Pain has been a stubborn mystery in the medical field. Pain from a temporary illness can turn into a chronic pain condition, while for others the illness passes without any lingering effect. This conundrum has boggled physicians and pain specialists alike for time immemorial. Despite understanding the functional mechanics of pain and how it’s processed, the reason why pain turns out to be chronic for an unfortunate few still remains a mystery.
Chronic pain is defined as pain that is experienced for more than six months, with a severity of 6 or more on a ten-point scale with ten being the highest. .
The scale refers to the degree of impairment experienced by the individual suffering from chronic pain. There are two types of pain – acute pain, which is a normal response of the body to warn the individual of injury. For example, when you drop something heavy on your foot.
Chronic pain, on the other hand, is the experience of prolonged and unremitting pain – this is when pain itself turns into a disorder.It is estimated that about 100 million Americans suffer from chronic pain. Click To Tweet
The pain individuals experience can range from mild to excruciating, incessant or sporadic, just a nuisance or extremely debilitating, such that the quality of life is significantly compromised. These various and wide-ranging criteria for chronic pain are subjective attempts to pathologically categorize a notoriously difficult-to-define condition.
Chronic Pain Explained in 5 Minutes
Recent studies on chronic pain beginning to show a developing understanding of what causes acute pain to transform into chronic pain. The glial cells, an unlikely culprit, are beginning to be suspected as culprits in this unfortunate transformational process. Glial cells are known as the neurons’ support structure. The neurons contain neurotransmitters that in turn conduct information and this is the fundamental process that underlies the chronic pain quandary.
However, glial cells now prove that they are not just a neuron’s support mechanism. Research studies conducted over the last few years now suggest that glial cells are the reasons why neurons become over-reactive and abnormally sensitive to pain. Normal nerve function is disrupted by glial cells after the release of inflammatory mediators.
Once an injury occurs, the inflamed or injured tissue then activates the immune system. This then triggers the glial cells and the “pain mode” is activated. Over-excitation of pain pathways’ nerves then occurs in the central nervous system.
This then enhances the pain that is felt by the individual. Recent laboratory studies seem to show that a variety of pain states can be inhibited when the release of pro-inflammatory mediators from the glial cells are blocked.
Research also indicates that glial cells have a role in opiate pain medication tolerance. The effectiveness of these drugs for pain management can be moderated by glial cells. This occurs when the opiates bind to the receptors found on glial cells, activating these cells instead of quieting them down. This causes the glial cells to continue releasing more pro-inflammatory mediators, continuing the “pain mode” and making the pain worse. Opiates then no longer provide relief because of the glial cells.
These recent research discoveries have encouraged medical science to shift its focus to the role of glial cells and an analysis of how to regulate their reaction to pain instead of focusing on the treatment of neurons. This research is ongoing and promises to provide important insights for the practice of modern pain management.
As we have observed – the experience of chronic pain is a mysterious and little understood, phenomenon. While tissue damage and injury are common factors there are some disease conditions that are also believed to be comorbid with chronic pain. For example, cancer, arthritis, fibromyalgia, and diabetes.
Currently, chronic pain is treated not just with medications but with a variety of alternative treatments.
Electrical stimulation, chiropractic therapy, acupuncture, acupressure, herbal remedy, meditation and physical therapy are some of the therapies that individuals with chronic pain utilize. Surgery is often the last option for physicians and the individuals with chronic pain, and this does not always completely relieve pain. Pain medications are also commonly used, and must be monitored for side effects and the possibility of abuse and addiction to these drugs.
Despite the different research studies on this subject, chronic pain remains a stubborn mystery to medical practitioners and its sufferers. A continuing inquiry into this medical anomaly will doubtless provide insights. What turns pain into a chronic condition? Why is pain more likely to turn into a chronic condition for some and not for others? What is the role of the brain and neurons in this process?
Answering these questions would certainly be cause for celebration and perhaps portend complete relief for individuals suffering from chronic pain. These questions are still not satisfactorily answered – and we are waiting on medical science to provide a solution. In the meanwhile, check out some of our favorite books on the subject…