Millions of people live with some form of back or neck pain every day. While most of these are only temporary and resolve on their own, many others will continue to experience painful symptoms long after the source of their pain has been treated or healed. Unfortunately, the exact cause of chronic pain is often misunderstood.
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What causes chronic pain?
First of all, what is chronic pain? It is technically defined as pain that lasts for 12 weeks or longer, even after the pain is no longer acute (short-term, acute pain) or the injury has healed. Naturally there are numerous causes of chronic pain that can influence any level of the spine, cervical (neck), mid back (thoracic), low back (lumbar), sacral (sacrum) or a combination of levels (eg, lumbosacral).
Common Causes of Chronic Pain
Back pain, among one of the most common forms of chronic pain, is a great example to use for this particular cause. Let’s say that over time and through normal wear and tear, you’ve worn out the cartilage that surrounds the joints in your spine (the facet joints). The joints subsequently become swollen, and you develop osteoarthritis in the spine. This inflammation makes it quite painful for you to move, and it is a source of pain. Your damaged facet joints and cartilage may have developed into chronic pain. That’s only one example. Other common back pain causes include:
- Trauma or injury: In a car accident, injury and trauma can occur and it might still cause pain once it’s healed.
- Bad posture: Years of slumping over can cause parts of your spine to wear out faster resulting in chronic pain.
- Obesity: It’s well-documented that excessive weight puts strain and pressure on the spine. It can wear quicker or simply not work out as well, possibly leading to chronic pain.
- Aging: Various areas of the spinal anatomy, as well as other joints, may wear out over time (a process called degeneration). There is no guarantee that spine degeneration will be debilitating, however: it depends on how it is affected by the degeneration process, to begin with.
The medical community is not certain severe (short-term) pain occasionally develops to chronic, (long-term) pain after the original pain source was treated. It is possible to learn more about chronic pain, in addition to other kinds of chronic pain, such as fibromyalgia or rheumatoid arthritis.
Chronic Pain Due to Nerve Damage
Nerves can be damaged or injured in a variety of ways. For instance, a nerve root may be pinched by a herniated disc, causing pain. After healing the herniated disc, the pain can persist because of the initial nerve damage. Nerves may be injured by arachnoiditis (inflammation of a tissue that protects the nerve roots), arthritis (again, the inflammation may compress the nerve), diabetes, cancer, Lyme disease, an infection, and more. Nerves may have trouble relaying essential neurological communications between the brain and the rest of the body, if they’ve been damaged. One theory about pain is that the nerves don’t stop sending pain signals to the mind, even after the source of pain exists.
Unknown Causes of Chronic Pain
As you can tell from the preceding two sections, there’s a good deal of doubt when it comes to chronic pain. Through study, the community is starting to better understand pain and its causes, but they can’t pinpoint a cause for chronic pain. That does not mean that they can’t help you find pain relief and approaches to take control of your life again. It’s possible to achieve this with the proper diagnosis and treatments, although it’ll be a process.
Obtaining an accurate diagnosis of the cause of your neck or back pain is essential for the result of your treatment plan. Depending upon the severity and cause of your chronic pain, you may have to seek the help of other healthcare professionals, such as pain medicine specialists, spine surgeons, neurosurgeons, physical therapists and/or chiropractors. Over time your pain may need to be reevaluated, and might vary in the way it is managed.
Your chronic neck or back pain treatment generally includes a combination of therapies to optimize outcomes. Some of the treatments your doctor prescribes and recommends may include:
- Physical Therapy: Stretching and strengthening muscles is critical in treating chronic back or neck pain. Your physical treatment may include ice, heat, transcutaneous electrical nerve stimulation (TENS), ultrasound, and myofascial release.
- Chiropractic Care: Based on your diagnosis, chiropractic care may be recommended by your physician. Studies have shown that two weeks of manipulation by a chiropractor may bring about significant improvement in some patients with chronic low back pain and referred leg pain, or sciatica.
- Medications: There are many prescription drugs to treat inflammation, pain, muscle spasms, and pain. Furthermore, there are medications to treat conditions that often accompany chronic pain, such as medication to assist you alleviate depression, sleep, and decrease anxiety.
- Procedures: Your doctor may recommend spinal cord stimulator spinal injections, drug pump, or spinal column operation. You can acquire a second opinion if you are not certain regarding the treatment program recommended.
- Coping skills: Never underestimate the ability of the mind. Your mood and mental prognosis can impact your degree of pain. Assess with a professional to find out relaxation and coping skills.
- Complementary Treatments: Doctors recommend acupuncture and other forms of traditional Chinese medicine. Speak to your doctor.
Fitness and Chronic Pain
While there’s some things you can’t stop from affecting your chronic pain, like the cellular changes which reduce muscle mass and/or bone density, it is possible to take steps to improve fitness which may benefit your symptoms.
It’s known that patients with chronic neck or back pain may not feel like going to the gym, being active or even following a house exercise program. However, being active can help improve chronic pain because during exercise, the body releases endorphins, your body’s natural painkiller.
Furthermore, by teaming up with your physical therapist, it is possible to start to construct abdominal muscles, essential for the core strength which helps support your spine of your body. Several studies show that aerobic exercise is successful in maintaining the integrity of the intervertebral discs in the lower spine, which can lessen back pain.
Were you aware that by losing even 5 to 10 pounds you can reduce back pain? It is true. Carrying around extra weight translates to added stress. In many cases, a difference can be made by early and aggressive therapy of chronic back or neck pain. But keep in mind that knowledge is power: Be certain that you understand your options.
The scope of our information is limited to chiropractic and spinal injuries and conditions. To discuss options on the subject matter, please feel free to ask Dr. Jimenez or contact us at 915-850-0900 .
By Dr. Alex Jimenez
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