What is Chronic Pain Syndrome? Symptoms, Causes and Treatment

Chronic Pain Syndrome is a condition characterized by persistent pain lasting more than 12 weeks. Pain will always make itself felt. The pain can be burning as well as dull. 

Pain can also severely restrict movement. 

Pain is usually a protective function of the body and helps prevent damage to the body. Sometimes, pain loses its protective function and greatly impairs the quality of life. Then it becomes chronic. Chronic pain syndrome symptoms can include:

• persistent or recurring pain
• fatigue
• insomnia
• difficulty concentrating
• anxiety, and depression

The causes of chronic pain syndrome can vary. And they can consist of previous injuries and medical conditions. Chronic pain syndrome treatment can include a combination of approaches, including:

• medication
• physical therapy
• relaxation techniques
• psychological support

In some cases, a multidisciplinary team approach can be necessary to manage it. The goal of treatment is to help manage pain, improve function, and enhance well-being. Read below in our article on what is chronic pain syndrome.

 

What is Chronic Pain Syndrome?

Chronic pain is pain that persists or recurs for over three months. Chronic pain accompanies a pathological process or post-traumatic condition. It develops in the human body over a long period. This pain can last from several months to many years. 

Unlike acute pain, it is monotonous, debilitating, and often diffuse. It can affect a large area of the body. For example, pain in the back, head, neck, legs, or arms can coincide. 

And patients suffering from this syndrome complain that “everything hurts.” The IASP defines it as an unpleasant sensory and emotional experience. They associate it with actual or potential tissue damage or a description of such damage.

Lots of people think that chronic pain disorder represents the disease itself. Environmental and psychological factors can exacerbate the pain. Chronic pain persists longer than acute pain. Ans it is resistant to most medical prescriptions. 

Typically, chronic pain creates serious problems for the patient. A person can have two or more concurrent chronic pain syndromes. Such syndromes can include:

• chronic fatigue syndrome;
• endometriosis;
• fibromyalgia;
• inflammatory bowel disease;
• interstitial cystitis;
• temporomandibular joint dysfunction. 

These syndromes can share a common cause. Chronic pain syndrome significantly worsens the quality of life. As it leads to serious disorders, from appetite impairment to long-term depression.

 

Chronic Pain Syndrome Symptoms

Chronic pain symptoms include:

• Chronic fatigue
• Persistent musculoskeletal pain
• Joint pain and stiffness 
• Headaches, migraines  
• Burning, tingling, or numbness in the extremities 
• Difficulty sleeping 
• Poor concentration and memory

Pain can be dull, sharp, burning, aching, or shooting. It can occur in different body parts, such as the back, neck, joints, or muscles. Also, people with chronic pain syndrome can experience a variety of symptoms. They can significantly affect their quality of life.

Professor Robert Gatchell was one of the first scientists in this field. It is a psychologist at the University of Texas. He investigated the transition process from acute to chronic pain from:

• a psychological;
• sociocultural perspective. 

The researcher distinguished three stages of chronic pain syndrome symptoms transition:

• The first stage of chronic pain leads to emotional reactions, such as:

– fear;

– anxiety;

– worry.

Pain is usually perceived as a harmful factor. A person reacts to it as a threat to the body. If chronic pain persists for 2-4 months, it transitions to stage 2. This transition can act as a factor preventing the person from recovering.

• In the second stage, stress and depression join the main symptoms resulting from pain. The person is afraid of becoming helpless and becomes irritable. Moreover, a person can have depression before the onset of chronic pain disorder. They can face economic problems. And let’s say due to job loss, depressive symptoms increase significantly. 
• We should consider the third stage as the patient’s final acceptance of the role of the patient. The person strives to reduce social tasks and perceives themself as disabled. Thus, it limits social contact. At the same time, psychological problems affect the person’s perception of pain:

           – the pain threshold is lower;

           – the pain increases.

Chronic pain can affect the digestive system. So there are other chronic pain syndrome symptoms. It leads to decreased appetite, weight loss, and malnutrition. Also, some people can experience nausea and vomiting. Other gastrointestinal symptoms related to pain are also not uncommon.

Finally, sexual dysfunction is a common chronic pain syndrome symptom. Chronic pain can affect sexual function, leading to:

• decreased libido;
• erectile dysfunction;
• pain during sexual activity. 

It can have a significant impact on relationships and self-esteem. It’s important to note that the symptoms of chronic pain syndrome can vary from person to person. Some individuals can experience extra or different symptoms.

 

Causes of Chronic Pain

Various factors and pathologies can cause chronic pain. It is often associated with:

• disorders of the central nervous system;
• somatic diseases;
• psycho-emotional disorders.

At the same time, it is not uncommon for it to be an independent disease. Clinical manifestations of depression are a frequent companion of chronic pain:

• insomnia;
• rapid fatigue;
• difficulty concentrating;
• a feeling of hopelessness.

The causes of chronic pain can also be perceptual disorders caused by:

• severe stress;
• surgery and trauma;
• strokes, or heart attacks.

Another common cause is clinical depression, in which pain appears as a distraction. They appear after the trauma of a psychological nature. And gradually, it becomes another factor aggravating the patient’s condition.  

Also, any damage to any part of the nervous system can cause chronic pain disorder. This usually occurs as a result of trauma or inflammation. Altered receptors or pathways begin to send impulses to the brain without stopping. This results in a permanent focal point of excitation there.

 

How is Chronic Pain Diagnosed?

Most often, neurologists use radiography or MRI. But at present, there are no objective methods of measuring pain or the intensity of pain. Also, it is quite difficult to find methods of visualizing pain manifestations. 

Thus, pain assessment has a subjective character. Doctors base it on:

• the description of pain;
• the description of its characteristics by the patient. 

A detailed description of chronic pain syndrome allows for determining the cause of pain manifestations. Still, it is real to determine the morphological source of pain by:

• instrumental methods;
• objective methods of investigation.

First, these include:

• EMG and ENMG allow us to determine impulse conduction along the nerve fibers and muscle. And in this way, doctors can detect the presence of nerve fiber damage.
• MRI. The most advanced method of neuroimaging allows for detailed tissue imaging.
• Radiography provides an image of bone tissues. And it is most often used in diagnosing trauma.
• Ultrasound allows you to determine changes in the soft tissues of blood vessels.
• Laboratory tests can determine the presence of inflammatory processes in chronic pain disorder.

The physical examination reveals the clinical manifestations of diseases. It includes the determination of neurological status. Accordingly, the doctor determines the following indicators: 

• the state of reflex functions;
• sensitivity;
• coordination of movements;
• balance.

 

Risk Factors for Chronic Pain Syndrome

One of the primary risk factors for chronic pain syndrome is a history of injury or trauma. People who have experienced physical trauma prone to develop chronic pain. Especially if it is:

• automobile accidents;
• occupational injuries. 

Also, the following people can have an increased risk of developing chronic pain syndrome:

• People who have undergone surgery;
• People doing medical procedures.

Other risk factors for  developing chronic pain syndrome include medical conditions such as:

• arthritis;
• fibromyalgia;
• inflammatory bowel disease. 

Mental illnesses can also increase the risk of developing chronic pain syndrome, such as:

• depression;
• anxiety;

Post-traumatic stress disorder. Also, lifestyle factors can increase the risk of this condition, such as:

• lack of exercise;
• improper diet;
• stress.

So, we strongly recommend a healthy lifestyle. It really does affect the quality of your life. So you can significantly reduce risk factors for chronic pain syndrome. Many neurologists say that a healthy diet can help prevent problems. 

You can also try to do an annual health checkup. It greatly reduces the risk of many neurological disorders. It’s much easier and cheaper to prevent disease than to treat it.

 

Chronic Pain Syndrome Treatment 

NSAIDs and analgesics (including opioids) are most commonly prescribed for pain treatment. NSAIDs reduce inflammation and thereby reduce pain. It works especially when the pain is due to inflammation (e.g., arthritis). 

Scientists have been working on a drug for years. They wanted it to have the same effect as morphine. But they didn’t want a lot of negative side effects. You can also use ointments containing both NSAIDs and substances such as capsaicin.

Massage therapy is a good option for chronic pain syndrome treatment. It can reduce back pain and restore the mobility of motor segments. The nonsteroidal anti-inflammatory drugs act by blocking two enzymes:

• cyclooxygenase-1;
• cyclooxygenase-2. 

They take active participation in the synthesis of hormones called prostaglandins. These hormones are responsible for inflammation, fever, and pain. The new COX-2 inhibitors mainly block cyclooxygenase-2. 

They also have fewer gastrointestinal side effects than NSAIDs. However, you should not take this chronic pain syndrome treatment for long periods. Because there is some evidence that they increase the risk of a heart attack. Read below for more about all options for chronic pain syndrome treatment. Although you have to take any medications only by doctor’s prescription.

Anticonvulsants

This group of drugs is mainly designed to treat epilepsy and seizures. But it is effective for some pain syndromes (such as trigeminal neuritis). These are drugs such as carbamazepine or gabapentin. The use of gabapentin is also possible for neuropathic pain.

Antidepressants

They are quite often prescribed to treat chronic pain syndrome. Doctors do it in the same way as tranquilizers or neuroleptics. The effect of these medications is due to their effect on the central mechanisms of pain. In addition, tranquilizers (benzodiazepines) have a relaxant effect and reduce muscle spasms.

Myorelaxants 

Mydocalm, sardalud, baclofen have a certain analgesic effect in the presence of muscle spasm.

Migraine medications 

They include triptans. Doctors use sumatriptan, sumatriptan, and zolmitriptan specifically to treat migraine. They can have serious side effects in some people. 

Physical therapy

There are quite a few different methods of this therapy for chronic pain disorder. They allow you to reduce pain and relieve inflammation in various tissues or joints. Among the modern methods are widespread, such as:

• Percutaneous electroneurostimulation;
• Laser therapy. Doctors use both low-intensity and high-energy, such as HILT.

Spinal cord stimulation 

Doctors perform this chronic pain syndrome treatment in some cases. Electrodes are surgically inserted into the epidural space. The physicians then apply an electrical impulse using an electronic device. The neurologist places it on the patient’s body.

Brain stimulation 

It is rarely used by neurologists and usually involves stimulation of the thalamus. Brain simulation is used for several conditions, such as central pain syndrome, cancer pain, and phantom pain.

Therapeutic Physical Therapy

It has been proven that there is a clear link between chronic back pain and tight, weak muscles. In such cases, even moderate physical activity can improve muscle circulation.

It also helps to reduce pain. Physical exercise also increases the production of substances such as endorphins. This chronic pain syndrome treatment has analgesic properties.

 

A Word from Our Lone Star Clinic Neurologists 

At our Lone Star Neurology clinic, any patient can get the most effective treatment. An experienced neurosurgeon and related specialists will do everything possible to treat chronic pain syndrome. 

Modern equipment of the center, comfortable conditions for diagnosis and rehabilitation, as well as competent and attentive medical staff, contribute to your speedy recovery. So do not hesitate to contact us for any help.

 

FAQs 

• Can severe pain cause illness?

Severe pain is not a disease. But it can lead to physical and psychological symptoms. And they will affect a person’s health and well-being. Chronic pain, in particular, can adversely affect physical activity, sleep, and mental health. It can increase the risk of developing other health conditions.

• Is chronic pain syndrome a mental disorder?

Chronic pain syndrome (CPS) is not a mental disorder. But it can affect a person’s mental health. People with CPS often have psychological symptoms such as depression, anxiety, irritability, and social isolation.

• Which signs are related to chronic pain?

Autonomic disorders often accompany chronic pain (e.g., fatigue, sleep disorders, decreased appetite, impaired taste, decreased body weight, libido, constipation), which develop gradually.

• What does chronic pain do to a person?

Physically, chronic pain can cause fatigue, decreased mobility, decreased appetite, and sleep disturbances. These symptoms can lead to decreased physical activity, weight gain, or loss. They also contribute to an increased risk of other diseases, such as heart disease.”