Üsküdar University NP Feneryolu Medical Center Psychiatrist Assoc. Dr. Serdar Nurmedov made statements about the causes and effects of chronic pain. Stating that pain that usually occurs as a result of a disease or injury and lasts longer than three months is called 'chronic pain', Psychiatrist Assoc. Dr. Serdar Nurmedov said, “Chronic pain can persist long after you recover from an injury or illness. Sometimes it can occur even for no apparent reason. Chronic pain is defined as a persistent or recurrent feeling of discomfort felt in an area of the body. he said.
Chronic pain is a very common problem.
Pointing out that chronic pain can occur for various reasons, Nurmedov said, “Conditions such as injuries, surgical interventions, rheumatic diseases, nervous system disorders, certain types of cancer, fibromyalgia, migraine, spinal problems can cause chronic pain. Chronic pain is very common and is among the top reasons a person seeks treatment. About 25 percent of adults in the United States suffer from chronic pain. Chronic pain is also increasing in our country. For this reason, 'Algology' departments dealing with the treatment of pain began to be opened in many public and private hospitals.” used his statements.
Patients can describe chronic pain in many different ways.
Emphasizing that some people also have chronic pain that is not due to an injury or physical illness, Nurmedov said, “We call it psychogenic pain or psychosomatic pain. Psychogenic pain is caused by psychological factors such as stress, anxiety, and depression. However, it is possible for more than one cause of pain to overlap. It's like an individual with cancer also has psychogenic pain." said.
Adding that patients describe chronic pain in many different ways, Nurmedov said, “They can use descriptions such as hitting, squeezing, burning, throbbing, stinging, squeezing. When mental illnesses caused by chronic pain are added to the work, the definitions can become much more complex.” he said.
Detailed physical examination of the patient is performed to make the diagnosis.
Reminding that the pain must be ongoing for at least three months in order to talk about chronic pain, Assoc. Dr. Serdar Nurmedov said, “During this period, the pain does not have to be constant. We can talk about chronic pain if it is recurring. In order to make the diagnosis, first of all, a detailed disease history is taken from the patient and a detailed physical examination of the patient is performed. Subsequently, various tests that are thought to be useful in revealing the origin of the pain may be ordered, including blood tests, MRI, CT, X-ray, EMG, reflex and balance tests, urine and cerebrospinal fluid tests. made the statement.
Living with individuals with chronic pain can be exhausting
Mentioning that chronic pain is not only a physical problem, but also a problem that can significantly affect a person's psychology, Nurmedov said, "Since chronic pain is constantly present, it can have negative effects on a person's daily life, relationships and general quality of life. Chronic pain can lead to many mental problems, including stress, anxiety, depression, and sleep problems. said.
Noting that although it varies from person to person and situation to situation, living with an individual with chronic pain can sometimes be quite exhausting, Nurmedov continued his words as follows:
“The energy, time and attention that a person spends in coping with pain is so much that there is neither energy, time nor attention to devote to family members and friends. This destroys relationships. However, a person living with chronic pain can place an emotional burden on the people around them as they face constant discomfort, stress and difficulties. Family members or close friends may be worried and upset at seeing their loved one suffer or failing to meet their needs. Chronic pain can cause a feeling of helplessness in those around the person. This can turn into anger over time. Relationships related to this can be strained and sometimes broken.”
There is no one-size-fits-all prescription for chronic pain
Emphasizing that the causes of the pain are investigated first and if it is detected, the appropriate treatment is planned, Nurmedov said, “Sometimes the source of the pain cannot be found, in this case the pain is treated symptomatically. There are many approaches to the treatment of chronic pain. Which approach is used depends on many factors, such as the type of pain, the source of the pain, age, general medical condition, and accompanying psychiatric disorders. Therefore, chronic pain management should be individualized and multidisciplinary. It should be noted that there is no one-size-fits-all prescription for chronic pain.” warned.
Nurmedov explained that the methods used in chronic pain treatment are drug therapy, physical therapy, cognitive behavioral therapy, acceptance and dedication therapy, psychological support including mindfulness methods, alternative medicine and surgical interventions.
The four pillars of chronic pain: stress, nutrition, exercise and sleep
Stating that the four main factors affecting people's lifestyles are the four pillars of chronic pain, Assoc. Dr. Serdar Nurmedov pointed out that keeping these factors under control can help in minimizing chronic pain. Listing these factors as stress, nutrition, exercise and sleep, Nurmedov said, “Stress can play an important role in chronic pain. That's why it's important to try to reduce your stress as much as possible. Everyone has different techniques for managing their stress. If the techniques you've tried so far haven't worked, try different options until you find what works best for you. Engaging in low-intensity exercise for 30 minutes each day can help reduce your pain. Exercise also has stress-relieving properties. It is beneficial for individuals suffering from chronic pain to pay attention to their nutrition. This is because red meat and refined carbohydrates cause inflammation. Inflammation also causes pain. For this reason, it is recommended to switch to an anti-inflammatory diet by eliminating foods that cause inflammation. Lack of sleep can cause you to gain weight, which can exacerbate your chronic pain. Quality sleep is also important for stress management.” made suggestions.
Complete elimination of chronic pain may not always be possible.
Nurmedov stated that the duration of treatment depends on factors such as the severity and duration of the pain, the complexity of the underlying condition, the response to the treatment and the treatment methods used. For this reason, patience, cooperation and regular control are important in the treatment of chronic pain. The goals of treatment are to control pain, improve quality of life, and improve daily functioning. I would like to remind you that many of life's most important and greatest problems, including chronic pain, are basically unsolved. We may not be able to solve them, but we can overcome them. For this reason, it will be more functional to channel the energy, time and attention we spend to completely eliminate chronic pain to overcome this problem. It should be noted that 'Cognitive Behavioral Therapy', 'Acceptance and Devotion Therapy' and 'Conscious Awareness' approaches are extremely effective in this regard.” used his statements.
Pain can increase the level of stress and stress can increase the severity of pain.
Pointing out that physical pain and mental health are in a cycle that feeds each other, Nurmedov said, “Just as chronic pain negatively affects mental health, deterioration in mental health also negatively affects our physical well-being. On the other hand, the experience of pain is not just a physical sensation, it is also associated with psychological, emotional and cognitive processes.” said.
Nurmedov said that one of the best examples of the interaction between physical pain and mental health is the effect of stress.
“Pain can increase the level of stress, and stress can increase the severity of pain. The increase in stress hormones can cause pain to be perceived as more severe. At the same time, chronic stress can facilitate the chronicity of pain and increase its severity. Another example concerns the perception and interpretation of physical pain. Namely; The experience of pain can vary depending on the person's perception, interpretation, and meaning of pain. Mental factors can be decisive in focusing on pain, perceiving pain as a threat, and also play an important role in the development of coping strategies against pain.