Carolinas HealthCare System

Chronic Pain

Chronic pain is a complex condition that is frequently severe enough to limit a person's activity and make it difficult to function at work or at home. The pain often lacks any outward signs of a particular injury, which can lead to the erosion of social and family support systems important to healing.

Pain can originate from many causes including accidents or injuries, nerve or spinal cord injury, spinal cord lesions, brain injury or lesions and disease processes. To further complicate matters, psychological and behavioral changes occur in people with long-standing pain. When our doctors design a treatment plan for an individual suffering from chronic pain, all of these factors are taken into account.

Our overall approach to chronic pain management can be viewed as a four-legged stool with each of the following components:

  • Medication management - Physicians review the patient's use of medications and develop the optimum approach.
  • Rehabilitation - In many instances, a program of rehabilitation, including physical and occupational therapy, can help provide pain relief.
  • Counseling - Long-term pain also has psychological implications, including anxiety and depression; we assist patients in coping with these concerns.
  • Intervention - As pain management specialists, our physicians have a wide array of highly specialized intervention techniques.

No Apparent Injury, But Lots of Pain

Chronic pain can occur long after nerve and tissue damage has apparently healed. Although there is no current injury, pain signals sent incorrectly to the brain make the pain quite real to the person experiencing it. Sometimes pain like this is caused by the short-circuit of a group of nerves referred to as Complex Regional Pain Syndrome (CRPS). Specific treatments are available.

Behavioral Changes Caused by Pain

When someone complains about chronic pain that does not have an apparent cause, they typically do not receive the same sympathy and support as they would with an injury or accident. In fact, pain in these situations can be as bad or worse than pain from a visual injury.

Lack of sympathy or empathy can result in severe mental stress and sometimes major changes in behavior or depression. Patients can become so distraught that it becomes an impediment to their therapy and recovery. Some patients become so depressed that they cannot work or participate in family life. In these situations, treatment must focus on behavior as much as pain.

Complexity of Pain Problems

Most of the time pain is experienced as a result of injury and is simply treated by allowing the injured area to heal. This is not always the case because certain painful conditions are more complex and require an integrated treatment program.

Because the body's pain system is extensive, an injury may result in anything from normal healing without any further discomfort to total numbness, or even continuous disabling pain. Additionally, various psychological and behavioral changes occur in patients with long-standing pain and these changes often hinder recovery.

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