What Is Chronic Pain?
Chronic pain is persistent pain lasting 12 weeks or more, oftentimes occurring after an injury or procedure. Chronic pain and addiction may co-occur. Chronic pain can cause decreased mobility, changes in appetite, stress sensitivity, mood swings, and other psychological impairments. Chronic pain can occur anywhere in the body. An injury in one area of the body may cause several additional issues in other areas of the body. For example, someone with post-trauma pain (pain resulting from a car accident, surgical procedure, or other physical trauma to the body) may also experience:
- Back pain
- Nerve pain (fibromyalgia)
- Joint pain
- Breathing difficulties
Chronic Pain And Health Conditions
The causes of both chronic pain and addiction can be complex and very difficult to treat. Chronic pain often calls for several medications, some with side effects that can be disruptive to daily activities. For example, conditions like fibromyalgia that cause chronic fatigue, tenderness, and bone pain not only cause chronic pain but can also be emotionally frustrating to deal with. Additionally, chronic pain can be caused by health conditions like:
- Endometriosis or uterine fibroids
- Chronic fatigue syndrome
- Multiple sclerosis
- Inflammatory bowel disease
- Interstitial cystitis
Chronic pain may also have lifestyle causes like:
- Long-term poor posture or bending
- Sleeping on a poor mattress
- Years of improper lifting or carrying heavy objects
- Wearing high heels
Other traits of chronic pain include an inability to move around, muscle tension, changes in appetite, and emotional frustrations due to ongoing pain. Lastly, women, tobacco smokers, obese people, and individuals who have had an injury are most at risk of battling chronic pain.
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Chronic Pain Treatment And Medications
Typically, both chronic pain and addiction are treated through therapies and medications. In the case of physical therapy, patients that need help with walking or completing daily tasks get hands-on help. In other cases, patients may use medications and be urged to practice healthy lifestyle changes that improve posture, stress levels, and energy. The management of chronic pain may require the use of several medications at one time; some may have side effects that can be disruptive to the accompanying lifestyle changes.
Medications that are mostly commonly associated with chronic pain relief include:
- Anti-inflammatory medications
- Steroids (Prednisone)
- Muscle relaxers
- Anticonvulsant and anti-seizure medications
If Advil is not strong enough to combat chronic pain, some patients may need to be prescribed anti-inflammatories or muscle relaxers. Muscle relaxers have a potential to be addictive. Antidepressants are effective in the treatment of symptoms related to depression. It is important to not abruptly discontinue Antidepressants without medical advice.
According to the CDC, in 2020, the ‘Opioid dispensing rate’ was 43.3 prescriptions per 100 people.
Chronic Pain And Opioid Abuse
Opioids are highly addictive and can be used as a last resort; they may produce both dependencies and withdrawal symptoms. Similar to withdrawal from Antidepressants, withdrawal from Opioids can create uncomfortable side effects that can push someone back into a cycle of dependency. Due to the addictive nature of specific substances, patients are required to discuss the medications they take with a doctor.
The Opioid epidemic often stems from patients who have chronic pain and other injuries transitioning from prescription medication to illegal street drugs when their need and tolerance for their medication surpasses what their medical providers are able to therapeutically and legally prescribe. This has resulted in Opioid abuse and chronic pain having a complicated relationship. A study noted that “chronic pain not caused by cancer is among the most prevalent and debilitating medical conditions.”
Chronic Pain Management And Opioid Abuse
Opioids are prescribed for chronic pain, as Opioids bind to the Opioid receptors in the brain; this creates euphoria and pleasure throughout the body. This reaction significantly reduces pain, however, chronic pain and addiction may become closely related once Opioids are involved. Due to the risk of a chronic pain patient developing an Opioid use disorder, it is important to know how to manage pain medication and to be alert for possible signs of abuse.
Opioid Tolerance, Dependence, And Abuse
When people take a prescription Opioid like Hydrocodone or Oxycodone for pain, they may not only feel pain relief but also feel extreme relaxation and even euphoria. Once patients begin to heal and no longer physically require the Opioids, they may crave those pleasurable psychological feelings. If the patient has taken prescription Opioids for months or years, the brain chemistry responsible for emotion and mood regulation becomes altered.
Tolerance builds when an individual has taken a substance for some time and needs a higher dose to feel the desired effects. Dependency occurs when the individual needs a particular substance to feel normal and experiences a physical consequence if they attempt to decrease their use. Dependent individuals often have unusual behaviors or act unlike themselves if they do not have the drug; irritability, depression, guilt, secrecy, shame, and fatal and non-fatal overdoses may occur.
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Once a physically dependent individual stops taking Opioids, they may experience withdrawal symptoms. Withdrawal symptoms and tolerance are signs of dependence and include the following:
- Intense cravings
- Flu-like symptoms
- Increased heartbeat
- Excessive yawning
- Watery eyes
In some cases, patients can benefit from holistic care like acupuncture and yoga alongside medications to manage the cravings and the symptoms of withdrawal.
Get The Quality Care You’re Entitled To
Long-term use of Opioids may worsen pain as time progresses. Being proactive about an Opioid use disorder can reduce complications in the future. If you or your loved one is experiencing challenges with chronic pain and has become physically dependent on Opioids, don’t hesitate to seek help. Contact a treatment provider and explore treatment options today.
Ashish Bhatt, MD, MRO
Doctor of Addiction Medicine
Learn about Dr. Ashish Bhatt
Dr. Bhatt has been Addiction Center's Medical Content Director for more than three years, providing his expertise to ensure quality and accuracy.
Doctor of Addiction Medicine
Expert in adult and child psychiatry
Over 20 years of professional experience