Chronic Pain Syndrome

A severely challenging condition threatening patients today is chronic pain syndrome. This occurs when various parts of the body and mind come together is a constantly recurring cycle of pain throughout the body. When it occurs, chronic pain syndrome can also affect certain areas of the body after they have been injured, wounded, or operated upon. The pain can be general or it may be concentrated, such as in the temples, legs, hands, or chest and back. A skilled physician experienced in observing chronic pain syndrome can assign this diagnosis and track the symptoms in their quality, severity, and consistency.
The hard part about treating chronic pain syndrome is that to many people it sounds like the typical complaining any patient might do. But the persistence of this kind of pain, its general presence, and the way it avoids being treated by drugstore or over-the-counter painkillers is one clue that chronic pain syndrome is present. Another trait of chronic pain syndrome is that it can subsume after a burst of general health, but then after a period the overall condition can suffer. The patient’s health will weaken and then the chronic pain syndrome can re-emerge when the patient’s overall sense of well-being or general health correspondingly weakens.
For reasons such as these, people in the main confuse chronic pain syndrome with “getting run down”. People in good health maintain regular cycles of endorphins and a balance of hormone. But depression and chronic pain sufferers actually alter the chemicals in their body and brain over a period of time when their behavior alters. Self-injury and accidents can occur as patients become more clumsy and careless dealing with another day in pain. Their impulses to deal with their stress and pain do not take healthy roads and the results can be seen in the way people stop taking care of themselves.
But with chronic pain syndrome, damaged nerves can keep up live pain enactions upon the central nervous system and mind long after the flesh and other damaged or diseased areas have been repaired. The axons of neurons keep firing and “informing” the brain of pain that in fact is no longer being inflicted. The patient feels pressure and the slightest sensation with a magnification that few nurses initially can credit. Just getting dressed, driving, and/or working activities can be physically and mentally impossible for some patients with chronic pain syndrome.
This can affect patients recovering from a long disease, suffering from other conditions at the same time, or suffering from chronic pain as a complication of other conditions, wounds, or diseases of the body. The physical treatment of the chronic pain syndrome also involves attention paid to the creative fulfillment, intellectual stimulation, connection to nature and energetic physical endeavors of the patient to put balance back into their routine. But many patients suffering from chronic pain syndrome are not ready for these interventions yet.
Not by medication alone can chronic pain syndrome be treated. And in some cases, patients will report as few as a two to three hours a day or even in one week when they can handle activities such as writing, reading, reviewing accounts, discussing business affairs, or even concentrating on complex ideas or complicated matters. The patient recognizes this loss even as they battle it being lost. The mental attitude of a chronic pain syndrome patient cannot convert chronic pain into nothingness, but a sharpened perspective and a better-motivated alertness to the positive side of things can assist in keeping the chronic pain from controlling and ruining one’s life.
Nurses taking care of patients with chronic pain syndrome will have some difficulty moving them out of a mode of lethargy and into a spirit of motivated exercise. Movement is a key way to change the ingrained tendencies toward “moping” and dwelling on the pain that chronic pain syndrome involves. Patients such as this need to be urged to get out once in a while, make lists of things they like to do and schedule them. Sufferers of chronic pain syndrome must take an active role in combating the wear and tear of the disease. The behavioral aspect of their choices can overtake their neurobiological symptoms.
Chronic pain patients, especially the elderly, develop patterns of coping with their pain that may not seem helpful to outsiders. But survivors of wounds, attacks, diseases, and other complicated life events will nurse problematic chronic pain conditions for the rest of their lives. This is in contrast to the acute care approach to many painful issues in the otherwise straightforward assistance that urgent care patients receive. But long-term care and elderly patients will usually have an onset of chronic pain syndrome with the severely worsening of arthritis, osteoarthritis, sciatica, and back pain.
Unfortunately, not a lot of physicians train or prepare their patients on how to deal with chronic pain syndrome psychologically. Pharmaceutically the plan of care can treat the pain as it occurs or worsens. But the ongoing struggle with the challenges of chronic pain syndrome, complex and long standing, are unique to the individual patient in many cases. Because many chronic pain sufferers avoid public places, noise, chaotic events like concerts or music clubs, and unpredictable and physically demanding environments, they develop a coping system of this avoidance and they become viewed as “shut-ins”. The outsider observes the behavior of avoidance and misses the fact that there is reason and a pattern of behavior behind it. The patient is just trying to avoiding trigger situations where their chronic pain can be set off.
Nurses can keep an eye on their chronic pain syndrome patients and counsel them about their health. Nurses and case managers can provide helpful advice about how to spend their free time as well as enhance the attention paid to details other than their vital statistics and medication schedules. Such patients may be suffering from depression because of their inability to deal with their chronic pain syndrome. Nurses spend a good deal of time talking with patients. They hear how the patients speak of themselves. These patients may need to learn to interrupt negative belief systems, they may need encouragement and praise, and they may need to find ways to reward themselves and learn new ways of spending their time.
Sufferers of chronic pain may give out signals that friends and relatives do not understand. And chronic pain sufferers do not like to advertise how much pain they are in. They can mask their problems with overeating, Internet surfing, “quick-hit fixes” like smoking, video games, light movies or soft drinks. These activities can hijack feelings of serious ongoing pain in extremities, the temples , in the lower back or neck, et cetera. Sufferers of chronic pain may not understand that they have a serious problem, and may simply put their issues down to emotional problems or being unsuccessful at functioning to a higher standard.
Patients dealing with chronic pain syndrome will plot ways to avoid dealings with their pain by avoiding exercise or going out, to compare themselves unfavorably with others. They know their health is in decline, they just may not understand why. Chronic pain victims will isolate themselves and often appear erratic and eccentric. Chronic pain sufferers can cope with sudden and uncontrollable pain by stomping their feet,(to displace nerve pain) drinking, (to numb the nerve pain) watching TV, (for distraction), playing music (to give the pain white noise to play against) , and/or driving too fast, (because they can’t control the pain in their limbs and leg nerves). Or, when suffering from unpredictable intensities of chronic pain patients may cancel appointments and social engagements because they can’t anticipate when the pain will peak.
The solution to a problem with chronic pain is to concoct a care plan with many moving parts . This plan then becomes the patient’s responsibility to keep those moving parts improving and going, growing and becoming better. These are significant goals that can alter the quality of life for sufferers of chronic pain syndrome. The many motifs in a successful care plan for chronic pain syndrome are simply a roadmap to access all the information involved and plot a best case scenario. A nurse can assist any patient in the parts of the care plan they feel most comfortable with. Sometimes just visualizing a better frame of mind or achieving small goals can be helpful to the health of the patient. Nurses should refer their patients showing symptoms to chronic nerve pain specialists, or care plan managers.

Chronic Pain Treatment Plans

Nursing contains treatment of all kinds of patients. A conscientious nurse can track the development of a chronic pain condition by assessing the Quality of Life scale for successive periods. Weighing the patient’s ability to perform daily activities, get dressed, go out, exercise, socialize, and perform productive activities like volunteer work or light labor, is a way to measure the complete index. A nurse or physical therapist should conduct a survey at quarterly or annual periods throughout the patient’s treatment duration to keep up with the wear and tear of natural aging and any other conditions.

Without an acute onset, chronic pain can gather from multiple sources, like arthritis, cramps, and headaches. The frequency and severity of the pain and the time during which the patient suffers becomes the analysis item. As a pain issue develops, these activities or tendencies in daily life will diminish. How much the ability to operate pain-free is not the issue, the ability to compensate or just give up regular activity over multiple areas of daily life is the measure. Consideration of over-the-counter pain medication is another part of the overall chronic pain evaluation.

Medical intervention for chronic pain can be difficult without a concrete diagnosis. Furthermore,  a surgeon or specialist may be reluctant to take on serious procedures with side effects of a potential to overreach the pain being felt by the patient currently. Some of the approaches to chronic pain onset can be less medical and pure common sense. Dyspepsia, GERD, and ulcers can account for some of the pain felt from natural aging. The severity of the onset should be evaluated and treated. Digestive and urinary conditions will reflect the patient’s lifestyle both past and present.

Nurses will come into contact with more acute situations of pain management. Injuries from car accidents, home mishaps, personal assaults, and sport injuries can be the beginning of a long lasting problem specific to the injured area or muscle system. Nociceptive pain involves muscle ends or actual end-of-system muscle fiber failings. Neuropathic pain is when the combined system failure results in sensation sof pain as symptoms of a larger disorder. Nociceptive pain and neuropathic pain form the basis of a category called somatogenic pain.

Psychogenic pain is a different type of chronic pain. When emotional or psychological issues and incidents form a repetitive or acute syndrome, psychogenic pain results. When a patient presents with pelvic pain of unknown origin, recurring headaches with no previous history of same, unusual facial pain of a typical frequency & duration, and/or low back pain, psychogenic pain should come to mind. Analysis of a patient’s daily schedule or habits will determine what unusual set of pain symptoms are unusual in sum.

Somatoform disorders are more mystifying and belong to the area of the professional psychoanalyst. The chronic pain markers for a somatoform patient are symptoms of pain that don’t match a patient’s current diagnoses or atypical recurrence of symptoms between stable schedule of medical or therapeutic intervention. As a nurse, is it a duty to report potential symptom and cycles of behavior to the case manasger or primary care physician. The worst that will happen is that you are overreaching, the best case scenario is that you have alerted key medical staff to a serious condition.

So, the nurse in charge of a patient or patients with chronic pain disorders should approach each patient with an individuality based on their own activity patterns and socializing habits. The deconditioning that occurs with a chronic pain sufferer is that they become “hermits”, staying alone in their pain cycles. Refusing to go out and refusing to continue with participation in group events and other healthy social exchanges can exacerbate pain. Long-term care facilities (or “nursing homes” ) often maintain a varied calendar of activities just to solve this problem.

A good nurse will challange her patient to set daily, weekly, or monthly goals to become more active, socialize with others, join a  group, and keep up improving exercise habits. A nurse may choose to give diet hints or have the dietary nutritionist meet with the chronic pain patient to underscore the importance of key food “do’s and don’ts.” The chronic pain patient must learn that anything that sets off blood pressure and systemic response triggers chronic pain events. Therefore keeping  a”low profile” in the battlefield of dietary tempations to binge, and fighting the inclination to slouch on the couch are what nurses should motivate their patients about.

It should be mentioned that many patients, especially aging patients of chronic pain, will insist on viewing themselves as a poor reflection of whom they “used” to be. But trying to keep up with the vision in the rear-view mirror is unhealthy and intimidating for the best of us. Some gentle persuasion to positively change the self-image and project and promote a more confident and updated idea of themselves will help patients cope with their current conditions. Aging in our culture has become more of a norm and in some areas has been acknowledged as a socially and economically powerful demographic.

Sufferers of chronic pain should be observed and monitored for unusual changes in behavior and habits. A nurse should become aware if a TV-addict patient suddenly shuns the TV room. Perhaps the patient known for her morning promenade starts sleeping in. A nurse should become concerned if a patient stops taking care of themselves, letting down personal standards of grooming or dressing. A supportive nurse will notice if their long-time patient is irritable and unreasonable over minor issues and becomes snappish with nursing staff the patients are known to prefer.

A chronic pain sufferer may be showing signs of depression due to lack of participation in many formerly “normal” activities. This is similiar to the depression felt by cancer patients. Chronic stress has been linked to fibromyalgia as well. A supportive nurse will observe if their regular patients sense a change in their lives and how they feel that they can’t quite pin down. Patients may verbalize unusual feelings or stressful responses to everyday queries. This can be an result (masquerading as a symptom) when chronic pain remains untreated capably.

The responsible and ethical treatment advice for a nurse who perceives a patient suffering pain is not to provoke an incident or disagreement. The supportive nurse will not try to spar or argue with a patient suffering from nerve endings already being pricked by uncontrolled chemical and electrical charges. A patient will not enjoy being prodded by a younger, more pain-free individual about why they are losing sleep or just how much more or less pain they feel than an hour ago.

It should be noted that not every nurse is a fan of supportive behavior. Access to a patient’s medical records and longtime treatment may make them privy to a lot of psychosocial details other nurses may not be aware of. Abusing this trust is not only unethical, but mean-spirited and should cause a nurse to question his or her own profesional motivations. Nurses who perceive other staff persecuting a patient prone to chronic pain with negative remarks, behaviors, or poor  attitude should be reported and re-oriented at once.