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Treating Chronic Pain

Summary & Participants

Chronic pain is pain that continues past the normal healing time for an injury. Learn about the causes and current treatment options, from NSAIDs to opioids, for chronic pain.

Medically Reviewed On: July 21, 2008

Webcast Transcript

ANNOUNCER: It’s estimated that over fifty million Americans suffer from chronic pain. Experts define chronic pain as pain lasting more than three months or past the normal healing time for an injury or illness.

RUSSELL PORTENOY, MD: Chronic pain has no biological function. Chronic pain is an illness in its own right. When pain persists beyond the healing of an -- of an injury or it occurs in the absence of an injury, then pain becomes the problem for the patient.

ANNOUNCER: Chronic pain has been associated with a variety of medical conditions.

RUSSELL PORTENOY, MD: The most common type of chronic pain is chronic joint pain which is becoming more common as our population ages. It's typically a disease of the elderly and is what most people call osteoarthritis; affects the hips, the low back, the neck, the shoulders, the hands. Cancer is a cause of chronic pain.

Another very common cause of pain is headache. Other common causes of chronic pain include low back pain, chronic neck pain, fibromyalgia and some specific types of what is known as neuropathic pain, like diabetic nerve pain or diabetic painful neuropathy or postherpetic neuralgia, which is also known as shingles.

ANNOUNCER: The pain often persists twenty-four hours a day and can affect a patient’s quality of life.

RUSSELL PORTENOY, MD: Pain can interfere with a person's ability to function physically, it can interfere with a person's psychological functioning, cause depression or anxiety, produces a sleep disturbance, chronic fatigue.

ANNOUNCER: And it’s often undertreated by health care providers.

BILL H. MCCARBERG, MD: Unfortunately, we don’t have enough pain experts to treat chronic pain, so most of the burden for treatment falls on the primary care provider -- the internist, the family medicine doctor, the pediatrician, the OB/GYN doctor. And unfortunately, many of these doctors aren’t trained to treat it, and they tend to depreciate the patient’s complaint of pain.

ANNOUNCER: Chronic pain can also prove difficult to diagnose.

RUSSELL PORTENOY, MD: Pain is inherently subjective and what we mean by that is there is no test that can determine whether or not a person's experiencing pain. There is no laboratory test, there's no X-ray, there is no test that can tell a doctor or -- or any other person that another human being has pain. The only way that we can tell if a person has pain is that they report it verbally or they show it in the way they move.

ANNOUNCER: There are different types of medications used to treat chronic pain. A group of medications called non-steroidal anti-inflammatory drugs, or NSAIDs, provide pain relief by reducing swelling and inflammation.

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