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| Patient Education -- Chronic Pain |
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Chronic
Pain
Pain is an unpleasant sensory and emotional experience
associated with actual or potential tissue damage, or
described in terms of such damage. The emotional component
of pain is called suffering. Pain is familiar to everyone
and yet so complex and subjective it cannot be easily
described or treated.
Pain is the body's mechanism of self-preservation. It
acts as a warning to indicate harm or potential danger
to tissues in our bodies. However, when pain persists
or reoccurs over a long period of time (more than six
months), it is said to be chronic pain. Because this pain
is not protective, and not a result of a continuing injury,
it is "pathological" nerve injury pain and, therefore,
treated as an end and not as a symptom.
More than 75 million Americans suffer chronic, handicapping
pain. Approximately 75 to 80 million people in the United
States are estimated to suffer chronic pain, and this
is generally considered a conservative estimate. Chronic
low back pain, for example, affects nearly 31 million
Americans and represents the most common cause of disability
in persons less than 45 years of age.
Persons with chronic pain fall into two groups -- those
with ongoing tissue injury, as occurs with cancer-related
pain; and those without ongoing tissue damage, perhaps
as a result of a previous injury.
Neurosurgeons can treat chronic pain by augmenting, or
stimulating, functional parts of the nervous system, especially
the spinal cord. Candidates for such surgery must undergo
a trial consisting of temporary implantation of an electrode
over the spinal dura. When successfully positioned, this
electrode produces a pleasurable sensation that overlaps
the regions of pain in the body. If it alleviates pain
adequately, a permanent battery or "pulse generator" is
connected and implanted surgically, much like a heart
pacemaker. This generator can be frequently reprogrammed
using a computer without resorting to further surgery.
Other surgical options include a number of ablative procedures.
Ablative operations involve creating an injury to the
sensory portion of the central or peripheral nervous system.
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