Pain Awareness: Pain consequences

Chronic pain has a massive impact in our lives. And it is important to remember that pain doesn’t exist in a vacuum all by itself… it has symptoms. And these impact our functionality along with the pain itself.

The pain itself is a massive obstacle to living a life. What if you woke up one day with the worst flu you ever had. So you call in sick for a few days. But what if it never goes away? What if you have to work with it, do social obligations with it, and everything you do drains you so much. And week by week it is harder to push yourself to do things especially when it makes you feel worse.

Pain is very much like that when it never goes away, when it become chronic pain. Trying to function to some extent with constant pain. Pain may vary from day to day, hour to hour, but it never turns off. And it is exhausting pushing ourselves to do anything. And push too much and we feel substantially worse. I don’t mention it below but constantly dragging through life with chronic pain causes immense fatigue.

Sleep

Disturbed sleep is common in patients with chronic pain,

occurring in 50–89% of the chronic pain population

[11,22,23]. The degree of sleep disturbance can be

directly related to the severity of pain. In a study of 268

consecutive patients with chronic low back pain, pain

intensity was found to be directly correlated to the degree

of sleep disturbance (r=0.31,P<0.0005) [24]. Because

one condition may perpetuate the other when existing

concomitantly [11,23,24], early treatment of chronic pain

is important for minimizing sleep disturbance Long-term consequences of pain

We all know painsomnia. We are very aware when the pain is severe or moderate at night it makes it extremely difficult or even impossible to get sleep. Lack of sleep can worsen symptoms. Just have symptoms of its own. And we can get pretty sleep deprived without some assistance to help us sleep.

Cognition

Cognitive processes such as memory and attention have

been shown to be impaired in up to two thirds of patients

with chronic pain [21,29]. Evidence indicates that these

cognitive disruptions are due to interruptions in memory

traces, which play a role in the unconscious processes

involved in everyday tasks [21] as well as physical changes

that lead to altered brain function (Table 2) [4]. Certain

regions of the brain comprise what is known as the default

mode network (DMN), which normally activates to help

maintain the resting state of the brain and deactivates

during the performance of a task. However, in a study

where patients performed a visual task unrelated to pain,

patients with chronic back pain displayed significantly less

deactivation (P<0.01) in the DMN compared with normal

controls, suggesting that chronic pain had effects on brain

activity beyond that of the original pain (Figure 1) [4]. Other

neurological changes that may occur in chronic pain

patients include abnormal brain chemistry [30] and loss of

neocortical gray matter [31]. These changes have been

associated with various sensory and affective measures of

pain and can be specific to distinct regions of the brain.

Thus, these physical changes in the brain are thought

to correlate with the perception of chronic pain and

behavioral aspects associated with it [30,31] Long-term consequences of pain

Brain fog and cognitive dysfunction can be tricky to deal with when we are trying to function at work or other places. Pain actually does things to the structure of our brain. Pain itself can cause a lot of the cognitive issues we have. We have issues with memory and concentration and focus.

Mood

Numerous studies indicate that patients with chronic pain

are more likely to develop psychological disorders than

those without chronic pain [17]. Chronic pain has been

associated with increased rates of major depressive dis-

order [18], suicidal ideation [20], and suicide attempts [20].

Prevalence of psychopathological disorders ranges from

33% to 46% [15,17,19] among individuals with chronic

pain conditions, while the incidence of psychological dis-

orders is much lower in populations not experiencing pain

(10%) or with shorter durations of pain [17]. Long-term consequences of pain

I know for me I developed Major Depressive Disorder. And suicidal ideation as well as two attempts. Frankly it doesn’t surprise me in the least. I bet it is because pain and coping with pain can cause neurological changes. But, honestly, depression does seem to be a prevalent risk factor with pain because it is pain.

Quality of life

A patient’s quality of life, both mental and physical, is another measure of the negative repercussions of pain.9 Several studies carried out on patients with fibromyalgia, rheumatoid arthritis, or low back pain have shown that these conditions often cause a notable deterioration in the patient’s quality of life,26 each affecting the physical component of the HRQoL and with a stronger impact on the mental component of the HRQoL, particularly in fibromyalgia patients.27 Similarly, when comparing the HRQoL of acute pain and CP patients with that of pain-free individuals, CP patients achieve worse scores in all the dimensions of HRQoL compared to individuals who suffer from acute pain or have no pain.28 

A review of chronic pain impact on patients, their social environment and the health care system

Our qualify of life, without treatment, takes a nose dive. And so early prevention in chronic pain can help with maintaining it. But that doesn’t happen. So it becomes harder the longer we have pain. And even then pain management struggles to find a way to manage it enough to give us a decent quality of life. Especially since opiates seem to be out of the question these days.

Work life

The impact of pain in the workplace is an important issue to be considered in CP patients. Studies carried out in different countries have shown that patients who are affected by pain present problems of absenteeism. Not only must they often change their occupational duties or post, but they may even end up losing their job as a result of their pain symptoms.1,12,19,34–37 In Spain, 24.4% of individuals who suffered from CP had requested sick leave in the previous year, and 12% had left or lost their job because of it.4 Moreover, when individuals with CP do not take time off from work despite being in pain, there is a reduction in their efficiency and productivity,2,25 an effect that is amplified as the intensity of pain increases.2,37 Indeed, it has been demonstrated that such presenteeism reduced productivity by 21.5% in a group of individuals with mild pain, as opposed to the individuals who suffered moderate (26%) and severe pain (42.9%) in whom these percentages were progressively higher.2

A review of chronic pain impact on patients, their social environment and the health care system

All of this leads to absenteeism at work. And presenteeism when we force ourselves to go to work. Leaves from work. And sometimes long-term disability or permanent disability.

Pain affects our work life, our social life, our mental and emotional well-being, and it affects all our relationships (spouse, children, friends, employer and co-workers).

see more:

15 things I’d say for pain awareness

Pain awareness: The opiate issue

Fibromyalgia is more than pain