It is important to note that chronic pain is a major issue, which affects the general population in several layers. The implications can range from mild discomfort to a severe decrease in quality of life as well as impairment. Although the current measures rely on the use of pain killers, the latter also comes with a host of other problems. Other approaches may also primarily utilize one’s coping psychology in regards to the given health condition. The given assessment will provide invaluable insight and information as well as justification for the importance of chronic pain, a critical subject.
The topic of chronic pain was selected due to the problem being a highly viable and relevant one since it is a common issue of public health. Historically, it was considered that chronic pain and pain, in general, was a biomedical issue, which required medical solutions since the professional community defined the issue as a mere consequence of tissue damage (New Harbinger, 2019). However, it should be noted that chronic pain is a biopsychosocial problem, which affects a person not only bio-medically but also psychologically and socially (New Harbinger, 2019).
In other words, one’s experience of pain can vary depending on his or her mental attitude towards it, and having a social support circle can greatly improve the overall experience of pain (New Harbinger, 2019). Therefore, chronic pain is a highly multifaceted problem, which requires a complex set of measures in order to manage it and minimize its effects on one’s life. It can also affect anyone regardless of age, gender, or ethnicity, which, alongside the previously mentioned statements, makes it both an interesting and relevant topic to analyze and understand.
In order to properly and comprehensively discuss holistic alternative therapies, it is important to learn and overview the historical measures used to treat the selected condition. One of the most conventional approaches primarily utilizes medications to relieve the pain, and these might include corticosteroids, antidepressants, anticonvulsants, and opioids. There is a wide range of options in regards to medications due to chronic pain manifesting itself in different types, mainly nociceptive, neuropathic, and sensory (GovInst, 2018). The use of pharmacological measures can be effective at giving an individual an opportunity to manage his or her own chronic pain, but it can also cause other issues, such as addictions. The most dangerous and common one is opioid use disorder or OUD, which is determined by the fact that a person using the drugs adheres to several criteria (GovInst, 2018).
These include having severe cravings for the drug, investing a significant portion of one’s time to obtain or recover from the opioids, role failure, recurring use in hazardous situations, and many others (GovInst, 2018). In other words, addiction emerges when a person’s life is worsened or burdened by the use of the drug, and adherence to a larger set of criteria makes the addiction case more severe.
There is a number of both old and new theories on chronic pain, which address its nature, implications, and categorizations. One such theory is the concept of biopsychosocial pain, which views the issue in three distinct layers, which are biomedical, social, and psychological (New Harbinger, 2019). The given framework provides an in-depth view of chronic pain, which allows deriving a more complex and multidimensional set of solutions.
In addition, it greatly improves the overall understanding of the issues as well as their implications. According to the biomedical model, comorbid signs of chronic diseases, such as sleep disturbance, depression, psychosocial abnormalities, and pain are considered a response to the disease and are therefore considered secondary. It is assumed that if the disease is healed, then the secondary reactions will evaporate. In such situations, which are common in chronic conditions such as back pain, headache, pain in myofascial pain syndrome, and temporomandibular syndrome, the patient’s complaints do not fit into the biomedical model (Darnall, 2018). Problems arise when the symptoms and disease are not comparable with the severity of the observed pathology.
Chronic pain is more than a physical symptom, and its persistent presence has many manifestations, including preoccupation with pain. This includes restriction of personal, social, and professional activities, demoralization and mood disorders, and the use of more medication and frequent medical seeking when the person as a whole becomes comfortable with the patient role. Although the importance of such factors has been recognized for some time, it is only in recent years that a systematic attempt has been made to combine these factors into a comprehensive pain model.
The topic deserves more interest and a closer look because its effects can be severe, and the issue can impact many groups. Therefore, there are both epidemiological and public health-related aspects to chronic pain. In addition, it can no longer be categorized as a solely biomedical issue since it has encompassing elements in regard to one’s psychology and social life. The latter two factors need more analysis and study in order to design successful treatment protocols and models, which will enable a multidimensional approach towards the issue.
In the case of speculations on the future directions for research with regards to the development of psychological based treatment or holistic alternative therapies respective to the topic, the emphasis should be put on resilience-based approaches. It is stated that “one of the key traits to overcoming adversity is that of resilience, which is the ability to withstand both physical and emotional difficulties” (Abaci, 2017, para. 2).
In other words, it can provide some form of mental and physical fortitude towards chronic pain. Modern experts in the field also address the topic with a strong recommendation of utilizing an interdisciplinary solution, which can greatly improve the outcomes (TEDx Talks, 2019a). It is suggested that resilience is achieved and implemented through three core strategies, which are an acknowledgment of a problem, selective attention to details, and taking control over the situation (TEDx Talks, 2019b). In other words, resilience-based approaches are built on a systematic process of chronic pain management, which involves addressing and enabling support systems in all three major areas of the biopsychosocial framework of view of the problem.
The information presented indicates that pain syndrome, regardless of the etiology of its occurrence, is the result of not only functional but also structural changes affecting the entire nociceptive system ranging from tissue receptors to cortical neurons. In nociceptive and psychogenic pain, functional and structural changes in the pain sensitivity system are manifested by sensitization of peripheral and central nociceptive neurons, as a result of which the efficiency of synaptic transmission increases and persistent hyper-excitability of nociceptive neurons occurs (Darnall, 2018). In patients with neuropathic pain, structural changes in the nociceptive system are more significant and include the formation of loci of ectopic activity in damaged nerves and pronounced changes in the integration of nociceptive temperature and tactile signals in the central nervous system (Darnall, 2018).
It should also be emphasized that the pathological processes observed in the nociceptive structures of the peripheral and central nervous systems in the dynamics of any pain syndrome are closely interrelated.
Damage to tissues or peripheral nerves, increasing the flow of nociceptive signals, leads to the development of central sensitization. In turn, an increase in the activity of central nociceptive structures is reflected in the excitability of nociceptors, for example, through the mechanisms of neurogenic inflammation, as a result of which a vicious circle is formed that maintains the long-lasting hyper-excitability of the nociceptive system (Darnall, 2018).
Evidently, the stability of such a vicious circle and, consequently, the duration of pain will depend either on the duration of the inflammatory process in the damaged tissues (Darnall, 2018). Therefore, they provide a constant flow of nociceptive signals into the nervous system structures, or on the initially existing cortical-subcortical dysfunction in the nervous system, due to which central sensitization will be maintained, and retrograde activation of nociceptors is achieved.
In conclusion, it is important to consider the fact that chronic pain is no longer a biomedical problem because it has major implications in a person’s psychological and social areas of life. Therefore, the topic needs to be illuminated, researched, and developed in order to improve the current systems of chronic pain management. One of such holistic alternative approaches is resilience-centered treatment, which is a multidimensional and procedural process of reducing the effect of chronic pain and its impact on one’s life.
References
Abaci, P. (2017). 7 ways to build resilience in the face of chronic pain. Chronicality. Web.
Darnall, B. D. (2018). Psychological treatment for patients with chronic pain. American Psychological Association.
GovInst. (2018). Overview of chronic pain and addiction [Video]. YouTube. Web.
New Harbinger. (2019). How is pain “biopsychosocial” and what does that mean in terms of how we treat pain? [Video]. YouTube. Web.
TEDx Talks. (2019a). What chronic pain has taught me about resilience | Trung Ngo | TEDxCentennialCollegeToronto [Video]. YouTube. Web.
TEDx Talks. (2019b). The three secrets of resilient people | Lucy Hone | TEDxChristchurch [Video]. YouTube. Web.