Living with chronic pain can be a deeply challenging experience, affecting not only your physical health, but mental health as well. Chronic pain, unlike acute pain, persists for three months or more and often occurs without a clear physical cause, making it difficult to treat.
“What makes chronic pain complex is that it rewires the brain,” says Caitlin Dacey Stuber, MD, a pain management specialist at OhioHealth. “Acute pain signals damage, but chronic pain can occur even without ongoing harm because the nerves are essentially misfiring.” This rewiring creates a persistent condition that requires a multifaceted approach to management.
Common causes of chronic pain
Chronic pain often stems from complex causes and may even occur without a clear physical trigger. People can experience chronic pain due to conditions like back and neck issues, arthritis or nerve damage, while others face it after surgeries or injuries. Other common causes include:
- Neurological conditions like multiple sclerosis or nerve damage.
- Rheumatologic disorders such as rheumatoid arthritis and fibromyalgia.
- Post-trauma pain, which can develop after an injury or surgery.
The impact on mental and emotional health
While the physical impact of chronic pain is evident, the emotional and mental toll is just as significant. “The number one risk factor for having chronic pain isn’t injury or disease,” says Dr. Stuber. “It’s mental health.” For example, fear-avoidance, like avoiding walking because a person feels pain when they walk, and other poor coping strategies can make people more likely to experience chronic pain and less likely to benefit from treatments.
Beyond that, when pain limits someone’s ability to do the things they love, it can lead to depression, anxiety or even post-traumatic stress disorder. Chronic pain often exacerbates anxiety, depression and poor sleep, which all feed into making the other worse. “Chronic pain creates a vicious cycle where pain impacts mental health, mental health worsens pain and poor sleep exacerbates both,” explains Dr. Stuber. She stresses the importance of addressing all three simultaneously to break the cycle.
Creating a personalized pain management plan
Tailoring treatment to the individual is at the heart of chronic pain management. “I start by pinpointing the source of the pain and assessing what treatments the patient has already tried,” explains Dr. Stuber. “From there, we progress from the least invasive options, like physical therapy, to targeted interventions if needed.”
Physical therapy often plays a pivotal role by improving mobility and strengthening muscles, while medications are carefully chosen to balance efficacy and side effects. For more severe cases, interventions like epidural steroid injections or nerve ablations may be recommended.
Lifestyle changes are equally vital in managing chronic pain. Maintaining a healthy weight, staying active, and avoiding smoking are foundational steps. “Activity is the most effective treatment for chronic pain,” Dr. Stuber says, noting that exercises like yoga and core strengthening can significantly improve outcomes.
Additionally, holistic therapies like acupuncture and chiropractic care can complement traditional treatments. While she encourages patients to explore these options, Dr. Stuber stresses that they should be part of a broader, multimodal plan that includes exercise and other active treatments.
Advancements in pain management
Recent advancements in pain management are creating new long-term solutions for chronic pain. “Neuromodulation, for example, which uses spinal cord stimulators, has been transformative,” reports Dr. Stuber. “These devices block pain signals before they reach the brain and can provide long-term relief without medication.” Other interventions, like radiofrequency ablation, which involves burning nerves to reduce pain in joints, has shown great success for managing arthritis and spine conditions.
“If someone feels they’re out of options, I’d encourage them to see a pain specialist. There are always more avenues to explore, and it’s important to find a provider who listens and works with you,” says Dr. Stuber.
To learn more about pain management at OhioHealth, visit our website.
