Chronic Pain

Causes

Long-term illness or disease, ongoing conditions, and injuries are the most common causes for chronic pain. Other causes include damage to the central or peripheral nervous system and vascular conditions. Long-term illnesses that may result in chronic pain include the following:

• Cancer
• Degenerative disease (e.g., osteoarthritis, osteoporosis)
• Fibromyalgia
• Inflammatory disease (e.g., rheumatoid arthritis)
• Multiple sclerosis

Cancer patients often experience chronic pain caused by tumors that infiltrate and compress organs or bones and by treatment (e.g., radiation, chemotherapy) that causes edema (tissue swelling).

Ongoing conditions that may cause chronic pain include ear infections, migraine headaches, and peripheral neuropathy (e.g., carpal tunnel syndrome).

Initial injuries (e.g., sprain, muscle strain) and under- and overuse injuries (e.g., back pain, Achilles tendonitis, and heel pain) also may become chronic.

Chronic pain caused by damage to the central nervous system (i.e., brain, brainstem, or spinal cord) or peripheral nervous system is called neurogenic pain. Central pain syndrome, trigeminal neuralgia, and phantom pain are types of neurogenic pain.

Central pain syndrome is a neurological condition caused by damage to the central nervous system. It may occur in patients who have experienced spinal cord injury, brain injury, or stroke and in patients with multiple sclerosis (MS). It is characterized by steady pain (usually described as a burning, aching, or cutting sensation) and brief bursts of sharp pain. Central pain syndrome may develop years after damage to the central nervous system occurs.

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Trigeminal neuralgia, also called tic douloureux, is a condition caused by damage to the fifth cranial nerve (called the trigeminal nerve). This condition is characterized by severe, stabbing pain on one side of the jaw or cheek, typically lasting a few seconds and recurring throughout the day. Talking, brushing the teeth, touching the face, chewing, or swallowing may trigger an attack. Trigeminal neuralgia may persist for days or months, disappear, and recur months or years later.

Phantom pain or "ghost" pain is a type of neurogenic pain that occurs in paralyzed patients or as a result of limb amputation.

Chronic pain also may be caused by vascular conditions that reduce blood flow to an area of the body. Vascular headache is one of the most common types of headache.

Chronic pain that is not related to physical disease or injury, or other physical cause is called psychogenic pain. This type of pain is also referred to as pain disorder with psychological factors. Mental and emotional disorders may cause, increase, or prolong pain. Headache, muscle pain, back pain, and stomach pain are the most common types of psychogenic pain. Physicians and mental health specialists work together to treat patients with this disorder.

Chronic Pain, Causes reprinted with permission from neurologychannel.com
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