Do you have persistent pain?

What is Persistent Pain?

A recent study published in the October issue of the Journal of Pain¹ describes persistent pain as pain that is present “every day or most days in the last three months”.  Persistent pain differs from chronic pain in that chronic pain is described as pain which continues over a three month period of time but not is necessarily experienced every day.  According to the Institute of Medicine (2011) 100 million Americans have chronic pain.

Data taken from  the 2010 Quality of Life Supplement of the National Health Interview Survey² states that 60% of adults report back pain over the prior three months.   Only 42% of those who reported back pain noted that their pain was frequent or daily and lasted over 3 months.  Therefore all 60% would be categorized as chronic, but only a portion of those would call their pain persistent.

Devastating Effects

The study goes on to report that sufferers of persistent pain are more likely to be older adults (60-69), with women having a slightly higher risk than men.  The long-term effects of this type of continuous pain include:

• Anxiety
• Depression
• Fatigue
• Work Disability
• Overuse of Pain Medications

Common Factors

Certain characteristics were noticed in those with persistent pain.

18% were overweight

25% were obese

35% had been hospitalized in the previous year

45% had anxiety

57% reported depression

64% had fatigue

What’s wrong with this picture?

A 2014 study in the Journal of the American Medical Association titled “Management of Persistent Pain in the Older Patient: A Clinical Review”³  reviewed 92 studies, 50 of which focused on “older adults with osteoarthritis.  Although the study recommended a multifactorial approach, their first line approach is with Acetaminophen therapy, despite the fact that acetaminophen is associated with liver injury especially in patients who are taking more than one drug (even over the counter drugs) or drinking alcohol. 4  According to the study, if that doesn’t work, other drugs should be tried and other modalities should be included, such as “physical and occupational rehabilitation“.

Per the study above, many of my patients can attest that physical therapy doesn’t always work.  Acetaminophen as a pain reliever gets laughs from the majority of my patients who are turning to stronger prescription medications to reduce their pain.

Moreover anyone who actually listens to these people can attest to the fact that exercise can be uncomfortable or even impossible when you are in pain.  Weight gain, anxiety, depression and fatigue can all be related to the increased difficulty of performing every day activities while in pain.  In the medical literature, much is made of “fear avoidance behavior” in which the patient becomes afraid of doing certain tasks because they can aggravate their pain.  No notice is given to the many patients who “push through” the pain to fulfill their responsibilities to children, parents and employer, all the while getting worse.  A significant number of these people want to know what else BESIDES pain medications can be done.

Why chronic pain and persistent pain sufferers need Alternative Therapies.

Pain sufferers must DEMAND to know why they have pain. I have seen many patients misdiagnosed with arthritis.  What they have is joint misalignment which, when treated, can alleviate the pain.  I have spoken to many people who tell me, “I’m just getting old, the doctor says I have arthritis.”  This statement is usually accompanied by a gesture pointing out the offending joint (a knee, more often than not).  My response is always the same, “How old is the other knee?”

If it’s a normal part of aging, why doesn’t it happen on both sides?

Arthritis does NOT have to be a normal part of aging.  Accidents and injuries cause joint misalignment and the older you are, the further in the past those injuries are, the more likely that the joint has degenerated from not moving properly.

You must demand a greater understanding of your body.  You must work to eat right, exercise, and manage stress when you are young so that your body can rely on its healing abilities as you age.

Alternative therapies address you as a whole person.  We don’t look at your knee or your spine or your sleep habits by themselves. The whole person must be addressed.

Anxiety, depression and fatigue can be indications of adrenal fatigue. Weight gain, fatigue and weakness can be a result of a sluggish thyroid or early thyroid disease. Both thyroid and adrenal conditions can be subclinical (the blood tests are normal) and can sometimes follow a physical injury or emotional stress.

On going stress can result in digestion problems, leaky gut and an inability to absorb nutrients and process hard-to-digest foods. This will also lead to an inability to heal and perhaps persistent pain.

Alternative Therapist, like many Chiropractors, Naturopaths, Nutritionists and Acupuncturists can analyze your blood work and send you for further testing. We can recommend supplement, herbs or essential oils to help your body deal with the stresses accumulated over a lifetime.

It’s your life, demand excellence!

1.  Prevalence of Persistent Pain in the U.S. Adult Population: New Data From the 2010 National Health Interview Survey http://www.jpain.org/article/S1526-5900%2814%2900774-3/abstract

2.  Nurse.com News http://news.nurse.com/article/20141029/NATIONAL06/310290021#.VFbMHhaExG4 or

http://www.cdc.gov/nchs/nhis/qualityoflife2010.htm

3.      Management of Persistent Pain in the Older Patient: A Clinical Review   http://jama.jamanetwork.com/article.aspx?articleid=1899177

4.  Acetaminophen and Liver Injury: Q & A for Consumers   http://www.fda.gov/ForConsumers/ConsumerUpdates/ucm168830.htm