HJAR Nov/Dec 2022

56 NOV / DEC 2022 I  HEALTHCARE JOURNAL OF ARKANSAS PAIN MEDICINE COLUMN PAIN MEDICINE DURING my experience treating chronic pain, I have realized that there is confu- sion in the understanding of what “chronic pain syndrome” means. Sometimes when I ask residents or med students what this means, they respond, “Pain that lasts more than three months.” Some textbooks, espe- cially some older ones, say pain that lasts more than six months. This is the defini- tion of “chronic pain,” not the definition of chronic pain syndrome (CPS). If you ask me, personally, how I define chronic pain, I would say that it is pain that lasts more than the normal healing process that involves the part of the body that is hurting (depending on the part of the body or organ, the healing process differs). Pain is our body’s normal reaction to an injury or illness — a warning that something is wrong. When our body heals, we usually stop hurting. But this doesn’t define CPS. When we hurt day after day, it can take a toll on our emotional and physical health. 1 CPS means that once a human being is suffering chronic pain, the organic cause not only impacts the body, but it starts to affect the psychological state and the interrela- tions with family and social environments that surround this patient. About 25% of Chronic Pain Syndrome people with chronic pain will develop CPS. 2,3 When we want to speculate on how pain impacts the psychological state of the pa- tient, we have detected that the patient has become extremely depressed (severe de- pression), developed GAD (generalized anxi- ety disorder), or experienced lack of restful sleep, among other symptoms like catastro- phizing or developing poor coping skills. 4,5 The way the social aspect is impacted, basically, affects the way the patient relates with the closer circle of their family: being rude, intolerant, and blaming them and “the rest of the world” for his/her situation and the excruciating pain they are suffering. CPS can be hard to treat, but it’s not impossible. Amix of treatments like counseling, physi- cal therapy, and relaxation techniques can help relieve pain and the other symptoms that come with it. 6 This is where we need to know and under- stand that treating chronic pain syndrome requires a multidisciplinary approach that will involve a painmedicine specialist, a psy- chologist, and a physical therapist. Around 25.3 million adults in the Unit- ed States live with chronic pain every day, which affects their emotional and physical health. In addition, chronic pain can cause complications such as trouble sleeping, stress, anxiety, and depression, as men- tioned above. 7 What Causes Chronic Pain Syndrome? We don’t know exactly what causes CPS. It often starts with an injury or painful con- dition such as: • Arthritis and other joint problems. • Back pain. • Headaches. • Muscle strains and sprains. • Repetitive stress injuries, when the same movement over and over puts strain on a body part. 8 • Fibromyalgia, a condition that causes muscle pain throughout the body. 9 • Nerve damage. • Lyme disease. • Broken bones. • Cancer. • Acid reflux or ulcers. • Inflammatory bowel disease (IBD). • Irritable bowel syndrome (IBS). • Endometriosis, when tissue of the uter- us grows outside of it. 10 • Epstein-Barr virus (EBV). • Surgical trauma.