Pain – chronic

Chronic Pain is pain which lasts for more than one month after
an injury has healed; pain that lasts or recurs for more than 3
months or pain associated with tissue injury that is expected to
continue or get worse.

DESCRIPTION

TYPES OF CHRONIC PAIN 

• General somatic pain: (pain from the outer body). Includes pain
  that is caused by fibromyalgia and chronic back pain. Treatment
  generally involves the use of NSAIDs.
• Visceral pain: (pain from the internal organs). Includes the
  pain associated with chronic pancreatitis, chronic active
  hepatitis, gallstones and appendicitis. Treatment may include
  surgery or the use of pain relief medications.
• Bone pain: may be caused by bone cancer, osteoporosis,
  osteomyelitis or arthritis. This pain can be described as gnawing
  and throbbing and may require long-term treatment with hormonal
  therapy or bisphosphonates. NSAIDs and posibly opiods may also be
  used.
• Muscle cramps: may be treated with pain relief medications or
  muscle relaxants if these are ineffective.
• Peripheral neuropathy: is pain that arises in the nerves
  leading from the head, face, trunk or limbs to the spinal cord.
  Sciatica, ruptured spinal discs, cancers, infections such as
  shingles, diabetes and AIDS can cause peripheral neuropathy. This
  type of pain is described as a “pins and needles” sensation and is
  treated with tricyclic antidepressants. More severe nerve pain may
  be felt as a sharp, stabbing, electric feeling and is treated with
  anticonvulsants. Treatment of shingles pain may involve topical
  pain medications and possibly opiods.
• Circulatory problems: can cause Chronic Pain. This type of pain
  may be treated by surgery or with blood thinning or opiod
  medications.
• Headaches: (e.g. migraine, cluster, tension) may be treated
  with non-opiod or opiod medications and/or oxygen therapy.
  Sinusitis pain may be treated with antibiotics and decongestants.
  The pain associated with neuralgia is often treated with
  anticonvulsants.

TREATMENT OPTIONS

Always consult your Doctor for diagnosis and advice. In no way
is this information intended to replace the advice of a medical
practitioner. 

Your Doctor can give you advice about Pain Management
medications and therapies.

ORGANISATIONS & SUPPORT GROUPS

See the Australian Pain Society topic on the
Healthpoint.

PHARMACIST’S ADVICE

Ask your Pharmacist for advice.

1. See the Pain Management – Drugs and Pain Management – Non-Drug
   topics on the Healthpoint.
2. Have regular exercise after a physical examination and approval
   by a Doctor. Walking and swimming are examples of gentle exercise
   which may help to reduce pain particularly in the joints, muscles,
   ligaments and tendons of the body. It is advisable, after checking
   with your Doctor, to have 20 to 30 minutes of gentle and continuous
   exercise each day. Regular exercise may help to prevent joint
   stiffness, muscle wasting and pain to some degree. 
3. Ask your Pharmacist about non-drug methods of pain relief. If
   your pain is associated with heat and swelling, a cold pack applied
   to the area may bring some relief. If the pain is associated with
   stiffness, applying a heat pack and warming linament to the area
   may help to ease the pain.
4. Make sure that you are taking the correct pain relieving
   medication for the particular pain problem. It is not advisable to
   continue taking the same pain relief medication without consulting
   your Doctor or Pharmacist. There may be a more suitable medication
   for your needs or the dosage may need to be changed. Ask your
   Pharmacist for advice.
5. Ask your Doctor or Pharmacist for advice before increasing the
   dose of a pain relieving medication.
6. Never take pain relievers which have been prescribed for
   another person. Not all pain relief tablets are the same. Different
   pain relievers have different effects, different dose
   recommendations and are suitable for different sorts of pain. Some
   types of pain relievers may have side effects which the patient may
   not be aware of e.g., Non-steroidal Antiinflammatory Drugs
   (NSAIDs), should not be taken by people with an allergy to
   aspirin.
7. Consider taking some supplements if the diet is inadequate.
   When managing pain the body may require extra nutrients such as B
   group vitamins. Pain relievers may increase the need for certain
   necessary vitamins. The following nutritional supplements may be
   required while using analgesics: Aspirin: bioflavonoids, vitamin C,
   vitamin B1, B5, B12, K, folic acid, iron, manganese. Paracetamol:
   vitamin E. Damage (ulceration) of the stomach lining is a common
   side effect of chronic NSAID use. This may increase the body’s
   needs for iron if bleeding occurs.

Aspirin should not be given to children under 16 years of age
unless specified by a Doctor.