Minor Ache or Something More? Identifying & Treating Chronic Pain

Whether a stubbed toe or a broken bone, pain is a normal part of life. It’s our body’s way of telling us that something is not right. Pain can be quick to come and go or last a long time.

But how long is too long? When does it become chronic pain? To answer that, you need to know the difference between the two types of pain: acute and chronic.

Acute Pain vs. Chronic Pain

Acute pain is your body’s response to an injury. It’s the immediate pain response when you burn your hand, cut your finger, or break a bone.  This type of pain typically lasts less than three months, and goes away when the injury heals.

Chronic pain is a longer-lasting pain that persists well after an injury or illness has healed fully. It can also be caused by a medical condition such as arthritis, cancer or fibromyalgia, but it may not have an obvious cause at all. Chronic pain happens as a result of a change in the nervous system that makes it more sensitive to pain. A doctor will usually diagnose any pain that has lasted for over 6 months with no relief as chronic. While your doctor may prescribe medication or therapy to help you manage, the pain does not fully go away.

How Is Chronic Pain Diagnosed?

Chronic pain is very difficult to diagnose because the symptoms can mimic other illnesses. A diagnosis can take months while your doctor tries to figure out the exact cause, and rule out anything else. Here is what you can expect from your doctor during the diagnostic process:

• Assessing the level of pain: The first thing your doctor will do is ask you to rate your pain on a scale of 1 to 10. You will also be asked about the type of pain (sharp, dull, burning, tingling, etc.). You will also discuss when the pain started, what triggered it, and what makes it worse or better.

• Mental health assessment: Chronic pain and depression can go hand in hand. Don’t be surprised if your doctor asks how your pain affects you mentally and emotionally. Be honest about how you are feeling, even if you don’t think you are depressed.

• Physical exam: Your doctor will perform a physical exam to check things such as your spinal alignment and range of motion, as well as check for any abnormalities. He will also check your reflexes and balance, and ask about any sensory difficulties such as numbness or tingling. These tests could help determine the cause of your pain.

• Imaging: If your doctor suspects that your pain is caused by bone or muscle damage, he will order imaging of the problem areas. This could come in the form of X-ray, MRI or CT scans. You may also be sent for an ultrasound to check for abnormalities in your organs.

• Bloodwork: While bloodwork may not be able to actually diagnose the cause of your pain, it can rule out illnesses that could be contributing factors. Since chronic pain can mimic a lot of other illnesses and disorders, it can be hard to know what exactly is causing it. Blood work will rule out (or diagnose) things like rheumatoid arthritis, lupus, and diabetes.

Treatment

Treatment of your chronic pain can vary, depending on the determined cause. Some commonly prescribed management methods are:

• Pain medication
• Physical or occupational therapy
• Antidepressants and anti-anxiety medication
• Counseling
• Nerve blocks
• Surgery
• Referral to specialists

Your doctor will want to see you at least every couple months to assess whether treatment is still working, and if anything needs to be changed or adjusted.

Pain Management Services in Central Maryland

At the Center for Advanced Orthopaedics - MMI Division, we offer specialized care in physical medicine and rehabilitation. Our team of skilled physicians can diagnose and treat your pain in the most minimally invasive way possible. We treat a variety of pain conditions,  both acute and chronic. Schedule an appointment today!