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Chronic Pain

Traditional Chinese Medicine (TCM)General PracticeOrthopaedics

According to the World Health Organisation (WHO) and the International Association for the Study of Pain (IASP) one in every 5 adults will have chronic pain.^[1]A local study conducted using phone interviews found that over 30% of participants reported symptoms of chronic pain.^[2]

Symptoms

Chronic pain is pain that has recurred repeatedly or persisted for over three months.^[1]

For those with chronic pain symptoms can include：

Consistent pain: sharp, heavy or burning and may be localized in one area or even affect the entire body
Sore muscles, joint pain
Exhaustion, insomnia, depression, anxiety and more
Pain affecting day-to-day life

Causes and Risk factors

There are a lot of causes for chronic pain including:

Previous injury, for example: bone fractures, sprained muscles or soft tissue damage and more
Problems due to inflammation or neurological issues
Other conditions such as osteoporosis, arthritis, or odontalgia

Risk factors for chronic pain can include:

Age
Sex (Women have a slightly higher tendency to develop chronic pain symptoms)
Genetic factors
Unhealthy lifestyle, persistent drinking, smoking or lack of exercise
Job type, work environment or conditions

A diagnosis of chronic pain is not definitive with these risk factors, but they can increase the chances to develop chronic pain.

Diagnosis

During the consultation, a thorough history will be collected, key questions such as when the pain started, the duration of the pain, severity and impact it has had on the patients day to day life. They may also perform the following test:

Physical examination
Imaging such as X-ray, MRI, CT scans could also be used to help identify the source of the chronic pain
If required the doctor may also order additional tests, such as a compression test, blood test to help further solidify a diagnosis

Treatment

The symptoms and severity of chronic pain differ between each patient, as such their prognosis will be tailored for each individual. Especially for those whose pain originate in muscles, nerves, blood vessels and more, the patient history combined with results from testing will be used to help individualise treatment plans to best soothe chronic pain. Treatment options could include medications, invasive procedures, physiotherapy or combined treatment with Chinese medicine.

Treatments with Chinese medicine will vary based on the type of pain, position, scope, cause and other accompanying symptoms such as the impact on mental health. They can include the use of Chinese herbal medication, acupuncture, tui na, cupping, moxibustion and more.

An important thing to note is that treatment is most effective when individualized to each patient, therefore and individual assessment will be needed to formulate a treatment plan. Patients can also help raise the effectiveness of treatment by altering their own lifestyle choices, such as losing weight, reducing stress, and increasing exercise. These changes even without medical intervention may also help soothe symptoms.

Impact of chronic pain

Patients with chronic pain can be impacted in several ways including:

Biological effects can include changes to the immune system, nervous system and endocrine system. These could cause increased pain, dyssomnia, appetite loss, exhaustion and more.
Psychological changes that could lead to anxiety, depression or mood swings.
Day-to-day life could also be affected such as work, family and even social events
Long-term treatment and medications can also impact the patient or their family’s economical situation.

The earlier the diagnosis, the earlier the treatment plan can be formulated and carried out, this will help with minimizing the impact of chronic pain elevating quality of life.

Prevention

Chronic pain is complicated and caused by numerous different factors, therefore preventative measures must be taken from multiple perspectives.

Doing warm ups before exercise and maintaining a good posture can help reduce risk of injury leading to chronic pain
Maintaining a healthy body weight ( Obesity can further add to the risk of developing chronic pain)
Curative treatment: if you have pain from other conditions eliminating that pain could prevent its development into a chronic condition.
Reducing stress can directly reduce pain, methods such as exercise, meditation and yoga can be beneficial
Healthy lifestyle, balanced diet, good amount of sleep, quitting smoking and reducing alcohol can all play a major role minimizing risk

In conclusion, following the advice above can lower the risk of chronic pain. Prevention of chronic pain requires a complex plan of action with each patient being unique, therefore each patient must consider their own health in using preventative measures.

Frequently Asked Questions

If the doctor doesn’t find the root cause of your chronic pain, perhaps you could start light exercise as it would be unlikely to cause further damage. During your exercise make sure you’ve properly warmed up beforehand. You could also always ask your doctor or physiotherapist for additional tips.

Patients with chronic pain typically find traditional treatments such as physical therapy, medication or other invasive procedures to be inadequate for their desired outcome. However Chinese medicine techniques such as acupuncture have shown to effective put pain into remission. Cognitive Behavioural Therapy (CBT) and combined therapeutic techniques can also increase bodily functions, mental health and overall quality of life. Even though the efficacy of pain management treatment is not guaranteed, maintaining a positive attitude towards treatment and the condition itself can be hugely beneficial.Beyond medical or psychological treatment simple things such as learning coping strategies to adapting activities and lifestyle changes can immensely improve chronic pain.

Because the cause of each patient’s chronic pain is different, their response to each treatment will also be different. Seeking advice from the right specialist can help pinpoint each individual’s appropriate treatment plan, such as involving acupuncture to ensure a positive therapeutic result.