Overview

Pain is your body's normal reaction to an injury or illness, a warning that something is wrong. When your body heals, you usually stop hurting.

But for many people, pain continues long after its cause is gone. When it lasts for 3 to 6 months or more, it's called chronic pain. When you hurt day after day, it can take a toll on your emotional and physical health.

About 25% of people with chronic pain will go on to have a condition called chronic pain syndrome (CPS). That's when people have symptoms beyond pain alone, like depression and anxiety, which interfere with their daily lives.

CPS can be hard to treat, but it's not impossible. A mix of treatments like counseling, physical therapy, and relaxation techniques can help relieve your pain and the other symptoms that come with it.

Diagnosis

There is no way to tell how much pain a person has. No test can measure the intensity of pain, no imaging device can show pain, and no instrument can locate pain precisely. Sometimes, as in the case of headaches, physicians find that the best aid to diagnosis is the patient's own description of the type, duration, and location of pain. Defining pain as sharp or dull, constant or intermittent, burning or aching may give the best clues to the cause of pain. These descriptions are part of what is called the pain history, taken by the physician during the preliminary examination of a patient with pain.

Physicians, however, do have a number of technologies they use to find the cause of pain. Primarily these include:

Electrodiagnostic procedures

Electrodiagnostic procedures include electromyography (EMG), nerve conduction studies, and evoked potential (EP) studies. Information from EMG can help physicians tell precisely which muscles or nerves are affected by weakness or pain. Thin needles are inserted in muscles and a physician can see or listen to electrical signals displayed on an EMG machine. With nerve conduction studies the doctor uses two sets of electrodes (similar to those used during an electrocardiogram) that are placed on the skin over the muscles. The first set gives the patient a mild shock that stimulates the nerve that runs to that muscle. The second set of electrodes is used to make a recording of the nerve's electrical signals, and from this information the doctor can determine if there is nerve damage. EP tests also involve two sets of electrodes-one set for stimulating a nerve (these electrodes are attached to a limb) and another set on the scalp for recording the speed of nerve signal transmission to the brain.

Imaging

Imaging, especially magnetic resonance imaging or MRI, provides physicians with pictures of the body's structures and tissues. MRI uses magnetic fields and radio waves to differentiate between healthy and diseased tissue.

A neurological examination

A neurological examination in which the physician tests movement, reflexes, sensation, balance, and coordination.

X-rays

X-rays produce pictures of the body's structures, such as bones and joints.

Treatment

Medications, acupuncture, local electrical stimulation, and brain stimulation, as well as surgery, are some treatments for chronic pain. Some physicians use placebos, which in some cases has resulted in a lessening or elimination of pain. Psychotherapy, relaxation and medication therapies, biofeedback, and behavior modification may also be employed to treat chronic pain.


 
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