EXCLUSIVE: Pain Awareness Month 2021: Managing chronic pain has become easier, say Experts

Most of us often feel embarrassed to talk about our pain in public, or even if we don’t, we don’t feel the need to do so? Why, do you ask? Because after all it’s just a pain and will go away on its own, at least this is what we think of it. And in case it doesn’t, we have our home concoctions ready. 

However, experts suggest that a pain that exists for a long time needs immediate attention. More so, because the cases of chronic pain are on a high. A study suggests more than 19 percent of the Indian population suffers from chronic pain.

Since September is Pain Awareness Month, Dr. Firdaus Shaikh, PT, Senior Orthopaedic Physiotherapist, AquaCentric Therapy Pvt Ltd, tells you that according to the Association for the Study of Pain, chronic pain is a ‘pain which has persisted beyond normal tissue healing time which, in the absence of other factors, is generally taken to be 3 months’.

“Both acute and chronic pain are provoked by a certain biological event (kidney stones/spondylitis/slipped disc etc.) or a painful stimulus (fall/injury/cut),” says Shaikh.

Chronic pain, she says, continues to exist even after the underlying cause of pain is taken care of. Secondly, unlike normal pain, chronic pain patterns are heavily influenced by psychological factors. Take, for example, an increase in pain and muscle tension each time one is stressed or each time one revisits a past mental trauma.

Dr. (Maj) Pankaj N Surange, Director and CEO, Interventional Pain and Spine Centre (IPSC) India, tells you that a lot of people suffer from chronic neck and back pain which may be spreading to other areas and we call it radiating to other parts like arms and leg, or non-radiating ones as well like facial pains, headaches, joint and cancer pain which is a huge unmet need. “Generalized vague body pains like fibromyalgia, stiff muscles, and sometimes pain that lasts long after a back or spine surgery, are also commonly seen in patients today,” says Surange.

The cause most often for back pain is a wear and tear of the small joints that take part in bending movements of the spine. Another cause can be an unhealthy dried-up fissured disc which may even cause a part of it to herniate, commonly called a slipped disc, compressing a nerve in the close vicinity causing its inflammation and sending shock-like pain down the legs or arms.

Shaikh adds and tells you that chronic pain as explained above is not just limited to a biological cause or stimuli, it is influenced by social, economic, psychological, and physical factors as well.

“There have been various medical studies that have linked chronic pain to mental health conditions like depression, anxiety, sleep problems etc. In today’s time, with social isolation at its peak, in combination with the job and economic crisis, mental health issues have seen a sharp peak which in turn leads to rise in chronic pain cases as it’s a part of the same vicious cycle. Anxiety and fear about pain are linked to a higher likelihood of developing chronic pain and a poorer prognosis of recovery,” he says.

While chronic pain may take some time to heal, Surange tells you that over the past three decades the specialty of pain management has grown by leaps and bounds, just as any other science. “This has contributed significantly towards reducing suffering, enhancing functionality and productivity for those who have acute or chronic pain,” he adds.

Pain management deals with a wide spectrum of chronic pains. The majority of back pain related cases can be treated with minimally invasive and day care procedures with the least disruption to the normal work life of patients, along with moderate exercise, medication, and healthy lifestyle changes.

“Minimally invasive procedures are just very similar to angioplasty that has replaced the need for a lot of open-heart surgeries. Similarly for back pain, minimally invasive procedures are done to target the exact pain source in the spine and with image guidance from ultrasound or fluoroscopy to the target and either deliver the medication or cause longer lasting numbing effect on the nerve with a radiofrequency ablation,” explains Surange.

Managing chronic pain, Shaikh opines, requires a multimodal approach comprising of physical therapists, psychologists, psychiatrists, and pain management specialists. “The best form of treatment for chronic pain is preventing acute pain from developing into chronic pain. This means the faster the underlying cause of acute pain is diagnosed and treated the likelihood of developing chronic pain is lesser. Physical activity, specifically aquatic therapy, has been shown to have a positive effect on certain kinds of chronic pain,” adds Shaikh.

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