Pain, according to the International Association for the Study of Pain, is defined as an unpleasant physical or emotional feeling associated with actual or potential tissue damage. Pain is a subjective phenomenon in the sense that each person experiences and describes it in a completely different way and consequently changes its response. It is understood that pain is a complex and multifactorial symptom indicative of underlying diseases or imminent biological risks.
The duration of pain can categorize it into Acute and Chronic. Chronic Pain is characterized as pain, which persists for more than three months. Other researchers describe the pain as chronic when it does not meet the usual treatment regimens.
In cases of acute pain, sufferers respond with avoidance and withdrawal actions designed to protect the human body, while in cases of chronic pain, these protective mechanisms are either not observed or under-functioning. Chronic pain is gradually incorporated into the daily life of patients and ceases to be a sign of dysfunction. It is also understood that the presence of chronic pain affects the daily life of patients and has a profound impact on their psychology and social activities. It is particularly important to clarify that chronic pain is not only a symptom of the progression of a disease, but is itself a development of a disease.
Mechanism of Chronic Pain
The human brain, when it senses pain, reacts in a multidimensional way. It can, for example, mobilize the muscular system to make moves to avoid the stimulus that caused the pain. Another reaction of the brain may be to modify the intensity of pain through specialized nerve signals.
In particular, in the case of Chronic Pain, the human body forms new neural synapses so that it can respond to pain, while at the same time a large number of nerve cells may be destroyed. In this way we realize that the nervous system is not static but is changing and adapting to new situations. This ability of the nervous system allows the pain to become chronic and thus develop into an autonomous disease.
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Factors Affecting Chronic Pain
It has been mentioned above that chronic pain does not serve any protective biological function. It is also a condition in which a number of psychological, environmental and other factors (such as individual characteristics) contribute. These factors modulate a person’s response to a painful stimulus. Similarly, areas of the brain involved in the perception and processing of painful stimuli appear to operate in synergy rather than in isolation.
Scientific research has linked a number of genes to pain sensitivity. Indeed, the same genes may also affect the different personality traits of a person that make them vulnerable to pain. Other conditions such as depression, or increased anxiety have also been linked to genetic polymorphisms in the serotonin pathway genes and thus to the risk of developing chronic pain. These gene pathways are associated with “endophenotypes” or intermediate phenotypes present in patients with chronic pain. These phenotypes include sleep disturbances, malnutrition, altered pain management, and anxiety. In addition, individual personality traits such as physical awareness, anxiety and depression are associated with genetic diversity in the serotonin pathway and are thus associated with the risk of chronic pain.
The effects of Chronic Pain on the patient
World Health Organization (WHO) defines Health as a “state of complete physical, mental and social well-being and not merely a state of absence of illness or disability”. It is thus understood that chronic pain affects one’s life in a way that directly affects the physical, emotional well-being and social aspects of one’s daily life.
Unaffected by chronic pain, family relationships cannot be left behind. In particular, there are disturbances in the relationships of family members, which can, at a later stage, lead to a redistribution of roles and responsibilities, emotional fluctuations and feelings of fatigue. Also, in the event that pain affects the work status of the sufferer, financial problems and additional stress can arise with regard to family living.
Chronic pain has been associated with problems in concentration, sleep disorders, fatigue, severe emotional fluctuations, increased blood pressure and irritability. These characteristics often reduce one’s self-esteem. Research in European patients with chronic pain states that over 40% of participants feel unable to think clearly and function normally because of the pain they experience. 1/3 of the participating patients also describe the intensity of the pain as intolerable. These findings make clear the association between chronic pain and its effects with traits of anxiety disorders, such as depression.
Classic Therapeutic Approaches to Chronic Pain
The classic approach to treating Chronic Pain often involves an aggressive first treatment aimed at preventing patient awareness and at a later stage in the development of chronic pain. Medication and / or psychological or behavioral support is used at this stage.
Medication may include analgesics such as non-steroidal anti-inflammatory drugs, opioids and adjunctive analgesics (antidepressants, anticonvulsants). Complementary analgesic drugs are usually used in cases of neuropathic pain. In cases of more severe or chronic pain that impair the functioning of the individual, opioid analgesics are used. These substances bind to specific receptors of the central nervous system. However, this option often has side effects as there is always the risk of addiction to these drugs and their subsequent overuse.
Cell Level Disorders and Their Impact on Chronic Pain
Malnutrition and the consequent deficiencies of vitamins, minerals and trace elements be one of the causes of the pain? The answer to this question is affirmative. The modern diet that prevails in the Western world causes a number of micronutrient deficiencies and is subsequently responsible for the emergence of diseases such as cardiac disease, diabetes, arthritis, fibromyalgia and obesity. The reason is that western-style diets are often based on processed foods, which lack the essential micronutrients. The long absence of these valuable ingredients leads to deregulation of metabolic pathways and the development and emergence of diseases, including Chronic Pain. The main micronutrients systemically deficient in Chronic Pain patients are Vitamin D, Complex B vitamins, magnesium, vitamin E, amino acids, Omega-3 fatty acids, and calcium.
A number of scientific studies have shown that patients with Chronic Pain often develop hormonal disorders. For example, cortisol levels in patients with chronic pain are often higher than normal. Also, opioid analgesics used as a treatment can reduce the levels of hormones with important functions in the human body, such as progesterone, cortisol, pregnenolone and dehydroepiandrosterone (DHEA). Scientific research has also linked estrogen deficiency in women to the development of osteoarthritis.
The Cellular Therapeutic Approach
There are often many factors that need to be addressed such as nutritional deficiencies, stress, poor immune function and hormonal imbalance. That is why there are natural remedies that address the chronic condition by boosting the immune system, reducing inflammation and correcting nutrient deficiencies that can worsen the condition. Possible natural remedies depend on individual needs. The best course of action, is to understand and examine the body to identify possible causes and address them through nutritional, natural hormonal rehabilitation and complementary support.
Targeted correction of hormonal and metabolic disorders can be an important tool in the physical treatment of Chronic Pain. The clinical context that encompasses the factors of Nutrition and lifestyle changes while correcting the effects of the environment on the development of this chronic condition is the modern medical reality. By understanding the causes at the Cellular level through specialized diagnostic tests, the physician can along with the patient perform all those actions to correct the cause of the disease. After all, we should not forget that Chronic Pain is initially a symptom of other underlying diseases and that its treatment includes, as is reasonable, the treatment of these diseases.
Dr. Nikoleta Koini, M.D.
Doctor of Functional, Preventive, Anti-ageing and Restorative Medicine
Diplomate and Board Certified in Anti-aging, Preventive, Functional and Regenerative Medicine from A4M (American Academy in Antiaging Medicine).
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