Chronic Pain is real and is always experienced in response to something ? even when there is no physical evidence that can be established. There is always some physiological, neurological or psychological basis that exists, even when we can’t see it. Normal ageing, previous injury, disease conditions, nerve damage, psychological factors ? any or all of these could be responsible for chronic pain.
Very often there has been an initial injury, a fractured leg, sprained back or some serious infection which might have healed a long time back but the pain persists. This could be for two reasons – either the injury did not heal properly, or changes occurred in CNS functioning. When moderate to severe pain has been present in the body for a long duration it can lead to changes in the peripheral nerves, spinal cord and even the brain itself. These changes cause the body to continue experiencing pain – even long after the injury has healed. Thus when pain is present, in the absence of any detectable damage, it is important to look at injuries that might have happened and been cured years earlier. Common injuries that can lead to chronic pain include back, spinal cord, neck and joint injuries.
Ongoing Causes of Pain/Disease Conditions/Neurological Factors
Existence of disease conditions is another cause of chronic pain. Individuals suffering from serious conditions like cancer, HIV infection or AIDS, multiple sclerosis, stomach ulcers or gall bladder disease often suffer from chronic pain. Diabetes, arthritis in the elderly, rheumatoid arthritis and osteoarthritis are other common causes of chronic pain. Pain which is experienced due to the presence of a disease condition could be due to actual suffering and treatment as in the case of cancer and/or be due to damage to nerves which carry information about pain, as in the case of diabetes. The damage causes faulty signals to be sent to the brain and is experienced as pain. This type of pain is referred to as Neurogenic pain. There are a number of other conditions with neurological bases that can cause chronic pain, some of them are facial nerve problems, shingles, fibromyalgia, spine injury and brain trauma.
Psychological disorders like Depression and Anxiety can also cause chronic pain. When the psychological component is predominantly the cause of pain – even though a medical condition is present – or where the experience of pain exceeds the actual physical injury, it is referred to as Psychogenic Pain. Having said that, this does not mean the pain does not exist and is in the head. Individuals suffering from psychogenic pain actually feel the pain (except in the case of Malingering). Additionally, chronic pain can often lead to psychological problems, like depression and anxiety, which further worsen the experience of pain.
The role of neurochemicals – especially one named endormophine – has also been implicated in chronic pain. Endomorphines are the body’s natural pain killers, produced by the brain and released into the body when it experiences pain. Some individuals with chronic pain have been found to have lower levels of these neurochemicals.