Pain is a part and parcel of your daily life. Pain is an uncomfortable feeling that can take any form, either physical, mental, or emotional. Physical pain manifests as headaches, tiredness, aching muscles, swelling & redness in your joints. Pain can be of throbbing, stabbing, steady, or pinching type and can interfere with your routine tasks. Mental and emotional pain is usually of psychological origin, and are characterized by strong negative feelings of anger, grief, frustration, etc., that can lead to sadness, mood swings, anxiety, and depression.
Most physical pains go away after a few days but if it persists and stays longer than 3 months, it is known as chronic pain. Chronic pain may also last for about 3 to 6 months, disrupting your routine activities and resulting in lower productivity at work and home. Chronic pain not only takes a toll on your physical health but also on your emotional as well as mental health. Identifying the types, causes, symptoms, and treatment methods can help you beat chronic pain at the earliest.
When chronic pain remains for a longer time even after an illness or a healed injury, it is known as Chronic pain syndrome (CPS). It is characterized by pain that lasts longer than 6 months and is mostly associated with anger, anxiety, depression, loss of sexual desire, and disability. Most often, chronic pain and CPS are used interchangeably and treated the same; however, they can be different in their forms and symptoms.
Who is More Likely to Suffer From Chronic Pain?
Anyone can suffer from chronic pain. However, it is a common complaint in women and older adults. Athletes and sportsmen also suffer from chronic pain. The risk of this type of pain is sometimes higher in people who are obese/overweight (a disorder involving excessive body fat). Instances of chronic pain are observed less in children.
Common Types and Causes of Chronic Pain
1. Lower back pain is a common disorder that involves the muscles, nerves, and bones in your back. It is generally a result of an injury in your spine, physical stress, wrong posture, injury, or a sprain.
2. Cancer pain is a pain caused by the spreading of cancer to the various bones and tissues of your body. It can range from mild to severe and can also be caused by a tumour pressing on your nerves, bones, or organs or pain arising during cancer treatment.
3. Arthritis pain is a combined result of joint pains and stiffness caused by the swelling and tenderness of one or more of your joints (arthritis). This pain can be a feeling of a dull ache or a burning sensation, which often worsens due to age. The most common types of arthritis are osteoarthritis and rheumatoid arthritis.
a) Osteoarthritis: The most common form of arthritis which affects the joints in your hands, knees, hips, and spine. Osteoarthritis occurs when cartilages degenerate gradually and progressively.
Cartilage is a soft, flexible, rubbery substance that allows your joints to move easily against each other.
When the cartilages begin to disintegrate or degenerate, the bone surfaces become rough, resulting in pain and inflammation around the joints.
Symptoms include stiffness, loss of flexibility, swelling, and increased pain.
b) Rheumatoid arthritis (RA): An auto-immune (a condition in which your immune system attacks healthy cells in your body), inflammatory disease that affects the joints of your hands and legs. RA usually happens on the same side of your body and is a leading cause of chronic pain, especially in older people.
Symptoms of RA are similar to those of osteoarthritis - swelling, tenderness of the joints, inflammation of the joints, redness, and pain.
RA is caused by external factors such as cigarette smoking, trauma or injury, or an infection that can trigger an autoimmune response.
4. Neuropathic pain occurs as a result of the abnormal functioning of your nervous system. Neuropathic or neurogenic pain is sharp and throbbing. It can start as a tingling sensation in your feet and arms and spread quickly to other parts of your body.
5. Psychogenic pain is a disorder that is caused by psychological factors such as fear, depression, anxiety, and any strong emotions in individuals. Headaches, muscle pain, back pain, and abdominal pain are some of the common types of psychogenic pain. As the pain occurs secondary to a psychological condition, the underlying disease should be treated for the relief of the pain.
6. Fibromyalgia: A long-term condition that causes pain throughout the body. Fibromyalgia is nothing but widespread muscle pain, accompanied by fatigue, poor sleep, and an irritable mood.
Common Symptoms of Chronic Pain
Chronic pain can result in extreme weakness, chronic (persistent) fatigue, muscle cramps, muscle soreness, loss of a range of movements, sharp bouts of jolting pain, depression, anxiety, and recurrent fevers.
Treatment and Management of Chronic Pain
Medications, along with a combination of therapies and lifestyle changes work best in the treatment and management of chronic pain.
Medications work mainly to reduce pain which involve topical analgesics and over-the-counter (OTC) painkillers. Topical analgesics are medications that are applied to the body (on the skin) to treat all types of pain.
Therapies such as physical therapy (physiotherapy), occupational therapy, relaxation techniques (meditation, yoga, and breathing exercises), behavioural therapy, and surgery have been beneficial in some cases. Talk to your orthopaedician to know more about each of these treatment methods.
One interesting point to note is that the use of topical analgesics for the management of chronic pain is on the rise. The reasons for this are mainly easy availability, their portable and handy nature, improved patient acceptance, and direct and immediate relief on the target site.
Topical Analgesics for Chronic Pain Management
Topical analgesics are nonsteroidal, anti inflammatory drugs (available in the form of gels, ointments, creams, foams or lotions) used for managing chronic knee pain, osteoarthritis, and other chronic joint-related conditions. Topical analgesics were introduced in the first place to provide the same relief as that of oral analgesics (painkillers or tablets taken orally).
Topical analgesics therapy is considered a valuable therapy for chronic musculoskeletal pains and neuropathic pain disorders. Now, let’s understand how topical analgesics work:
Topical medications work similarly to a heat therapy from a heating pad/heating pack or a hot-water bottle.
The active ingredient in most topical analgesics is diclofenac, which when applied to the site of pain or inflammation provides a warm sensation initially. Diclofenac penetrates into your muscle and provides instant relief from pain and reduces inflammation. Warmth from the topical application increases blood flow to the site of pain. This oxygen-rich blood brings nutrients to the affected area, promoting healing.
Slowly, this warm sensation turns into a cool feeling due to camphor and menthol oil present in the medication. This icy hot blanket relaxes your muscles and relieves pain.
Why Glaxosmith Klein’s (GSK’s) Iodex Ultragel is Recommended for Chronic Pain
Iodex Ultragel (IUG) contains Diclofenac Diethylamine, a non-steroidal anti-inflammatory drug (NSAID) with emulgel formulation. This gel penetrates deep into your skin to enhance the effect of diclofenac on the site of pain. IUG is effective for different types of musculoskeletal and chronic pains like neck/shoulder pain, back pain, joint pain, arthritis. A formulation designed for fast absorption, this gel is highly effective and widely accepted.
Consult your doctor before using topical analgesics for body pain.
To summarize, most of the time pain goes away after an injury heals. However, if pain persists more than a month or two, it can become chronic. Consult your doctor immediately in case of a severe pain which does not respond to medications.
References:
1. Department of Neurology. 2021. Chronic Pain Syndrome. [online] Available at: <https://www.columbianeurology.org/neurology/staywell/chronic-pain-syndrome> [Accessed 25 January 2021].
2. Mayoclinicproceedings.org. 2021. [online] Available at: <https://www.mayoclinicproceedings.org/action/showPdf?pii=S0025-6196%2812%2901170-6> [Accessed 25 January 2021].
3. Rudin, N.J. Topical Analgesics for Chronic Pain. Curr Phys Med Rehabil Rep 1, 315–321 (2013). https://doi.org/10.1007/s40141-013-0028-8
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