Chronic pain syndrome

Most people with low back or neck problems can expect to have repeated episodes of mild to moderate discomfort and pain. But for a small number of people, pain becomes a chronic problem that severely affects their quality of life.

In some people with long-lasting pain, biochemical changes are triggered in the body, causing a different type of chronic pain (neuropathic pain) that doctors currently find difficult to diagnose and treat. Pain signals are somehow triggered by the nervous system and continue to fire for months or even years. (It is also possible that certain brain chemicals that suppress pain do not work properly.)

Regardless of the cause, chronic pain affects all aspects of your life, straining relationships and making it difficult to keep up with work and home responsibilities. Common reactions to chronic pain over time include fear, frustration, anger, depression, and anxiety. These feelings can make it increasingly tough to conquer chronic pain, particularly when combined with abuse of alcohol, medications, or illegal drugs to manage symptoms.

Chronic pain often requires both counseling and medical treatment, because it can have a wearing effect on both the body and the mind. Consider seeking treatment at a chronic pain management clinic, where you can get multidisciplinary treatment from a team of specialists, including:

• Physiatrists, who are medical doctors specializing in physical medicine and rehabilitation, and who often coordinate a chronic pain treatment team.
• Psychologists or counselors who teach cognitive-behavioral skills for managing pain, anxiety, and depression.
• Physical therapists, who teach exercises for improving and maintaining strength, function, and mobility.
• Doctors who prescribe pain medication and are skilled in pain management devices and procedures (such as a neurologist, anesthesiologist, physiatrist or physical medicine specialist, internist, family medicine doctor).
• Doctors who prescribe medication for supporting mental health (such as a psychiatrist or family medicine doctor).

Other specialists, such as complementary medicine providers, may also be available in a chronic pain management clinic. These specialists meet to share information and ensure coordinated care.

Some chronic pain clinics have a stronger emphasis on invasive treatment, such as injections and surgical procedures, than others. Look for a clinic that offers you a choice of noninvasive treatments, including cognitive-behavioral therapy. Before having an invasive pain treatment, ask your doctor about research that shows how effective it is for your condition and his or her experience with that treatment.