Monday, May 23, 2022

OVERVIEW: IDENTIFYING THE TYPES OF PAIN

BATTLING THE OPIOID CRISIS WITH INNOVATION

Introduction:
The Integrative Pain Healers Alliance was originally inspired by every chiropractor or PT  visit where patients often get a more comprehensive explanation of how their personal injuries relate to their physiology.  We are blessed to have doctors who take the time to educate us on our issues and as educators themselves, pain therapists possess the talent to bring additional healing through the calming power of direct knowledge.

Statistics show that the United States continues to struggle with a significant drug crisis with more than 1,500 deaths per week from opioid-related overdoses, a toll that has spiked across the country amid the COVID-19 pandemic. Meanwhile, millions more Americans suffer from opioid addiction.  Analysts say the problem started with the overprescription of legal pain medications, but note that it has intensified in recent years with an influx of cheap heroin and synthetic opioids, particularly fentanyl, supplied by foreign-based drug cartels. The crisis has reached such a scale that it has become a drag on the economy and a threat to national security: opioid misuse is costing the country tens of billions of dollars annually, not only in health-care expenses but also in the form of a weakened workforce. [1]


PAIN 101: THE MIND-BODY CONNECTION
Written by: Josh T. Schueller

Pain is everywhere.  Billions of dollars are spent each year in the United States alone on pain treatments and remedies. Per the National Center for Health Statistics almost 60% are living with pain.  While most sufferers of pain want relief and answers, many medical professionals may be providing inefficient or incorrect pain reliefs counters.  The “cookie cutter” approach for pain over the last several decades has left the world in a pain crisis.  One of the main reasons why- the current treatment model does not do an adequate job in categorizing pain.  


Pain falls under different categories.  Most people do not understand that the type of pain you have directly correlates the type of treatment given.  Personalized medicine in the treatment of pain holds the key to understanding the types of pain and developing the correct course of action to treat the pain.  

Even though no one wants to be in pain, pain is the body’s early warning system that something is wrong.  If not for pain, we wouldn’t know to move our hand off a hot stove before doing serious damage.  When pain becomes an interference to our normal activities is when we have a problem.  Most people will group all pain into one big category but there are actually many different types of pain.  By recognizing and knowing the different types of pain clinicians can formulate an appropriate treatment plan that is pain specific to the person’s needs.


Here is a brief description of the types of pain:

ACUTE PAIN is sudden onset (within 3 months) that is normally caused by an injury such as a burn, strain, sprain, fracture, laceration, and surgery.  Typically, an abnormal trauma to the body causes the body to respond with pain.  Acute pain is described as throbbing, burning, stabbing, tingling, weakness, and numbness.  The pain will normally go away after healing has occurred with no lasting restrictions.

CHRONIC PAIN occurs during an event that lasts over 3 months in duration.  The original injury may have healed or resolved itself, but the pain persists for months into years.  Pain signals remain on high activity levels in the nervous system, despite no acute injury.  In instances of chronic pain corresponding emotional effects may occur such as depression, anger, anxiety, and fear.  

NOCICEPTIVE PAIN is sensation caused by tissue damage. This pain is described as sharp, aching, and throbbing. This can be caused by an external injury such as a athletic event injury or stubbing your toe that typically results in bruises, sprain, swelling and redness.  The brain responds to the information received from the nociceptors to initiate healing process

NEUROPATHIC PAIN occurs when there is damage to the neurological system.  Pain messages are sent to brain via the Central Nervous System from many times an infection or injury.  People have described this pain as burning, shooting, or numbness.  Pain associated with diabetic neuropathy and multiple sclerosis are neuropathic in origin.

PSYCHOGENIC PAIN is caused by psychological factors.  This can occur from a non-physical origin.  Psychogenic pain can be caused by embarrassment, shame, bereavement or in response to emotional or mental trauma.  Treatment for this type of pain can be challenging for many clinicians.

CENTRAL PAIN SYNDROME occurs when damage is to the brain, spinal cord, and/or brainstem. Possible causes of this pain can occur with stroke, MS, tumors, seizures SCI or Parkinson’s. disease.  Pain is moderate to severe, burning aching with sharp stabbing.      

COMPLEX REGIONAL PAIN SYNDROME is a rare and not much research has been performed.  This tpe of pain usually affects the arm or leg and occurs after injury, stroke, or heart attack.  Common symptoms is hypersensitivity, swelling, pain, skin changes, spasms and atrophy.  Many times, reflex sympathetic dystrophy (RSD) occurs.

VISCERAL PAIN is caused by injury or damage to your internal organs.  Pain is in your trunk or back or abdominal or chest and is referred pain from the organ.  Can be described as pressure, aching, cramping, nausea, and vomiting.  Examples can be IBS, gall stones, kidney stones, appendicitis, and bowel obstruction.  In many instances proper care is delayed because of inability to recognize the origin of pain and can lead to life threatening emergency.

When someone says “I am in pain” the first line of defense is medications.  Pharmacological interventions have become as American as apple pie and fireworks on July 4th.  Many times, the same medication is given for all types of pain.  Pain suffers often experience ineffectiveness of the desired results (no pain), but also develop debilitating side effects.  Knowing what type of pain, the suffer has can go along way in developing a personalized treatment approach that can alleviate or abolish the pain and allow a return to normal activates without a financial burden.


RELATED ARTICLES

WHAT IS PLANTAR FASCIITIS?
Approximately 3 million people per year.  PF is the inflammation of a thick band of tissue that connects the heels bone (calcaneus) to the toes on the underside of your foot.  The most common symptoms is sharp, stabbing pain in the bottom of your foot that is worse in the morning and after long periods of inactivity.  When getting out of bed in the morning, the bottom of your foot can feel like someone had pounded a spike through the bottom of your foot. The increase tension and stress of repetitive pounding (such as in running) can cause microtears in the plantar fascia causing inflammation and pain.


WHAT IS KREBS CYCLE? - Otherwise known as citric acid cycle, Krebs Cycle can be synonymous to the process of converting your paycheck into cash and going shopping with it. When you receive a paycheck (glucose) through direct deposit that paycheck is deposited into the bank (mitochondria).  Throughout this process there are fees (byproducts) that must be paid in order to receive the money.  These fees (NADH, GTP, CO2 etc.) are an essential part of the process.  The result is currency. In order to receive the money (ATP) it must go through to the ATM (electron transport System).  When you withdraw the money (ATP) you can spend on goods or services (energy production). As money is essential to the survival of the economy the Krebs Cycle is essential to the survival of the organism."



ABOUT THE AUTHOR

JOSH T. SCHUELLER has dedicated his life's work to the support and treatment chronic pain and disorders with non-invasive, safe, effective treatment solutions. He is the current VP of Clinical Operations and Business Development at AxioBionics LLC. and the Clinical Director for Orthopedic Physical Therapy Clinics (Rockford, MI).  As an active member of APTA, he holds advanced certification in Physical Therapy treatment techniques including the McKenzie method of patient empowerment.  He has over 20+ years experience in the treatment of neurological conditions such as Spinal Cord Injury, Traumatic Brain Injury, CVA, Cerebral Palsy etc.  In 2021, Josh is elected a clinical advisory role and educational advocacy for IPHA (Integrated Pain Healers Alliance) and has published research articles in pain management while co-launching the MedTech Reviews program of therapeutic devices.   Today, Josh continues to support patient suffering from disabilities and has expanded his focus to contribute his expertise in treatment programs for Veterans and first responders. 


References:

1) The U.S. Opioid Epidemic- Council on Foreign Relations: https://www.cfr.org/backgrounder/us-opioid-epidemic


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