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  • Chronic Pain

    Chronic pain is often defined as any pain lasting more than 12 weeks. Chronic pain can be mild or excruciating, episodic or continuous, and at times totally incapacitating. Approximately 100 million Americans suffer from chronic pain.

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    <p><a href="">Family Physician&nbsp; </a>discusses What is Chronic Pain?</p>

    Family Physician  discusses What is Chronic Pain?

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    <p><a href="">Family Physician&nbsp;</a> discusses treatment of chronic pain.</p>

    Family Physician  discusses treatment of chronic pain.

  • How is Chronic Pain Treated?

    By addressing biological, psychological, and sociological aspects, healthcare professionals can develop a more holistic and personalized treatment plan. Let's explore each of these factors in more detail:

    1. Biological Factors: Chronic pain can be caused by tissue damage, inflammation, nerve dysfunction, or other physiological factors. Treatment options may include medications, physical therapy, surgical interventions, or other medical procedures aimed at addressing the underlying biological causes of pain.

    2. Psychological Factors: How individuals perceive and cope with pain can greatly influence their experience and quality of life. Psychological approaches such as cognitive-behavioral therapy (CBT), mindfulness-based techniques, relaxation techniques, and biofeedback can help individuals manage their pain, improve coping strategies, and reduce emotional distress associated with chronic pain.

    3. Societal Factors: The social context in which individuals live can significantly impact their experience of chronic pain. Supportive social networks, access to healthcare services, employment opportunities, and disability accommodations can play a crucial role in facilitating or hindering individuals' ability to manage their pain effectively. Addressing societal factors may involve advocating for policy changes, improving access to pain management resources, and promoting community awareness and support.

    By adopting a multidimensional approach that addresses biological, psychological, and sociological factors, healthcare providers can tailor treatment plans to the specific needs of individuals living with chronic pain. This integrated approach can enhance pain management, improve overall well-being, and foster a better understanding of pain within the healthcare system and society as a whole.


    Most physicians will assess chronic pain by looking at the particular part of you that is in pain, deciding if they need any investigations, whether they should have consultations to help them understand why you’re having chronic pain, and then try to look at the impact of chronic pain and decide if you’re having problems with anxiety or depression and look at ways to manage that.

    While physicians are typically knowledgeable about diagnosing and treating pain conditions, they may not always have extensive training in instructing patients on self-management techniques. It's not uncommon for patients to seek additional resources outside their physician's office to find the support they need.

    In cases where a physician recognizes the need for specialized expertise in assessing and managing chronic pain, they may refer the patient to an individual physician who has specific training and experience in this area. This referral ensures that the patient receives care from a healthcare professional who has in-depth knowledge of chronic pain management strategies.

    Alternatively, a physician may refer the patient to an interdisciplinary team that includes various healthcare professionals with expertise in chronic pain management. This team-based approach allows for a comprehensive evaluation and treatment plan that addresses different aspects of the patient's condition. Interdisciplinary teams often consist of physicians, physiotherapists, occupational therapists, psychologists, and other specialists who collaborate to provide a holistic approach to pain management. This approach acknowledges that chronic pain is a complex condition that requires a multifaceted treatment strategy.

    The interdisciplinary team may work together to develop an individualized care plan for the patient, which may include a combination of medical interventions, physical therapy, occupational therapy, psychological counseling, lifestyle modifications, and self-management strategies. These strategies may involve techniques such as relaxation exercises, stress management, pacing activities, sleep hygiene, and the use of assistive devices.

    By referring patients to individuals or teams with expertise in chronic pain management, physicians can ensure that their patients receive specialized care and guidance in self-management techniques. This approach aims to empower patients to take an active role in managing their pain, improving their overall quality of life.

    Medications used to manage chronic pain can belong to various classes, and analgesics are one such class commonly used for pain relief. Analgesics can be categorized into different groups based on their mechanism of action and potency.

    1. Acetaminophen (paracetamol): This is a common over-the-counter analgesic that can be effective for mild to moderate pain. It is believed to work by inhibiting prostaglandin synthesis in the central nervous system (CNS), which helps reduce pain and fever.

    2. Nonsteroidal anti-inflammatory drugs (NSAIDs): NSAIDs such as ibuprofen, naproxen, and aspirin are widely used for pain relief. They reduce pain, inflammation, and fever by inhibiting the production of prostaglandins. However, it's important to note that long-term or high-dose use of NSAIDs can have side effects on the gastrointestinal system, kidneys, and cardiovascular system.

    3. Opioids: Opioids are potent analgesics that work by binding to opioid receptors in the brain, spinal cord, and other parts of the body. They can provide effective pain relief but are associated with a risk of dependence, tolerance, and potential for misuse. Examples of opioids include morphine, oxycodone, hydrocodone, codeine, and fentanyl.

    4. Antidepressants: Certain classes of antidepressants, such as tricyclic antidepressants (TCAs) and selective serotonin-norepinephrine reuptake inhibitors (SNRIs), have been found to be effective in managing chronic pain, especially neuropathic pain. These medications work by influencing the levels of neurotransmitters involved in pain modulation, such as serotonin and norepinephrine. Examples include amitriptyline, nortriptyline, duloxetine, and venlafaxine.

    It's important to note that the choice of medication for chronic pain management depends on various factors, including the underlying cause of the pain, individual patient characteristics, and the severity of pain. A comprehensive approach to pain management may involve a combination of medications, physical therapy, psychological interventions, and lifestyle modifications. It is always essential to consult with a healthcare professional for an accurate diagnosis and appropriate treatment plan.

    We also use anticonvulsants. Those are medications usually used to treat seizures, but they also help with nerve related chronic pain. Anti-inflammatories are medications used to treat chronic pain if the pain is mild to moderate or if there’s an element of inflammation.
    Another class of medications used to manage chronic pain are the cannabinoids.  Marijuana is a plant that has 60 different cannabinoids, of which THC and CBD are cannabidiol, are two of the most active for pain management.
    There are pharmaceutical companies that have manufactured medications that contain one or both of those compounds, and we often use them when we manage chronic pain.  Often seeing a local family physician or a physiotherapist in conjunction with a registered dietitian and athletic therapist is a great option to take control of this condition. Smart Food Now and exercise is also optominal for overall health.    

    chronic pain is defined as pain that persists beyond the expected healing time of tissues, typically lasting for three months or longer. Unlike acute pain, which serves as a warning sign of tissue damage or injury, chronic pain is more complex and involves both the hardware (nerves) and software (neurological processes).

    While there is no specific test to diagnose chronic pain, healthcare professionals rely on a comprehensive assessment of symptoms, medical history, and physical examinations to make a diagnosis. They consider various factors such as the duration, intensity, location, and impact of pain on daily functioning.

    Chronic pain can involve alterations in the nervous system's processing of pain signals, leading to increased sensitivity and amplification of pain sensations. This can be compared to a software problem, where the pain signaling and processing within the nervous system become dysfunctional.

    In some cases, chronic pain may have an identifiable cause, such as nerve damage, inflammation, or a specific medical condition. However, there are instances where the cause of chronic pain may be more elusive or difficult to explain, such as phantom limb pain.

    If chronic pain significantly affects your quality of life, disrupts sleep, impacts mood, or interferes with your ability to work despite receiving appropriate care, it may be beneficial to seek a referral to a healthcare team that specializes in managing chronic pain. Pain specialists, such as pain physicians or multidisciplinary pain clinics, can provide a comprehensive approach to pain management. They can help in understanding and addressing the complex nature of chronic pain, tailoring treatment plans, and offering interventions that may include medication management, physical therapy, psychological support, and alternative therapies.

    The goal of chronic pain management is to improve overall functioning, reduce pain intensity, and enhance quality of life. Working with a healthcare team experienced in managing chronic pain can provide valuable insights, support, and treatment options tailored to your specific needs.

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