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Chronic Pain - Why It Lingers


Another specialist in pain management, Dr. Jennifer Schneider, explains that your body’s nervous system is ultimately responsible for two major forms of chronic pain.


The first is called nociceptive pain.  This is triggered by an injury to muscles, tendons and ligaments.  It could also be prompted by an injury to the internal organs.  In this form of pain, undamaged nerve cells respond to an injury outside of themselves.  The cells then transmit pain signals 

to the spinal cord and then onward to the brain. 


Nociceptive pain is most often described by those experiencing it as “deep and throbbing.”  Low back pain is a good example of this type of pain, as is fibromyalgia, headaches, osteoarthritis, and chronic pelvic pain.


There’s a second type of pain however.  This is the form that “results from abnormal nerve function.”  It could also result from direct damage to a nerve.  This type of pain is called neuropathic pain.  Examples of this type include shingles, diabetic neuropathy, phantom limb pain, spinal stenosis, multiple sclerosis, Parkinson’s disease, stroke and spinal cord injury.


Here the damage nerve fibers appear to fire spontaneously, not only at the site of the injury but along other locations along the pathway of the nerve as well. The tricky aspect of this pain is that it can – and often does – continue indefinitely, “even after the source of the injury has stopped sending pain messages,”  Dr. Schneider explains.


Neuropathic pain can be constant or it can be intermittent.  It can also be felt as a burning, aching, shooting or stabbing sensation, Dr. Schneider says.  And it can also radiate down the arms or legs.


This form of pain many times involves exaggerated responses to painful stimuli as well as the spread of the pain to areas that were not initially affected.  Additionally, this type of pain may cause a response from the person afflicted with it that seems inappropriate to the stimulus.  For example, a light, mild touch may seem to hurt much more than it should.


Additionally, neuropathic pain often reaches its peak at night and it may also include some abnormal sensations, such as tingling, that feeling of pins and needles and intense itching.


Then there’s the chronic pain syndrome that involves both nociceptive and neuropathic pain.  This might appear as sciatica, a pinched nerve which causes back pain to radiate down the leg.  In this case, the pain of sciatica is not only felt in the back, but also in the leg, making the cause extremely difficult to diagnose with the use of a MRI – magnetic resonance imaging.  This is a non-invasive method of taking images of your body.


The real price tag of chronic pain though extends far beyond the immediate treatment of the pain.  Pain comes with a whole host of potential physical effects, some of which are quite surprising.  They include poor wound healing, growing muscle weakness and eventual breakdown.  Not only that, but the decreased movement that is incurred because it’s just to painful to move fully about as a person used to can lead to blood clots, shallow breathing.  It can also be the beginnings of a suppressed cough that can raise the risk of pneumonia, sodium and water retention in the kidneys, not to mention a raised heart rate and blood pressure. 


Chronic pain has also been cited in a weakened immune system, the slowing of gastrointestinal motility, as well as the more obvious problems of sleep difficulties, loss of appetite, weight loss, and fatigue.


One would think that the problems would end there – but they don’t.  We haven’t even begun to enumerate the psychological and social consequence of chronic pain.  Pain that never ends robs a person of the very ability to enjoy a good quality of life, maintain important personal and professional relations, as well as fulfill spousal and parental responsibilities and perform at his optimum at work – if the individual



Note: Some statements in this article may not be approved by the FDA. This article is for informational purposes only and should not be taken as professional medical advice.

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