Chronic pain is any pain that lasts longer than six months. It can occur anywhere in the body. Chronic pain can range from a mild irritation to a severely debilitating condition.
Chronic pain can affect one’s daily routine and quality of life. It may also be a risk factor for depression, anxiety, or insomnia. Thus, someone who has chronic pain may wish to speak to a therapist, in addition to pursuing other lines of treatment.
WHAT CAUSES CHRONIC PAIN?
Chronic pain often occurs due to a physical health issue. Long-term conditions such as arthritis, cancer, fibromyalgia, and AIDS might all cause chronic pain. Chronic pain can also be caused by:
- Ulcers
- Poor posture
- Repetitive stress injuries (caused by doing the same motion repeatedly)
- Traumatic injuries
- Nerve damage (also called neuropathic pain)
In some cases, chronic pain can have a psychological source. Muscle pain, fatigue, and headaches can be reactions to unexpressed emotions or needs. This unconscious conversion of a mental state into physical symptoms is known as somatization.
People who somaticize feel actual physical pain, not imagined pain. Their symptoms may be severe enough to affect work, relationships, and daily life. Stress and worry resulting from the symptoms tend to cause an individual's condition to worsen. A person with somatic symptoms may wish to see a therapist in addition to a health care provider.
HOW COMMON IS CHRONIC PAIN?
In 2016, 20% of adults in the United States had chronic pain. Around 8% reported high-impact chronic pain that limited at least one major activity in their lives (such as work). Estimates suggest chronic pain costs the U.S. $560 billion each year.
In America, chronic pain is more common among:
- Older adults
- Women
- Non-Hispanic white people*
- Individuals in poverty
- People who are unemployed after previously having a job
- Military veterans*
*Veterans and white people have much higher rates of general chronic pain. However, they show no differences regarding high-impact chronic pain.
CHRONIC PAIN AND MENTAL HEALTH
Chronic pain often goes hand in hand with mental health concerns. Research suggests between 30 to 50% of individuals with chronic pain also have anxiety or depression. Sleep disturbances, grief, and anger issues are also common among people with chronic pain.
Chronic pain syndrome (CPS) describes when chronic pain and a secondary issue feed into each other. For example, the stress and isolation involved with chronic pain can lead to depression. Depression, in turn, can cause a person to ruminate on their pain and become less motivated to pursue treatment. Because some people may manifest depression in the form of physical symptoms along with psychological ones, depression can also result in chronic pain.
Stress in and of itself can increase a person’s pain by:
- Triggering muscle tension and spasms.
- Causing additional health problems such as heart disease.
- Making the nervous system more reactive, thereby amplifying pain signals.
Individuals with CPS often benefit most when they have a holistic treatment plan. They will likely need to treat their emotional concerns and chronic pain simultaneously. Care providers will likely include both physical and mental health professionals.
CHRONIC PAIN AND SUICIDE
Chronic pain is a serious risk factor for suicide. Individuals who cannot access effective treatment for chronic pain may see a large drop in their quality of life. They may believe their pain will never get better and thus feel hopeless for the future.
One study looked at over 123,000 Americans who died from suicide between 2003 to 2014. The data showed 8.8% of people who completed suicide showed evidence of chronic pain. Among the decedents with chronic pain:
- 53.6% used firearms to kill themselves.
- 16.2% died from opioid overdose. (This was four times the rate of opioid-related suicides for people without chronic pain.)
- Back pain was the most common condition (22.6%), followed by cancer (12.5%).
In some cases, chronic pain may have been one of many factors leading to suicide. For example, over half (51.7%) of people with chronic pain had a diagnosed mental health condition. The most common diagnosis, depression, is a big risk factor for suicide. In other words, chronic pain may make people more vulnerable to other suicide triggers.
Yet chronic pain seems to be a significant variable in most cases. The study authors also looked at 95 cases in which a person with chronic pain left a suicide note. Of these 95 notes, 64 of them specifically mentioned pain as a motivating factor.
If you or a loved one are experiencing a crisis, you can call 911 or the National Suicide Prevention Lifeline (1-800-273-8255) for help. After the crisis is over, you may wish to find a therapist. A trained therapist can help you cope with the social and emotional consequences of chronic pain. They can also act as an advocate to help you get the treatment you need. Chronic pain is a challenging issue – you do not have to handle it alone.
References:
- Defining the prevalence of chronic pain in the United States. (2018, September 14). Retrieved from https://nccih.nih.gov/research/results/spotlight/Prevalence-of-Chronic-Pain
- Chronic Pain: Symptoms, Diagnosis, & Treatment. (2011). NIH Medline Plus, 5-6.
- Managing chronic pain: How psychologists can help with pain management. (2013, December 1). Retrieved from http://www.apa.org/helpcenter/pain-management.aspx
- McAllister, M. J. (2016, September 8). Chronic pain syndrome. Retrieved from http://www.instituteforchronicpain.org/understanding-chronic-pain/what-is-chronic-pain/chronic-pain-syndrome
- Petrosky, E., Harpaz, R. Fowler, K. A., Bohm, M. K., Helmick, C. G., Yuan, K., & Betz, C. J. (2018, October 2). Chronic pain among suicide decedents, 2003 to 2014: Findings from the National Violent Death Reporting System. Annals of Internal Medicine, 169(7), 448-455. Retrieved from http://annals.org/aim/fullarticle/2702061
- Rogge, T. (2014, September 2). Somatic Symptom Disorder. Retrieved from http://www.nlm.nih.gov/medlineplus/ency/article/000955.htm
- Smith, K. (2018, February 14). Chronic pain and depression. Retrieved from https://www.psycom.net/depression.central.chronic.pain.html
- What is chronic pain? (n.d.). WebMD. Retrieved from http://www.webmd.com/pain-management/guide/understanding-pain-management-chronic-pain
- Wilson, F. P. (2018, September 11). Suicide notes suggest ‘chilling’ role of chronic pain. Retrieved from https://www.medscape.com/viewarticle/901649
