Inside Chronic Pain:

The Good, the Bad, and the Ugly

 P ain can be hard to define as it is subjective and unique unto the person suffering with it.  In clinical practice, we hear, “I have a high pain tolerance.”  That patient may be right.  Given a similar diagnosis, the pain that he or she experiences may be different than the next person.  They may feel more or less pain than others.  This is normal, after all, because we are all made wonderfully and uniquely different.

However, we can use lots of terms to give an idea as to how pain feels, such as burning, stabbing, grinding, piercing, and throbbing.  These are helpful, but no one else truly knows what your pain feels like.  Take it a step further and think of a pain you had in the past.  You might recall that, “it hurt really bad.”  But, over time, it may be hard for you to remember just how bad you felt.  (Mothers help me out here.  If you had the capacity to remember the severity of labor pains, many of you would refuse to have any more children).

But what about when the pain doesn’t go away … ever?  This type of condition is called “chronic pain.”  How is it different from normal pain?  Good question.  In general terms, chronic pain is a pain that persists longer than six weeks.  Nothing magical happens once the pain has been there for six weeks, it just gives health care providers a better way to categorize the pain.  In an attempt to quantify pain and make it generally more universal, health care providers use what is called an analog scale for pain.  It is a number assignment for pain.  Zero is equivalent to no pain while ten would be the most severe pain imagined.  For example, a patient may arrive to a clinic with pain of five on a scale of ten.  If after treatment, pain is reduced to less than five, then, we have done a good job.  Sufferers of chronic pain have often lost the ability to use this scale correctly.  In order for the scale to work, one must have a realistic reference of “no pain.”  If someone has had pain for so long that they can no longer remember what it was like to be without pain, the whole scale seems to shift to the right, meaning that the new normal would be greater than zero.  When this happens, the scale loses some of its usefulness.  It does let the health care provider know, however, that the pain sufferer may need help in shifting the scale back to a normal reference.  This is called breaking the pain cycle. 

There are many methods to aid in controlling pain and breaking the pain cycle.  Medications can be helpful and are often necessary, but can be costly, toxic, have unwanted side effects, and can become addictive.  Acupuncture can also be used to better control pain by stimulating the release of certain hormones and neurotransmitters that help alleviate pain, but it doesn’t treat the source of the pain.  Covering up the symptoms only means that the pain will be revisited later.  Physical therapy can help with inflammation, weakness, and muscle imbalance, which are often the causes of the pain.  In order for physical therapy to be a true success for people with chronic pain, pain management doctors and physical therapists must coordinate and collaborate with each other.

For instance, the doctor may prescribe medications that enable the patient to better tolerate physical therapy intervention.  There may be injections or procedures that the doctor may implement to better control the pain symptoms.  Nonetheless, it is important to understand that anything that covers the pain is helpful, but will only buy time.  Correcting the cause of the pain is the only long-term fix.

Unfortunately, there are times when a condition or an injury is so severe that a person will never be without pain.  In these scenarios, the pain management team — often consisting of physicians, physical therapists, occupational therapists, psychologists, patients, and their families — have to work together to create the best strategy for tackling the pain. 

Chronic pain is ugly.  It is real.  And it requires the help and support of many.  It is only together that we can have the greatest effect!

In good health,
Daniel M. Lent-Koop, MPT, CHT

About Dan

Physical therapist, Daniel M. Lent-Koop, MPT, CHT, is highly experienced in managing high-volume clinics with the direction of support staff to include PT's, PTA's, OT's, COTA's, PT technicians and front office reception. Daniel, a California native, is proficient in both English and Spanish evaluation and treatment of orthopedic and neurologic diagnoses, which include pain syndromes, musculoskeletal disorders, peripheral compression, cerebrovascular accident and post-operative rehabilitation.

Daniel, who is also a trained clinical instructor under IACCC guidelines, became a certified state licensed physical therapist in 1996 and a certified hand therapist in 2006.  He’s also a certified strength and conditioning specialist, and member of the American Medical Athletic Association.Daniel, who spearheads Orleans Park Rehabilitation Services, in Hattiesburg, Miss., earned a Bachelor of Science degree with honors in physical therapy from the California Lutheran University in 1994, and a master’s degree from the University of Southern California in 1996.  Daniel said his greatest achievement, however, is “becoming a husband and father of four beautiful children.”  Besides his family and physical therapy, Daniel’s other loves include Jesus, USC football and surfing.

Need advice from Physical therapist Daniel M. Lent-Koop?   Submit your question using the Ask Dan Submission Form . Entries may be edited for clarity or space.

Disclaimer

Chinika.com’s  "Ask Dan" segment, updated bi-monthly, does not constitute medical and/or legal advice.  All materials and resources (“content”) presented on this Web site (the “site’’) are provided for informational purposes only.  The content is not intended for to be a substitute for “in person”  professional medical advice, diagnosis or treatment. Always seek the advice of your physician, or mental health provider or other qualified health providers with any questions you may have regarding a medical or psychological condition. Never delay seeking professional treatment or advice because of anything you may have read on this site!  If you think you may have a medical emergency, call your doctor or the emergency telephone operator (in the United States Dial 911) immediately. 

While chinika.com encourages your questions, please understand that you are not entering into a doctor and patient relationship with Daniel M. Lent-Koop, MPT, CHT.  A doctor and patient relationship is only entered upon when a person has a face-to-face meeting with Daniel M. Lent-Koop.  Any persons participating in the "Ask Dan" segment agrees to hold harmless chinika.com or Daniel M. Lent-Koop from any claims resulting from the use of his advice or any other circumstances and/or which damages the participant or any other party.

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