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The good and bad news about Chronic Pain ...

Pain is a signal that something is not right in our body and may be caused by injury, illness, disease, hormonal changes, emotional upset or stress. The first step is finding out and understanding the cause of the pain. If it is a one-off headache or the pain is from a physical injury such as muscle strain, then treatment can be straight forward. There are a number of pain relief medications available in the pharmacy and our pharmacists can determine which is the most suitable for you and make sure you aren't doubling up with other preparations. Simply email us on info@ahuriripharmacy.co.nz.

Chronic pain is pain that has continued for three months or longer and is present most days of the week. It may be caused by ongoing injury or disease (back pain, osteoarthritis, neuropathy, cancer) or it may continue after an injury has healed or illness has passed. In pain due to inflammation, complimentary medicines can play a role alongside prescription medicines to reduce your need for anti-inflammatories. Fish oils and boswellia have been shown to reduce inflammation in osteoarthritis or rheumatoid arthritis, while glucosamine and chondroitin can help to repair damaged cartilage in the joints of osteoarthritis sufferers.

However, in chronic pain not caused by ongoing injury, the pain may persist because of lasting changes to the nervous system. This seems bizarre but our nervous system is capable of adapting and changing (called neuroplasticity) and this may affect us in a positive or negative way.

Examples of positive neuroplasticity include driving home on “auto-pilot” or remembering how to ride a bike where our nervous system has learnt and adapted to do these tasks and free up brain capacity to do other things. Unfortunately, in chronic pain, neuroplasticity can make the brain and nervous system more sensitive and reactive to otherwise normal activities, making them painful. Psychological and physical stress often triggers negative neuroplasticity which can lead to chronic pain or make it worse. The good news is that there are ways to train the brain to reduce chronic pain.

It is important to understand that in chronic pain, the aim of treatment is to improve function despite the pain and reduce the level of pain by about a third to a half. This should help improve your ability to be more active and in time, be able to enjoy the things you used to. Pain management is a five step process:

  1. Consider medical interventions – surgery and medications can be an option to some people. Medicines can offer relief to help you increase activity levels and then doses tapered off. Your doctor and pharmacist can suggest different medicines that may help.

  2. Your thoughts can also play a major role in managing pain. Being in pain can restrict your activities, disturb sleep, make you feel depressed, stressed or anxious and affect your relationships. A positive outlook and reducing stress levels can help you deal with the pain better and in fact reduce the pain itself.

  3. What we eat and how we live may contribute to a sensitised nervous system so adopting a healthy diet and lifestyle can be beneficial. Avoid smoking and alcohol while improving food choices and activity levels.

  4. Many people will find that a worrying period of life has been associated with increased pain levels and letting go of past hurts can be part of the healing process. Counsellors can help you work through deeper issues to pain.

  5. In short term pain, we are often told to rest the affected area to let it heal. Once the pain becomes chronic, the muscles in the affected area need to be used so they don’t waste away. Aim to move at comfortable levels and gradually build up as you can. Pacing yourself to do small amounts of activity often with short breaks in between every day is sensible. If you have not been active for a while, when you start building up your activity, it is normal to feel some extra pain and muscle stiffness.

Expect that pain reduction will be slow, usually occurring over six to twelve months. Keeping a diary may help you to look back and see your progress.



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