Opioids are highly addictive, cause withdrawal symptoms, and lose effectiveness over time. They require a prescription. In situations involving severe trauma and pain, the doctor will carefully manage and administer the dosage, gradually reducing the amount to minimize withdrawal symptoms. People should discuss all medication options carefully with a doctor and disclose any health conditions and current medications. Opioids may significantly affect the progression of several chronic diseases, including:.
Opioids can cause dangerous side effects in people with certain chronic diseases. For instance, they can cause respiratory depression, which can exacerbate the symptoms of COPD.
A range of nondrug therapies can help relieve pain. These alternatives to medication may be more suitable for people experiencing chronic pain. These therapies include :. With adequate pain management, it is possible to maintain daily activities, social engagement, and an active quality of life. Discover how yoga can help people who have fibromyalgia.
There are many possible causes of sharp lower back pain, from a mild muscle strain to some potentially more serious underlying conditions.
Read this…. Vaginal pain may result from injury, infection, or an unknown cause. Learn what can cause vaginal pain, as well as other symptoms that may also occur…. There are several potential causes of right shoulder and arm pain. Read on to find out the various causes and when to see a doctor. Lower abdominal pain and bloating sometimes occur together. Read on to find out the potential causes of these symptoms and the treatment options….
A heart attack is a common cause of chest pain, but women may have different symptoms than men. Learn about the causes, diagnosis, and treatment of…. What is pain, and how do you treat it?
Medically reviewed by Angela M. Causes Types Diagnosis Racism in pain management Treatment Pain is an unpleasant sensation and emotional experience that links to tissue damage. Share on Pinterest Pain can be chronic or acute, and it takes a variety of forms. Racism in pain management. Treatment and management. How to stay safe while having fun this Halloween. Environmental factors significant contributor to heart disease.
This happens to all animals, and always has. Even more exotic, the human mind may even be capable of triggering it with the perception threats to our health e.
Like stress itself, neuroinflammation is a generalized response — regardless of the trigger, the system has the same effect. This may explain how many baffling symptoms work, 16 even just hurting too much.
What better way to force an animal to take it easy than to make everything hurt too easily? Unfortunately, peripheral neuropathy does not always announce itself so clearly. Sometimes all you get is pain. Consider this remarkable case study of cluneal nerve entrapment…. The cluneal nerves pass from the low back and sacrum into the buttocks, just under the skin, and they can get tangled up with ligaments and connective tissue on their way, potentially causing chronic low back pain.
The patient was decisively cured. Which is pretty cool. But that was after years of suffering, and a pointless surgery on her intervertebral discs. It used to refer to the chasm between social classes. Smoking doesn't hurt per se — not directly — but smokers hurt. Smoking has already come up in the context of things that probably increase systemic inflammation, which is likely a major way that it increases the risk of pain.
However, it's such a powerful independent predictor of pain 23 — that is, smokers are quite a lot more likely to suffer from pain, regardless of anything else about their health status — that it probably does its dirty work in multiple ways, and should be called out as a cause of pain in its own right.
That seems reasonable for anything that makes several types of pain two to three times more likely. Most likely this is just yet another strong sign that poor health is the real problem, which works in many ways, and almost any amount of smoking just guarantees poor health. See Smoking and Chronic Pain. Most of us have some unexplained sore sports, which mainly feel like sensitive muscle tissue but also tendons and ligaments.
And some of us have a lot of them. No one doubts that the sore spots exist, but many doubt what they are : their biology is still mysterious and contentious. Conventional wisdom says they are basically tiny cramps, but they might also be more of a sensory glitch.
Regardless, they are often associated with strong pain that often spreads in confusing patterns referred pain , and they grow like weeds around other painful problems and injuries, making them clinically interesting and tricky. Although well known to many specialists and researchers, most doctors and therapists know little about them, so misdiagnosis is epidemic. You cut your finger and the tissue around the cut is much more delicate while it heals.
But sometimes this reaction spins out of control, becoming a disease in its own right. The most extreme example of this phenomenon is complex regional pain syndrome , which causes extreme pain, usually in a limb, and usually following some relatively minor tissue insult like an insect bite, a minor cut, or a small fracture.
Many times in my career I have become quite convinced that a patient had to be suffering from some lesser form of CRPS, awful but not enough to clinch a CRPS diagnosis. Whenever something painful happens to me, amid all the distress I am surprised at being reminded of how painful pain is. An irritated spinal cord — usually irritated by being slightly pinched by a narrow spinal canal — can cause an astonishing variety of problems, including pain, without ever clearly giving itself away.
Symptoms can be in virtually any location in the body, if the location of the trouble is high in the spine. This can go on for years, bad enough to cause pain but never bad enough to be easily diagnosable. Subtle dysautonomia from chronic mechanical irritation of the spinal cord is definitely a plausible, sinister, and thoroughly obscure explanation for some chronic pain and anxiety.
Sometimes an artery gets narrowed or pinched off and causes serious pain. Sometimes it is easy, like a straightforward case of a cyclist with a couple months of leg pain and weakness with exertion. A patient had sciatica-like leg pain for thirty-five years and was misdiagnosed many times until finally getting not only a definitive diagnosis but a cure.
Not even a difficult diagnosis in the end, really. There were some pretty glaring clues there that got ignored by a lot of people who should have known better. But not only was he misdiagnosed many times over more than three decades, he was misdiagnosed fashionably : that is, each misdiagnosis neatly fit a paradigm in physical therapy better than it fit his symptoms.
This carried on right up to and including the present day fascination with psychosocial factors and sensitization which served him no better than any of the other paradigms had.
Taylor and Kerry :. This, of course, had been explained away to him more recently by current research and evidence-based thinking on central sensitization and pain. Just fascinating. The authors thoughtfully explore the implications of this rather shameful episode. The bottom line? Good diagnostic skills are never out of fashion.
Hypermobile patients get hurt easily and have a lot of chronic body pain. Hypermobility spectrum disorders HSD are a group of conditions defined by joint hypermobility — unexplained joint looseness.
HSD is a bucket diagnosis for people with symptomatic hypermobility, but without a connective tissue disorder that explains it, like Ehlers—Danlos syndrome or Marfan syndrome. Most connective tissue disorders are relatively obvious, but EDS can easily evade diagnosis, making it a prime suspect in many cases of chronic pain…. Ehlers—Danlos syndrome EDS is a group of conditions that includes hypermobility along with fragile tissues that injure easily and heal poorly especially skin , with many consequences.
Given the musculoskeletal troubles that we know hEDS can cause, it is reasonable to guess that less severe hypermobility HSD may also be both clinically important and yet even less obvious. There is not a single supplement or anti-inflammatory superfood that is clearly beneficial for any common kind of pain, but there are a couple nutritional deficiencies that stand out as significant, legitimate suspects in many chronic pain cases.
Pain may be the only clear symptom of either one. Vitamin D deficiency is on the firmest ground. It is probably more common than once suspected — at least 1 in 20 people in the lowest estimates, 32 and possibly many more.
For more information, see Vitamin D for Pain. Magnesium deficiency is also a suspected factor in chronic pain, especially migraines. Ironically, magnesium in a clinical setting is known to induce cramping and severe muscular pain, so none of this biology is straightforward!
Mitochondria are the microscopic organs that generate energy, invariably described as the power plants of our cells. They produce energy and, it turns out, they may also distribute it, like a network of power lines. Mitochondrial disease might prove to be the key to understanding some of the mysterious syndromes as well as a deeper explanation for more familiar diseases, especially in neurology. For instance, the Borrelia burgdorferi bacteria causes Lyme disease, but many people continue to suffer even when all the B.
The cause is probably a lingering molecule produced by the bacteria during their campaign. In , researchers discovered that B. Although the primary symptom is painful arthritis, a chronic immune response like this would also tend to provoke generalized illness — fatigue, malaise, sensitization — via the mechanism of neuroinflammation.
If correct, then this study has solved one of the bigger puzzles in medicine — a big deal — but it also demonstrates an extremely important general principle: immunity is a double-edged sword with many, many complications that are impossible to guess. Yes, believe it or not, syphilis can actually be a stealthy cause of pain. The second stage consists a few weeks of malaise and rashes.
The disease then goes dormant to some degree, for years, or forever, but in some people it will develop into the final stage, which is where the chronic aches and pains may develop just one of a great variety of possible symptoms. Some patients with unexplained chronic widespread pain fibromyalgia probably have syphilis.
Biology is destiny, and this condition is a really good example of it. How many people out there are in that multi-decade period of wondering why they get so sore so easily, before finally being diagnosed with FSHD? The autoimmune diseases are a huge class of pathologies that can cause essentially any non-specific symptoms for a long time before diagnosis.
These are conditions like lupus, rheumatoid arthritis, celiac disease, inflammatory back pain spondyloarthritis, a common cause of the phenomenon of morning back pain , and many, many more. Lupus is one of the most common and notoriously unpredictable and slow to develop. Some people with a variety of weird aches and pains and other symptoms are going to end up getting diagnosed with lupus eventually, but it can take literally years for the situation to clarify.
So it's another autoimmune disease, but it's one that is particularly common, serious, and prone to causing pain and other woes well before diagnosis. It definitely does not cause primarily pain in every patient; the classic onset of multiple sclerosis is more blatantly neurological in character tingling, numbness, weakness, and so on.
But some patients definitely start with pain, and spasm is the primary mechanism. Although the feeling of constriction is the classic symptom, many patients also just experience widespread and erratic pain in the chest wall, probably from erratic, isolated painful contractions. It will probably reveal itself sooner rather than later. But there is definitely potential for a period of unexplained pain. Lymphoma is a cancer of the infection-fighting cells of the immune system, cells in the lymph nodes, spleen, thymus, bone marrow, and other parts of the body.
These cells grow out of control. The swollen nodes are not painful, and pain is not a classic symptom … but it can happen, depending on where tumours are forming and what they are pressing on, and possibly because of ramped up systemic inflammation. Other kinds of pain are possible too, but those are usually more distinctive and readily identified as a drug side effect.
Joint and muscle pain are easily mistaken for the ordinary aches and pains of aging, removing suspicion from the drugs that are actually causing them. Some of the usual suspects are:. Actonel risedronate is one of the more popular bisphosphonate drugs, any of which may cause severe musculoskeletal pain years after first exposure. The bisphosphonates — On January 7, , the U. This medication has almost certainly explained some otherwise inexplicable pain in some of my patients over the years!
The statins — The drugs that lower our blood cholesterol, like Lipitor and Crestor, may also cause pain. Statins are important and widely used drugs, and their deleterious effect on muscle is widely considered a diagnosable condition: statin myalgia , or statin-associated muscle symptoms SAMS.
And yet there is also confusion and controversy about the prevalence of statin myalgia. There might also be some tricky X-factors, like vitamin D deficiency, which seems to be linked to statin myalgia. Fortunately, for the genuinely statin intolerant — and you probably do exist! Opioids are, of course, the cause of an enormous amount of misery and controversy right now. Endorphin production, for instance, will drop.
This can have disastrous consequences when you stop taking the drugs, resulting in worse pain than ever. This is part of the phenomenon of the well-known serious withdrawal symptoms from some drugs; it is a less well-known problem with over-the-counter pain-killers.
Depending on the underlying cause, you may develop other symptoms as well. For example, these may include fatigue, swelling, nausea, vomiting, or mood changes. There are several different types of pain. Acute pain develops over a short period of time. It tends to occur suddenly, often as a result of a known injury, illness, or medical procedure. Acute pain tends to be sharp, rather than dull. It usually goes away within a few days, weeks, or months, after the cause has been treated or resolved.
Chronic pain lasts, or comes and goes, over multiple months or years. It may result from a variety of health conditions, such as arthritis , fibromyalgia, chronic migraine , or cancer. Some people also experience chronic pain following an injury, even after the initial injury has healed.
In some cases, the cause of chronic pain is hard to identify. This is known as functional pain. More than 7 percent had chronic pain that frequently limited their activities at work or in wider life. Nociceptive pain is caused by tissue damage. For example, it may result from injuries such as cuts, burns, bruises, or fractures. It may also result from certain health conditions that cause tissue inflammation and damage, such as arthritis, osteoporosis , or inflammatory bowel disease IBD.
Nociceptive pain may be acute or chronic, depending on the underlying cause. It may feel achy, throbbing, or sharp. Neuropathic pain results from nerve damage, which may be caused by a variety of injuries and illnesses. For example, you may experience neuropathic pain if one of the discs in your spine slips out of place and puts pressure on a nerve. You may also develop neuropathic pain as a result of certain illnesses, such as shingles , diabetes , multiple sclerosis , or cancer.
It tends to be chronic, but acute neuropathic pain may also occur. Neuropathic pain may feel like a stabbing, shooting, burning, or prickling sensation. It tends to be chronic, although acute functional pain may also develop. Examples of functional pain syndromes include:.
If you seek medical attention for your pain, your healthcare professional will first do a physical examination and ask you some questions. Be prepared to describe the pain specifically, including when it started, when it is most intense, and whether it is mild, moderate, or severe. Depending on your symptoms and medical history, your doctor may order one or more of the following tests to check for potential causes of your pain:.
These syndromes are diagnosed based on symptoms, after other potential causes are ruled out.
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