Chronic pain is rampant in our society. It affects approximately 50 million Americans, or about one out of every six people in the United States, according to the American Academy of Pain Management. Of these individuals, 36 million miss work at some point each year due to chronic pain. Even more frequently, productivity is lost due to reduced performance at work. According to a study published in The Journal of the American Medical Association, chronic pain costs U.S. employers an estimated $61.2 billion per year. Pain falls into one of two categories: acute and chronic. Acute pain is what you feel when you break a bone or have surgery. It is temporary and lasts until the healing process is complete. Chronic pain lasts for six months or longer and can persist even when an injury has healed or where there was no physical damage to begin with.
There is help for chronic pain sufferers. Your primary care doctor often can help you find relief. If not, your physician may refer you to a specialist in the diagnosis and treatment of pain. Pain management specialists such as Dr. Eric Lonseth, clinical director of the Pain Management Institute at East Jefferson General Hospital, formulate an individual treatment plan to fit each patient's needs.
'The causes of chronic pain are as diverse as the treatments," he says. "But whether the cause results in headaches, low-back or neck pain, pain in the extremities or diffuse pain, there is one thing that they share in common they are often under-treated or not treated at all."
Chronic pain can be devastating and can have a significant impact on an individual's ability to concentrate, exercise, socialize, sleep and even perform daily tasks, Lonseth says. "Chronic pain can be debilitating because of its ability to influence our lives resulting in suffering, depression and anxiety, impacting family life and limiting our ability to work and causing disability," he says. "In fact, low-back pain is one of the leading causes of disability, and up to 80 percent of people have back pain at some time in their lives."
Treatments for chronic pain vary as much as the causes, but some of the more common options include physical therapy, cognitive therapy, medications and injections.
'In addition to more standard treatments like anti-inflammatories and opioids, there are new medications which target the source of the pain itself," Lonseth says. "An unpleasant sensation may be sensed by a body's peripheral nerve system or be caused by a damaged nerve itself, travel up the spinal cord and ultimately be transmitted to the brain, which perceives the signal as "pain.' Neuropathetic medications work to block the transmission of this signal, thereby decreasing its perception and therefore lessening the pain."
Ways to treat pain continue to improve and have done so dramatically in the past decade, especially in interventional pain treatment, or literally "intervening" in the production and/or transmission of a pain signal. One area in which this has been most apparent is the treatment of low-back pain, which now can be cared for using a variety of minimally invasive techniques including epidural steroid injections; spinal cord stimulation; intrathecal pain pumps, medical devices which deliver very small quantities of medications directly into the spinal fluid; and vertebroplasty, or injecting bone cement into the vertebrae to stabilize fractures.
'These procedures target the source of the pain rather than flooding the system with medication," Lonseth says. "These procedures allow us to deposit the medication more directly at the generating source of pain. The added benefit to many of these treatments is that they help the patient to avoid surgery."