Strategies to Manage Chronic Pain

No less than nine million people, one in six, live with chronic pain in Spain on a daily basis. It is estimated that the cost to the healthcare system of treatment for this disease, as defined by the World Health Organization, is between 2.2% and 2.8% of GDP. Chronic pain affects the sufferer, above all, but also his or her entire environment. And yet it remains a little-known and little-understood disorder.

One of the most important findings of research in this field is the subjectivity of the experience of pain. When something hurts, each person feels, understands, and interprets it in a personal way. We all have different pain thresholds, sensations, and tolerance to pain.

This individuality is one of the characteristics of this phenomenon and poses a challenge when it comes to finding an effective treatment, but according to experts, it also opens up many possibilities, since, with the right information and medical support, each person can end up finding the individualized pain management method that best suits his or her needs. Because it is such a personal experience, no other person can fully understand another person’s pain even if they try, which makes many patients feel misunderstood.

Dr. Javier Medel, head of the Pain Unit at the Vall d’Hebron Hospital in Barcelona, explains that chronic pain “is pain that goes beyond the normal healing times of a tissue injury and persists beyond what is expected. Its persistence is not due to the injury itself, but to factors that can change the structure of the nervous and sensory system”. Medel insists that we must remember that it is a disease and not a symptom and that as such it is a patient’s right to receive the appropriate treatment.

Dr. Helena Miranda, a specialist in chronic pain for more than twenty years and a resident in Helsinki, where she practices as a physician and researcher, explains that pain is a reaction that originates in the brain. “It is the brain’s interpretation of the signals it receives from the body regarding damaged tissue; an interpretation it makes based on our previous experiences, the memories or facts we have heard or read about pain, how our parents reacted to their own or ours when we were littleā€¦”

He continues, “All of that affects the interpretation it makes of those signals. For example, if you twist your ankle while walking down the street, the nerves start sending signals to the brain. That’s important because then we understand that it’s important not to lean on that foot while it’s still injured. But in chronic pain, which is when the pain is treated and yet persists for six months or more, things are different. Today we also know that the central nervous system (CNS) and the spinal cord play a fundamental role. Sensitization of the central nervous system is key in cases of chronic pain.”

Despite its prevalence and impact on individuals and society, chronic pain remains an underdiagnosed and under-treated condition. According to Dr. Miranda, this may be due to a lack of understanding and education about pain. She emphasizes the importance of educating both patients and healthcare professionals about pain, its causes, and potential treatments. This includes dispelling common misconceptions about pain, such as the belief that pain always indicates tissue damage or that it is purely physical in nature. By increasing awareness and knowledge, patients and healthcare professionals can work together to better manage chronic pain and improve their quality of life.

Another challenge in treating chronic pain is the stigma that often surrounds it. Patients may feel shame or embarrassment about their condition, or fear being labeled as weak or seeking attention. This can make it difficult for them to seek help or discuss their pain openly. Healthcare professionals may also hold stigmatizing attitudes towards patients with chronic pain, viewing them as difficult or “drug-seeking”. Addressing this stigma is essential to providing compassionate and effective care for those living with chronic pain. By acknowledging the complex and individual nature of pain, and treating it as a legitimate medical condition, we can work towards breaking down these barriers and improving outcomes for patients when they try this.

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