Why Is Chronic Pain So Hard to Treat?

Chronic pain comes in many forms: persistent and intermittent, mild and extreme, and can be located practically anywhere in the body. But no matter what, chronic pain almost always presents challenges to effective treatment.

What is it about chronic pain that makes it so hard to treat? And what are the best options available for people experiencing it?

The Many Types and Causes of Chronic Pain

We can’t categorize chronic pain the same way we might categorize something like a broken arm. Chronic pain can affect almost any part of the body, and may affect many parts of the body simultaneously. 

Furthermore, the pain can present in a wide variety of different ways and different levels of intensity; one person may feel a burning sensation while another experiences more of a dull, throbbing pain. Additionally, chronic pain can arise from many potential root causes, or from no discernible root cause at all.

For example, take chronic pelvic pain. Chronic pelvic pain feels different to different people and can affect people at different levels of intensity. It may arise as a result of a specific medical condition, or it may have no underlying cause. 

Fortunately, physical therapy can help many people alleviate the symptoms of chronic pelvic pain regardless of its root cause; however, this isn’t the case for all types of chronic pain.

Most instances of chronic pain can be traced back to one or more of the following:

·       Acute injury. If you experience an injury, you may suffer from chronic pain in the injured area even years after the initial incident.

·       An underlying disease. Diseases like arthritis and cancer can cause chronic pain throughout the body, or in specifically affected areas.

·       Psychological factors. Sometimes, the pain arises from psychological factors. That doesn’t mean the pain is all in your head, but psychological afflictions or complications may be heightening your reaction.

·       Overlapping causes. It’s also common for chronic pain to arise due to overlapping causes from different areas.

·       A total mystery. And in some cases, chronic pain doesn’t have any underlying cause; its origins are a mystery even to experienced practitioners.

Patient Reports and Lack of Objective Data

It’s also problematic that doctors and medical professionals are almost entirely reliant on subjective patient reports for understanding and treating chronic pain. This pain is typically invisible and impossible to detect with medical equipment. Accordingly, it’s very hard to diagnose and properly understand. Patients can report where they’re feeling pain, what kind of pain they’re feeling, and the intensity on a scale from 1 to 10, but this information isn’t always objectively accurate and isn’t always helpful for diagnosing or treating the pain.

Medication Problems

Some people find medications to be helpful in alleviating pain symptoms, but there are several problems with it.

·       Patient responsiveness. Not all patients respond equally well to all forms of medication. For example, antidepressants can be useful for some people, but useless for others. There’s no pill you can take to get rid of chronic pain reliably.

·       Habit formation. Some medications designed to relieve pain can be habit forming. In some cases, medications can lead to complications far worse than the chronic pain itself.

·       Availability and cost. Thanks in part to the opioid overdose epidemic, some types of medication are very rarely, if ever prescribed. Despite the potential efficacy of these medications, medical professionals want to be as cautious as possible to minimize potential harm.

Challenges in Other Treatments

Treating chronic pain is also complicated by the following:

·       Not every treatment works for every patient. What works for one person may not work at all for another. Medication, physical therapy, exercise, diet and lifestyle changes, and even psychological therapy are all potentially beneficial, but there’s no guarantee.

·       It often takes time. When treatments do work, they often take time to work. Almost nobody finds instant chronic pain relief after a single appointment or a single dose of a prescription medication. Not everyone has the patience or motivation to follow through.

·       Effects may be subtle. Some treatment methods that relieve chronic pain only relieve it subtly or temporarily. Some patients are dissatisfied or frustrated by this, eventually becoming jaded on the topic of treatment altogether.

·       A combination of treatments is often the best approach. For many patients, the best approach is to combine many different treatment methods. But finding the right combination and the right balance can be frustrating and time consuming.

For all these reasons, and more, treating chronic pain is complicated. If you’re experiencing chronic pain, it’s important to experiment with many different treatment methods and seek advice from the best medical providers you can afford. Even if your chronic pain can’t be eliminated, it can probably be better managed.