Damage from Uncontrolled Chronic Pain

Here is a list of posts (21, through Dec 2016) covering the damage caused by uncontrolled chronic pain, both physical and mental.

While the news is filled with stories of damages from opioid abuse, the damages of pain itself are never mentioned anywhere in the media.

This leaves the public completely ignorant of all the biological damages pain patients suffer if they are not provided effective pain relief quickly.

These are arguments for allowing pain patients access to opioids, showing how important it is to eradicate pain by any means possible as soon as possible.  

What chronic pain does to your brain

What chronic pain does to your brain – ABC News Australia – March 2016 – by Lynne Malcolm and Olivia Willis

At least one in five Australians lives with chronic pain, and often the cause is unknown. Scientists are just now discovering the crucial role the brain plays in how pain is experienced, and how it might pave the way for innovative treatment, write Lynne Malcolm and Olivia Willis.

‘At the moment we have focused our work to two areas in the brain,’ says Dr Sylvia Gustin from Neuroscience Research Australia. ‘One is called the thalamus—the other is the prefrontal cortex.’

Described as the ‘border in the brain’, the thalamus acts as the gateway between the spinal cord and higher brain centres.  

Epigenetic Changes in Post-Surgical vs Chronic Pain

Distinct Sets of Genes are Activated in Post-Surgical and Chronic Pain Conditions– Clincial Pain Advisor – Florence Chaverneff, Ph.D. – December 02, 2016

The locations of epigenetic changes brought on by pain show how long-term pain affects numerous areas of our physical functioning, including:

  1. neurodevelopment,
  2. cell-mediated immune response,
  3. amino acid metabolism,
  4. humoral response (involves substances found in the humors, or body fluids), and
  5. cell cycle.

The dynamic effect of pain on attention

The dynamic effect of pain on attention – Body in Mind – 12/14/16

Pain tends to grab our attention, making it difficult to concentrate on other tasks.

This is generally a useful feature of pain – if we burn ourselves while cooking, it’s good that our attention switches away from the food and towards the pain so that we can adequately protect ourselves.

However, if the pain doesn’t signal threat (e.g. a tension headache) or if it becomes chronic, this could have negative consequences for our ability to concentrate, with no benefit to our safety.

What Happens When Pain Goes Untreated?

What Happens When Pain Goes Untreated? | October 16, 2016

Untreated or under-treated pain is more than uncomfortable. There are profound effects in someone who lives with pain

A 1999 Chinese study of cancer patients showed that, after taking into account the effects of cancer, the more pain someone had, the worse the effects on their health and how they functioned.

Understandably, the relationship between the severity of pain and impairment was nonlinear: patients with no pain or only mild pain were significantly better functioning than those with moderate and severe pain.

Complications of Uncontrolled, Persistent Pain

Complications of Uncontrolled, Persistent Pain | January 28, 2012  

Incurable, persistent pain is truly its own disease regardless of its underlying cause.

Persistent pain, which is also often characterized as chronic or intractable, has all the ramifications of a disease in that it may have pre-clinical and overt phases.

The most unappreciated clinical feature of persistent pain, however, is the plethora of complications that may result — particularly if the pain is constant and unremitting.

Many recent and emerging studies clearly document that persistent pain exerts profound impacts on the body’s endocrine, cardiovascular, immune, neurologic and musculo-skeletal systems.

Chronic Pain Harms The Brain

Chronic Pain Harms The Brain — ScienceDaily | February 6, 2008

People with unrelenting pain don’t only suffer from the non-stop sensation of throbbing pain. They also have trouble sleeping, are often depressed, anxious and even have difficulty making simple decisions.

Researchers found that in a healthy brain all the regions exist in a state of equilibrium. When one region is active, the others quiet down.

But in people with chronic pain, a front region of the cortex mostly associated with emotion “never shuts up,” said Dante Chialvo, lead author and associate research professor of physiology at the Feinberg School. “The areas that are affected fail to deactivate when they should.”

What chronic pain does to your brain

What chronic pain does to your brain – All In The Mind – ABC Radio National (Australian Broadcasting Corporation)

‘At the moment we have focused our work to two areas in the brain,’ says Dr Sylvia Gustin from Neuroscience Research Australia. ‘One is called the thalamus—the other is the prefrontal cortex.’

Described as the ‘border in the brain’, the thalamus acts as the gateway between the spinal cord and higher brain centres.

When you sustain an acute injury there is an opening in the thalamus for information to pass through from the affected body part to the brain.

‘This is very important because then we need to heal, we need to relax, we need to look after ourselves. After an acute injury is healed, we know that this border should actually close.‘

When researching people who experience chronic pain, Gustin identified a key neurological difference: the opening in the thalamus remains open long after acute pain is gone.   

Chronic pain remodels brain region for emotion

Chronic pain remodels brain region for emotion – Futurity | December 22, 2015

Chronic pain remodels a brain region that controls whether we feel happy or sad, as well as addiction, a new study reports.

The scientists have also developed a new treatment strategy that restores this region and dramatically lessens pain symptoms in an animal model.

The new treatment combines two FDA-approved drugs: a Parkinson’s drug, L-dopa, and a non-steroidal anti-inflammatory drug.

The combined drugs target brain circuits in the nucleus accumbens and completely eliminate chronic pain behavior when administered to rodents with chronic pain.

Severe Chronic Pain is a Killer, Literally

Pain-Topics News/Research UPDATES: Severe Chronic Pain is a Killer – Study Finds

Previous research has demonstrated a clearly negative influence of chronic pain on health.

Now, a new study portrays a profound link between severe chronic pain and death; inflicting nearly a 70% greater mortality risk than even cardiovascular disease.

The physiological effects of unrelieved pain

Understanding the physiological effects of unrelieved pain | NursingTimes.net | Sept 2003

This is a lengthy, well-organized, and detailed list of each of the physiological reactions to chronic pain.

A noxious stimulus or pain is a stressor that can threaten homeostasis (a steady physiological state). The adaptive response to such a stress involves physiological changes that, in the initial stages, are useful and are also potentially life-saving.

However, if the stress response is allowed to continue, a variety of harmful effects may ensue that involve multiple systems of the body and are potentially life-threatening.

Sudden, Unexpected Death in Chronic Pain Patients

Sudden, Unexpected Death in Chronic Pain Patients | September 2012

Severe pain, independent of medical therapy, may cause sudden, unexpected death. Cardiac arrest is the cause, and practitioners need to know how to spot a high-risk patient.

Unexpected, sudden death due to severe pain is poorly appreciated, since many observers still view severe pain as a harmless nuisance rather than a potential physiologic calamity.

In many cases, just prior to death, the patient informs their family that they feel more ill than usual and seek relief in their bed or on their couch. Unfortunately, some of these patients don’t awaken. Other patients die, without warning, in their sleep or are found collapsed on the floor

Long-term consequences of chronic pain

Long-term consequences of chronic pain: mounting evidence for pain as a neurological disease and parallels with other chronic disease states. – PubMed – NCBI| Pain Med. 2011 Jul;

Here’s an official PubMed article documenting the damage of chronic pain.

OBJECTIVE: This article reviews the potential physical and psychological consequences of chronic pain and the importance of implementing effective therapeutic strategies to mitigate the harms associated with inadequate treatment.

RESULTS: A review of recent literature examining the neurobiology and pathophysiology of chronic pain reveals that this highly prevalent condition negatively impacts multiple aspects of patient health, including

The Long-Term Effects of Untreated Chronic Pain

The Long-Term Effects of Untreated Chronic Pain – NAIDW iBlogger

Chronic pain, a diagnosis including arthritis, back pain, and recurring migraines,can have a profound effect on a person’s day to day life when it goes untreated.

People dealing with ongoing or long-term pain can become irritable, short-tempered, and impatient, and with good reason. Constant pain raises the focus threshold for basic functioning, which leaves the pained person with a greatly reduced ability to find solutions or workarounds to even relatively mundane problems.

Something like a traffic jam, which most people would be mildly annoyed by but ultimately take in stride, could seriously throw off the rhythm of someone who is putting forth so much effort just to get through the day.

Baffling Chronic Pain Linked to Rewiring of Brain

Baffling Chronic Pain Linked to Rewiring of Brain: Northwestern University News | November 2008

Scientists peered at the brains of people with a baffling chronic pain condition and discovered something surprising. Their brains looked like an inept cable guy had changed the hookups, rewiring the areas related to emotion, pain perception and the temperature of their skin.

The people whose brains were examined have a chronic pain condition called complex regional pain syndrome (CRPS.)

Understanding Chronic Pain as a Disease of the Brain

http://www.medpagetoday.com/resource-center/pain-management/brain/a/38479

Detailed scientific explanation of how chronic pain causes harmful changes in the brain.

The plasticity of the CNS is characterized by functional, structural, and chemical changes in the brain. These changes are associated with activation of the pain matrix in response to chronic pain.

Advances in brain imaging technology reveal that patients with chronic pain have altered pain modulatory circuits as well as structural abnormalities.

Imaging techniques have a promising role to play in the diagnosis of different chronic pain disorders and assessment of responses to current and new therapeutic interventions.

Chronic pain increases Cardiovascular Disease risk

medwireNews – Cardiology – Chronic musculoskeletal pain increases CVD risk

medwireNews: Chronic musculoskeletal pain (CMP) is associated with an increased risk for cardiovascular disease (CVD), researchers have found.

the association could not be explained by reduced physical activity or increased sedentary behavior

Clinically, this study suggests the intriguing implication that CMP may be a modifiable risk factor for CVD.

Chronic Pain Leads to Mood Disorders

Chronic Pain Leads to Concomitant Noradrenergic Impairment and Mood Disorders

Patients suffering chronic pain are at high risk of suffering long-lasting emotional disturbances characterized by persistent low mood and anxiety. We propose that this might be the result of a functional impairment in noradrenergic circuits associated with locus coeruleus (LC) and prefrontal cortex, where emotional and sensorial pain processes overlap.

As expected, nerve injury produced an early and stable decrease in sensorial pain threshold over the testing period

Chronic, Noncancer Pain Boosts Suicide Risk

Chronic, Noncancer Pain Boosts Suicide Risk

Certain types of noncancer pain conditions are associated with an increased risk for suicide, a new study suggests.

psychogenic pain, back pain, and migraine, but not arthritis or neuropathy, were associated with an increased risk for suicide.

As any pain patient, I find the concept of “psychogenic pain” to be unscientific, vague, and insulting to those of us who suffered for years from undiagnosed – not psychogenic – pain.  Dr Ilgen seems to agree in his comments at the end.

Although some of this risk appears to be due to co-occurring mental health problems, there may be something about the experience of pain that also contributes directly to suicide risk,

Watching Pain Become Chronic

Watching Pain Become Chronic | Pain Research Forum

This research suggests it’s critical to suppress inflammation and pain when they first start so that the pain doesn’t become chronic and persist even after the inflammation is gone.  Could part of chronic pain be the body’s chemical exhaustion from fighting recurrent inflammation and pain?

How do acute painful bouts of inflammation progress to chronic, intractable pain? Identifying the molecular basis of that transition—and how to stop the process—is critical to understanding, and treating, many chronic pain conditions.

the transition from acute inflammation to chronic organ damage and pain involves a switch from transient neuroinflammation driven by TRPV1 and TRPA1 channels on sensory neurons to a later, lasting pain state that is impervious to treatment with TRP inhibitors.

The work suggests that in mice subjected to repeated inflammatory insults “there is a transition point” in the molecular mechanisms driving inflammation and pain, Gebhart said. “There are some players that are involved in the beginning …but not after some critical point.”

Opioids Disturb Hormones, but Function Improves

Study Suggests High – Dose Opioids Disturb Hormones Long Term, but Mental and Physiologic Function Improves   April 11, 2013

Notice the high number number of patients (all) reporting significant improvement in quality of life, versus how many also showed hormonal disruption.  The hormonal disruption definitely didn’t affect their quality of life as much as pain did.

Half of patients … had hormonal disturbances or signs of inflammation, while 100% reported improved pain control and mental outlook.

The results present rare data on the effects of opioids beyond 10 years. Most clinical trials that examine opioid use are of short duration, and little is known about long – term outcomes, particularly in patients who suffer from noncancer pain.

The Realities of Painkillers, Addiction and Chronic Conditions

Hillary St. Pierre: The Realities of Painkillers, Addiction and Chronic Conditions

Ms St. Pierre points out that opiate pain medications are a necessary facet of the treatment regimen for painful chronic conditions.  They don’t only relieve the immediate pain, but serve to lessen pain’s stress on the body, allowing better healing to take place.

Yes, biases among health care professionals are very real, and yes, I believe that they do affect treatment.

everybody has their own experiences they use to decide how to treat others

Nobody with severe health problems expects to take massive doses of narcotics. They expect to die or get better, but that doesn’t always happen.

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2 thoughts on “Damage from Uncontrolled Chronic Pain

  1. humanecare

    Thank you for this timely and important post!
    The next thing is to come up with all the disease processes that have pain as a component, as they all seem to have their ears plugged now due to brainwashing –about the word pain!
    Thank you for your tireless research and caring! You are a gem Zyp!

    Liked by 1 person

    Reply

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