions regarding a chronic pain diagnosis. In order to reach a diagnosis of chronic pain syndrome, the American Medical Association (6th edition) has outlined diagnostic criteria that include:
- Overuse or dependence on pharmaceuticals or recreational substances
- Excessive dependence on medical personnel or friends and family members
- Withdrawal from previous social engagements
- Deconditioning and/or avoidance of activity due to fear of pain
- Failure to return to pre-injury level of functioning
- Development of psychological sequelae following the triggering incident/injury
In addition to the above-noted criteria, a physician’s objective examination of the patient, an understanding of their medical history, and a determination of their overall level of functioning are essential in allowing the physician to determine whether the patient meets the criteria for diagnosis of a chronic pain syndrome.
How common is chronic pain?
A 2019 article titled Chronic pain: a review of its epidemiology and associated factors in population-based studies reported that “worldwide, the burden caused by chronic pain is escalating: 1.9 billion people were found to be affected by recurrent tension-type headaches, which were the most common symptomatic chronic condition…low back and neck pain have consistently been the leading cause of disability internationally, with other chronic pain conditions featuring prominently in the top 10 causes of disability” (Mills et al. 2019). According to an article written by the Cleveland Clinic in, an estimated 25% of adults in the USA suffer from chronic pain (https://my.clevelandclinic.org/health/diseases/4798-chronic-pain).
Living with chronic pain — treatments and strategies
Living with chronic pain can feel like a daunting and relentless ordeal; however, there are numerous strategies for managing your symptoms and improving quality of life. Some of these options include:
- Learning breathing techniques
- Developing stress management strategies – physical or psychological stress can amplify the body’s sensitivity to pain
- Physical activity – exercise can increase endorphins that both improve mood and reduce pain signals, as well as aiding in weight management and improving overall health
- Smoking cessation
- Minimal alcohol consumption
- Practicing proper sleep hygiene
- Eating a healthy, balanced, nutrient-dense diet and avoiding inflammatory foods and cooking methods
- Maintaining interests and social activities as a distraction to avoid becoming fixated or preoccupied with your pain as well as to maintain a social support structure
- Massage therapy
- Acupuncture and acupressure
- Aquatics or pool therapy
- Physiotherapy
- Assistive devices such as TENS, orthotics, orthopedic mattresses, and many more
- Topical creams, such as Menthol, Lidocaine, Camphore, Traumeel, and Tiger Balm
- Acetaminophen to reduce pain
- NSAIDs (non-steroidal anti-inflammatory drugs) to reduce pain and inflammation
- Other oral medications specific to treating arthritis and inflammation
- Prescription pharmaceuticals
What do we do at WMC?
At the Wilderman Medical Clinic, we specialize in treating patients with chronic pain conditions. Treatments offered at our clinic include both interventional pain management and non-interventional pain management; the type of interventional therapies offered are dependent on the type or location of the pain. Some of these options include:
Interventional pain management alternatives:
- Nerve block injections
- Epidural injections
- Joint injections
- Dextrose (prolotherapy) injections
- PRP (plasma-rich protein) injections
- nStride injections
- Trigger point injections
- Radiofrequency ablation
- Dilute alcohol injections
- Botox injections
- Ultrasound-guided injections with cortisone
- Lidocaine infusions
- Ketamine infusions
Non-interventional pain management alternatives:
- Medications
- Pharmacogenetic testing
- Psychotherapy
- Kinesiology education sessions
- Biofeedback sessions
Works Cited
Chronic pain. Cleveland Clinic. Retrieved from https://my.clevelandclinic.org/health/diseases/4798-chronic-pain
Mills SEE, Nicolson KP, Smith BH. Chronic pain: a review of its epidemiology and associated factors in population-based studies. Br J Anaesth. 2019 Aug;123(2):e273-e283. doi: 10.1016/j.bja.2019.03.023. Epub 2019 May 10. PMID: 31079836; PMCID: PMC6676152.
