Pain Disorder - Causes and Effects

Pain Disorder - Causes and Effects

Psychogenic pain exists when no nociceptive or neuropathic mechanism can be identified, and there are sufficient psychological symptoms to establish criteria for a painful somatoform disorder, depression, or other diagnosis associated with a DSM-V classification commonly associated with complaints of pain. Pain is a defense response of the body, but it can also work in a wrong or exaggerated way, characterizing a disease as chronic pain. When the brain interprets that the pain is not being "solved" it becomes even more "sensitive" to the pain stimuli, catching them more intensely. The recruitment of another nervous system called autonomic makes the pain even more "rooted" and difficult to solve. The pain system can also become ill, generating chronic pain. 

Generally women are more susceptible to chronic pain due to their genetics and hormones. For example, the use of high heels, menopause, and the lack of protective hormones in the bones, as well as during pregnancy - where the spine undergoes changes in its axis - are factors of the woman that provide the pain. The main chronic pain is headache, followed by pain in the spine. For example, 75% of people will experience a "locking" in the lumbar spine at least once in their life, while about 38% will develop some type of spinal pain during their lifetime. These two pains correspond to most pains, followed by joint pains. 

It has not yet been proven why these regions are most affected but it is believed that, in regards to headache, hormonal factors are the main related factors, while in the column genetic and postural factors would be the most important ones. It is important to treat chronic pain, since it can lead to a drop in quality of life, discouragement - the person does not want to leave because of the pain, nor has the spirit to perform any activity - depression, irritability (even generating a problem of coexistence with family and friends), low productivity at work, and other factors.

     The main treatments for any type of pain are based on: 

  1. Physical-oriented exercises: Movement is one of the best remedies for pain. The release of endorphins and joint and bone movement generate an analgesic effect in the brain. 

  2. Muscle strengthening: Strengthening muscles will protect bone structures, such as the spine and knees, for example by decreasing and avoiding pain. However, this strengthening has to be guided by a professional in the area, especially for those who already have been experiencing pain.

  3. Analgesic physiotherapy: It is used in acute pain by a professional in the area. Techniques include ultrasound, laser, elongation, and transcutaneous electrical nerve stimulation.

  4. Medications: Medications are used in some cases of pain, with each disease presenting specific types of drug treatments to be evaluated by the physician. Self-medication as well as prolonged use may leave the pain chronic, and is not an advisable practice.

  5. Pain blocking: This procedure is done through a guided needle and local anesthetic, placing the medication in the region affected by the pain. We use, for example, the spine or sciatic nerve in cases of herniated disc. 

  6.  Radiofrequency: A needle is introduced into the region reaching the affected nerves, which will be treated by the radiofrequency method, which is nothing more than a type of energy that causes the nerve to interrupt the message of pain sent to the brain. 

  7. Surgery: In specific cases, surgical interventions are performed with conventional or minimally invasive techniques. These cases usually encompass some types of pain, such as herniated disc that has not been resolved with clinical steps, blockages and radiofrequency.

References:

https://mhnpc.com/2021/08/24/what-is-a-pain-disorder/

https://www.webmd.com/pain-management/guide/pain-management-treatment-overview

https://my.clevelandclinic.org/health/diseases/4798-chronic-pain 

https://www.verywellhealth.com/what-is-psychogenic-pain-2564617

https://health.clevelandclinic.org/women-are-more-likely-to-have-chronic-pain-heres-why/

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