When Pain Doesn't End...

By Peter J. Gough, Esq.

Chronic pain is pain that exists six months beyond an injury or illness. This pain permeates all aspects of an injured worker's daily existence. Chronic pain patients often fall into a pattern of medication use, depression, anxiety, loss of self-esteem and despair.

Some of the more common types of chronic pain include myofascial pain syndrome, fibromyalgia syndrome, failed back surgery syndrome, post-laminectomy syndrome, complex regional pain syndrome (CRPS) and reflex sympathetic dystrophy (RSD). Regardless of the title, complex regional pain syndrome is clearly a group of syndromes and symptoms that do not respond to the typical medical model of care. Complex regional pain syndrome is a condition best managed with a multidisciplinary approach.

In recent years, a medical specialty of managing chronic pain has emerged. The medical discipline that treats such pain is known as pain management. Generally the types of physicians who can obtain board certification in pain management include psychiatrists, neurologists, anesthesiologists and physical medicine/rehabilitation physicians. Pain management specialists evaluate patients with complex regional pain syndrome and offer appropriate therapeutic interventions, including injections, medications, physical therapy, implementation therapy, psychiatric care and any combination of the above.

The cause of complex regional pain syndrome is complex and not completely understood by the medical profession. Some physicians have suggested that complex regional pain syndrome might be a learned behavioral syndrome. However, most physicians believe that complex regional pain syndrome arises from a trauma and that it is not yet understood why the body reacts as it does.

Complex regional pain syndrome is not uncommon. Approximately 35 percent of Americans have some type of chronic pain and approximately 50 million Americans are partially or totally disabled by it. Complex regional pain syndrome affects patients in many different ways, including depressed mood, fatigue, reduced activity and libido, and symptoms and disability seemingly out of proportion to the injury.

Medically, much still needs to be investigated and explained. One thing remains clear: chronic pain adversely impacts not only the injured person, whose personality and life can be shattered, but also family and friends. Treatment is the most important step. There is hope and the likelihood that appropriate treatment will restore the sufferer to good health.

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