Paralysis Resource Guide - (Page 77) HEALTH MANAGEMENT CHRONIC PAIN Pain is a signal triggered in the nervous system to alert us to possible injury. Acute pain results from sudden disease, inflammation or trauma to tissues. Acute pain can usually be diagnosed and treated; the discomfort can be confined to a given period of time and severity. Chronic pain is the kind that doesn’t go away and it’s resistant to most medical treatments. There may be an ongoing cause of pain — arthritis, cancer, infection — but some people have chronic pain for weeks, months, even years in the absence of any past injury or evidence of body damage. A type of chronic pain called neurogenic or nerve pain often accompanies paralysis. The problem with chronic pain is not just the hurting. Pain leads to inactivity, which leads to anger and frustration, which leads to isolation, depression, sleeplessness, sadness, then to more pain. It’s a spin cycle of misery with no easy exit. Treatment options for chronic pain include drugs, acupuncture, local electrical stimulation, brain stimulation and surgery. Psychotherapy, relaxation, biofeedback and behavior modification may also be employed. The goal of pain management is to improve function and allow people to participate in day-to-day activities. These are among the most common treatments: Acupuncture dates back 2,500 years to China and involves the application of needles to precise points on the body. While some research suggests this technique boosts levels of the body’s natural painkillers (endorphins) in cerebrospinal fluid following treatment, acupuncture is not fully accepted in the medical community. Still, it is very popular, noninvasive and inexpensive compared to many other pain treatments. Anticonvulsants were developed to treat seizure disorders, but are also sometimes prescribed for pain. Carbamazepine is used to treat a number of painful conditions, including trigeminal neuralgia. Gabapentin (sold as Neurontin) is commonly prescribed “off label” (unapproved by the FDA) for neuropathic pain. Antidepressants can be helpful for the treatment of pain. In addition, antianxiety drugs called benzodiazepines also act as muscle relaxants and are sometimes used as pain relievers. 77
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