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Chronic Pain

What is chronic pain?

Chronic pain has been recognized as pain that persists past normal healing time and doesn't always have an identifiable cause. Usually, pain is regarded as chronic when it lasts or recurs for more than 3 to 6 months. Pain as a warning signal protects the person and his/her life when the pain is in an acute phase, but when it becomes constant, then the warning purpose disappears. Any kind of pain may become chronic and may last for months or even years. It can disappear and reappear. Pain is a universal phenomenon and everybody experiences it differently. It can be difficult for others to understand the pain of the person who suffers from it, and the intensity can be easily underestimated from the outside. The pain sufferer can experience resistance to his or her body and doing the everyday activities can be seriously disturbed. People very often feel they have lost control over their lives and that they are not useful for society. Sometimes the person feels that he or she is not heard by others and the pain experience may be misunderstood by them.

What causes chronic pain?

Chronic pain may have different reasons: constant tissue damage (e.g. advanced cancer), neurological diseases (e.g. multiple sclerosis), degenerative diseases (e.g. arthritis), and many others. In some cases, the cause of chronic pain is unknown- especially if the lesion that initially caused the pain has healed.

Pain as a phenomenon is difficult to grasp; besides the physiological factors, it also includes emotional, cognitive, sociocultural, behavioral, and psychological aspects.

Pain is perceived in the brain, primarily in the cortex. The pain pathway is the following:

  • Pain messages are picked up by receptors and transmitted to the spinal cord via small myelinated fibers and very small unmyelinated fibers.
  • The signal is processed, translated, and given meaning in the brain. The information that reaches the consciousness in a few seconds has several components; pain location and intensity, unpleasantry, and other emotions related to it. It's important to be aware of the impact of previous experiences, worries, fears, and negative expectations on pain perception. It's important to modify them to manage the pain more successfully.


In the central nervous system, there is a complex pain regulation system that functions well in a normal situation. Our body constantly sends signals about different sensations, but not all the signals reach the brain: more than 70% of the signals stay in the spinal cord. Those signals are dampened by the nerve pathways that descend to the back part of the spinal cord and also by neurotransmitters which inhibit the transmission of the pain signals. When there is a failure in the system also “ innocuous” signals pass and are interpreted as pain. The amount of gray matter in the brain starts to decrease when the pain lasts for a long time. Those changes occur quite quickly even after a 3-month pain cycle. The excessive pressure in the nervous system can be durable and this is how the vicious cycle between the pain and the nervous system is created.

How to cope with chronic pain?

Look for valid information

It's very important to get adequate information about pain. Managing pain can be emotionally more challenging if the cause of it is unknown. In Estonia, there is a pain association where you can get further information about pain management.

Physical touch

Strokes, hugs, and caresses stimulate the mind in different ways. Touching and massage calm down the body and reduce the release of the stress hormone cortisol, lower the blood pressure and help to overcome stress.

Talk about your emotions

Feelings can have a great impact on our health. Although positive thinking gives us strength, ist's also important to leave space for negative emotions. Many people who suffer from chronic pain suppress their emotions to protect themselves or others by negative emotions. It's important to express all kinds of emotions so they wouldn't cause tensions in the body.

Mindfulness

Mindfulness is a way of meditation that teaches us to have an open, kind, curious, and accepting attitude towards ourselves, life and emotions. You can find some mindfulness techniques from here.

https://www.mindful.org/mindfulness-meditation-guided-practices/