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by: Sara Aksoy
The effects of chronic, or ongoing, pain
include physical, mental, emotional and social pain that impact
all parts of life. These varying symptoms can feed off each other
in a vicious cycle.
The chronic pain cycle illustrates the
relationship between the symptoms of pain, immobilization,
disability, loss of self-esteem, depression, isolation, stress,
and muscle tension.
When someone is in pain, moving around may
be the last thing on one’s mind. If that lasts for too long
however, disability can set in, leading to a loss of self-esteem.
When one is feeling low, depression can creep in, leading to
isolation and stress. Stress keeps muscles from relaxing and
healing, and muscle tension can add more pain, igniting another
cycle. The reverse cycle can also occurs with the final result
being more pain.
Current arthritis
treatments seek to alleviate specific symptoms in this cycle. If
the cycle is slowed or stopped, then all of the symptoms in turn
is relieved. Understanding this cycle and how treatments effect
it can clarify why specific medications are used and what
complimentary therapies can aid in relieving pain.
The treatment of pain can come in a variety
of forms from alternative to medical treatments. Please talk to
your medical professional before proceeding
If pain can be stopped, then the chronic
pain cycle never forms. Several treatments for pain come in the
form of topical creams. When applied to the joint area, the
active ingredients are absorbed through the skin where they take
effect. These active ingredients can be of natural or
pharmaceutical origin. Three popular ingredients are capsicin,
counter-irritants and salicylates.
The next step in pain relief often involves
oral medication. Analgesics like acetaminophen (Tylenol),
directly treat pain and are available over-the-counter. They tend
to be the first line of defense because of their low cost and low
incidence of side effects. However, they do nothing to
reduce inflammation.
Non-steroidal anti-inflammatory drugs
(NSAIDs) reduce inflammation that in turn reduces pain. They may
be used alone or in conjunction with analgesic drugs, and come in
a variety of over-the-counter forms like ibuprofen (Advil) and
naproxen (Aleve) and prescription forms (Motrin, Orudis).
COX-2 Inhibitors are a new class of NSAIDs
that offer the anti-inflammatory effects of traditional NSAIDs
without the gastrointestinal side effects. However, these are
available by prescription only, and because of their high cost
may be difficult to obtain with some insurance plans. The
COX-2 group includes drugs such as celecoxib (Celebrex),
rofecoxib (Vioxx), and valdecoxib (Bextra).
Cortisone injections make use of cortisone,
a steroidal anti-inflammatory, to relieve arthritis pain. It
consists of a shot into the arthritic joint that provides pain
relief for three to six months. Because this treatment is
injectible, it allows for local treatment of pain that does not
expose the entire body to the drug. However, because
cortisone is a steroid, it can break down bone and other joint
structures with repetitive use, so most physicians limit the
number of cortisone shots that a patient can receive every year.
Cartilage breakdown and the progression of
arthritis can make carrying out routine activities so painful
that they are avoided completely. However, many assistive
devices are available to allow activities to be feasible to avoid
immobilization.
Many products aid in carrying out routine
activities such as a grab bar in the shower to give more
stability and eating utensils with wide handles for those with
arthritis of the hand. Items such as canes and walkers
improve mobility in people with arthritis of the hip or knee,
distributing weight over a number of joints and therefore reduce
the load on the arthritic joint. Products like braces and splints
work to stabilize joints and in that make them more mobile.
It is important to your health to stop the
chronic pain cycle before it can continue on. If immobilization
continues for too long, it can lead to disability, a loss of
self-esteem, and depression.
Depression is a serious condition that
affects one’s happiness and well-being so be in tune with
oneself.
Support groups are a great way to bring a
nurturing and understanding environment into one’s life to
help combat depression. Finding the right support group may do
wonders in alleviating mental pain.
Another silent mental pain is stress.
Because of its role in the chronic pain cycle, it is important to
take active steps to relieve stress in your life. Continued
stress can compound depression and muscle tension, leading to
more mental and physical pain.
Exercise is an important stress reliever as
it can reduce depression and pain by releasing endorphins, your
body’s natural painkiller. Endorphins are released through
exercise or when you laugh.
While in the past it was thought that
exercise accelerated the progression of arthritis, it is now
known that it has a very much beneficial role in strengthening
the bones, muscles and other components of the joint as well as
slowing the chronic pain cycle. Other ways of reducing stress may
include relaxation exercises and meditation.
One method of relieving muscle tension is
using heat or cold treatments such as a heating pad or an ice
pack. When applied to the joint, these can offer short-term
relief for pain and stiffness. Examples include a warm
bath, shower, heating pad or a bag of heated uncooked rice as
heat treatments and a cold pack, ice bag or bag of frozen
vegetables as cold treatments.
Massage can also offer relief from muscle
tension. However, be sure to tell your massage therapist
that you suffer from arthritis so that he or she can treat the
area appropriately. A swollen area should never be massaged as
more pain can be inflicted.
These treatments are aimed at stopping the
chronic pain cycle in its tracks so that you are in charge of
your arthritis, not the other way around.