How to Deal With Chronic Pain & Depression – Back Pain & Failed Treatment Strategies By John Zajaros
Chronic back pain is a condition that affects millions of Americans every year. Chronic pain of any kind leads to depression in as high as 85% of all individuals diagnosed with the disorder. Chronic back pain may result from any number of factors and is in fact one of the least understood conditions affecting millions of back pain and sciatica sufferers worldwide. The often insidious and frequently misunderstood complex of chronic back pain and depression leads to its own set of conditions and consequences. The combination of depression and chronic pain often leads to total disability, with little hope of a real solution or cure.
Back pain, in fact pain in general, often falls into one of two categories. The two types of pain are nociceptive pain and neuropathy or neuropathic pain. Nociceptive pain is sensed by what are called nociceptor sensory fibers. Neuropathic pain or neuropathy is a term used to describe damage to a nerve or nerve tissue. With nociceptive pain, messages are sent to the brain signaling an injury to the skin, muscles, connective tissue such as ligaments and tendons, bones and joints or other vital organs. Nociceptive pain may be described in terms of trauma or a specific injury that often heals with time and treatment. Examples of this type of pain include the pain after spine surgery, the pain due to a fall or an accident, stubbing your toe, and arthritis pain, just to name a few. Neuropathy or neuropathic pain is generally a deep sensation, whether aching, throbbing or soreness. Neuropathy is generally associated with back pain and sciatica but may also indicate damage in other areas, such as pain in the neck extending into the shoulders, arms, hands, and fingers. It is believed that in cases where the nociceptive pain is prolonged, with no clear resolution or outcome, it may evolve or progress into neuropathic pain. It is not uncommon for a patient to have a constellation of conditions in which both categories, both classifications of pain are present.
Within the context of nociceptive pain and neuropathy, there are gradations ranging from mild to acute and from short term or abrupt manifestations to a chronic, long term state. While pain is a subjective state and classification next to impossible, we will define it as falling into one of two basic expressions, acute and chronic. Acute pain and chronic pain are very different, not only in terms of the actual sensation or expression, but in terms what the sensation or sensations are “telling” us, as well. Acute pain generally reflects the degree of damage at a specific location on or in the body. In cases of acute pain, there is a positive correlation, a relationship, between the sensation and the amount of actual damage. As a result, pain is considered a protective mechanism, an adaptive response allowing us to remove the cause or cease the behavior, thus interrupting the pain and minimizing the damage. Thus, acute pain is an expression of nociceptive pain. Chronic pain, on the other hand, does not send the same message acute pain does. Nor is chronic pain protective or adaptive, it serves no real biological function either. In fact, you could almost say that the signal is a mistake. The reason? Chronic pain, or neuropathic pain, continues to send impulses to the brain long after the event is over and there is no longer tissue damage to report.
It is chronic back pain, with no clear causality, pathology or otherwise, that is so difficult to treat and leads so many of its sufferers into depression, debilitation, and disability. Depression and chronic back pain are inextricably linked and treatment is difficult, if not impossible. The typical chronic pain sufferer with depression also experiences a loss of appetite, insomnia, irritability, anxiety, and a myriad of other mental and physical maladies, all linked back to chronic back pain. Unfortunately, it is at this point the pain management practitioner usually steps in and medicates the patient with an amazing array of narcotics, exacerbating the situation further. Now we have an individual suffering from chronic back pain and depression, probably disabled and unable to work; and, if he or she does work, they have been completely marginalized by the stigma and their inability to function at optimal levels. The addition of narcotics serves to fully debilitate the chronic pain sufferer, usually addicting them to pain medication in the process. The spiral continues downward into worsening depression, hopelessness, loss of identity, loss of self-esteem, and, very possibly, loss of everything around them that was ever important to them.
Pretty grim, huh? Well, it’s not without hope and certainly not without resolution. However, it takes a concerted effort including, at times, treatment to get off the pain medication. But it can be done! More and more chronic pain sufferers every day are seeking alternative “bad back” or chronic back pain treatment strategies. Many people suffering from the devastating and deadly complex of chronic pain and depression, addicted to narcotics, are starting to understand that traditional pain management, with its “let’s thrown medication at it” mentality is a black hole from which, if not fully extricated from in time, will completely suck the life out of the individual at risk, literally and figuratively.
The program? Exercise, get off the medication, education, and re-entry into your life. Sounds simple but it’s not. The chronic back pain may continue for quite a while and medication may be required to alleviate the symptoms of depression. However, if an individual really wants help, it is available. The result may be a new life, one far from the devastating reality of the old one. Exercise, get off the meds, education, and re-entry. Stare with a good, individualized exercise program, get treatment if necessary to get off the pain killers, go back to school or begin to educate yourself, it does wonders for your self-esteem, and re-enter your life, become involved with your family again, with friends, with your dog if you have one. And then? Take life as it comes, one day at a time, as they say. The results will be worth it. The journey? Fantastic!
For further information and an intelligent program of treatment for neck pain, back pain, and sciatica, what I refer to as the “back pain complex” try the program below:
For additional resources dealing with neck pain, back pain, and sciatica, including additional treatment plans and a community for support; an awesome resource for New Balance running shoes, great for heel cushioning and a must for anyone suffering from neck pain, back pain, and/or sciatica; ice-compression braces, crucial for inflammation and swelling; orthotics for the times when the New Balance can’t be worn; and, natural antinflammatories for the back pain complex:
Professor John P. J. Zajaros, Sr., The Bad Back Guy
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