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Old 04-01-2006, 09:47 PM   #1
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Longterm untreated chronic pain...

I asked my doctor a question last week. I asked her if a person's chronic pain is left untreated for a long time can that in itself cause problems?

She said there are studies being done on that now. She called it something and I can't remember what it was. But the theory is that if the body feels pain 24/7 for long periods of time w/o relief, the brain chemistry changes and your body actual overreacts or gets overly sensitive to painful stimulus. I was horrified !! I think my pain may have grown into the monster it now is because my pain has been ignored for so long.

I told doctors for almost 2 years my pain was unbearable and that vicodin hardly touched it. Now, I am thinking if my pain had been addressed within months instead of 2 years would I have as much pain as I am now??? I will never know.

But what I do know is that if someone in here is having high levels of chronic pain, really make an effort to treat it. I thought I was being "strong" by trying to tough out my pain instead of demanding stronger drugs. I may have done more harm than good by not wanting to appear "weak".

Right now I don't know if I'll EVER get away from high level pain meds and that still scares me, especially since there may have been a chance had I treated it sooner it wouldnt have gotten so out of control.. oh well

Maybe some one in here can learn from my mistake.

If anyone has heard of this theory or any studies being done let me know.

Barb

 
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Old 04-02-2006, 08:18 AM   #2
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Re: Longterm untreated chronic pain...

in short,this is how neuropathic pain develops as the nerves get ingrained with the constant pain being there,so much so that even when the actual pain generator is fixed or removed,that nerve just 'remebers" the pain.this is when the pain really gets much harder to treat as you are not actually treating a real generator but the nerve that is remembering the pain.Phantom pain is also kind of like this too.but in a different way.

shore can really explain this much better and in much more detail,but that is kinda the readers digest version.i am a bit suprised that your doc is not actually aware that this "theory" has been around for a very very long time.any new studies are hopefully looking into ways to actually try and prevent this crap from even happening or looking at better ways of actually treating it.do ya see things a bit more clearly now or did I just confuse you even more,lol?

shore really has a wonderful very clear explanation of how this all happens and i do believe there is a post from him somewhere in here but don't know what the title of the thread actually is so you could find it.maybe he remembers.shore???are ya out there big guy??marcia
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Old 04-02-2006, 01:05 PM   #3
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Re: Longterm untreated chronic pain...

I'm just kinda thinking that since my pain levels were NEVER treated properly since my surgery a year ago that perhaps that is part of my problem.

Oh well... at this point I'll probably never know. But, I have another surgery schedule May 5 to help a pain that might be one that has been generated by fact it hasn't been properly addressed to begin with...

Does that make sense?

Barb

 
Old 04-03-2006, 12:24 PM   #4
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Re: Longterm untreated chronic pain...

It's part of the Gateway therory Barbie, they also call it pain imprinting where the signaling process and neuro-chemicals invodved just contue to travel and be produced. There are sevral neuro chmical differences between the way acute pain is transmitted and chroinic pain. The theory has been around for longer than a decade, I just think more docs are taking a second look and trying to use documented medical studies to justify the work they do, not only legally but to get insurance to pay for Botox and other exepensivve but effective methods for some.

Different neuro transmitters are created with chronic pain, signals travel both ways instead of the one way with acute pain. Chroinic pain, specifically fibro patients have a higher level of substance P, a Neuro inflamatory agent in their spinal fluid. They use anti depressents to supress substance Pbut it's only s efective on it's own. It's te same theory they used to treat me for 7 years without actual opiaetes. Obviously it's been modified but there is a lot of science involved in pain and the docs that know about the science are more likely to truly help someone.

I certainy belive in the use of PM and opiates to treat intractable pain. The problem is every doc and certainly not every patient was educated or researched the theory. If they didn't need it in their specialty, not knowing created a lot of ignorance. If a doc and PM doc will prevent someone from consulting a surgeon to fix something that the surgeon would consider worth fixing, simply treating pain from a defect that can be corected is wrong.

The doc and the PM doc overstep their boundaries and the patient was pacified with meds. Some times with high doses and this could allow the window to pass for a sulution as much as not prescribing pain meds or treating pain can cause chronic pain. A Pm can turn a patients pan into chronic when you can eliminate all the pain of an impinged nerve or any problem that has a solution someone doesn't want to choose.

All the changes in neurtransmitters and calcum channels and bio chemicals once they occur, are not reversed by opiates or surgery. PM can treat the after math or create it. If someone was given enough pain meds to put off needed surgery for 2 years, then the meds are doing harm, if your not actively pursuing a solution.

The window for the chance of succesful surgery and the patient no longer wanting or needing opiatse gets samaller and smaller the more time that passes and pain signals are basically engrained into nerve tissue and your brain is on overload producing chamicals trying to combat it the wrong way or something that isn't there, in the case of phantom pain.

Particluarly if you have nerve pain. The back pain may be relieved by meds and PT but if your left with nerve pain and likely high enough tolerance to be an issue when surgery is finally performed the odds drastically decrease. I'm not advocating surgery for everyone who has back pain. But if you have leg pain and other neruo symptoms, no pill is gong to un-impinge a nerve. There are in-operable problems and problems that can't be fixed with PT or chiro. The ballpark term sciatica may very well be muscular and that can be treated, if you don't treat it properl y and thngs move to the chroncic phase, your more likely to continue to have problems.

Everyone needs to focus on the solution if a problem is causing pain that requires these types of meds before giving up and being satisfied with treating the symptom. After a while the symptom is the problem that can't be fixed. If you give up looking for an answer or choose not to have surgery or even get a consult we are partly responsable. You have to demand finding an answer with the same vigor we demand the pain to be treated.

Going straight to PM for palliative care, and a doc condeming somone to a life of chronic pain is just as bad as making someone suffer when their pain can and should be treated to prevent chronic pain.

If you can't find a published version of the gateway theory I'll see what I can find.

Sorry you feel this happened to you Barb, I''m pretty sure the gateway theory can be applied to me and the prognosis is very poor.
Take care, Dave

Last edited by Shoreline; 04-03-2006 at 12:42 PM.

 
Old 04-03-2006, 10:39 PM   #5
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Re: Longterm untreated chronic pain...

Dave,

Thanks for your post. I've not had a spinal tap and my whole pain issue is complex.... AND, I could have surgery after surgery and I'm still not sure it's going to help "fix" the pain. I DO believe something is wrong mechanically however and is creating this pain. But, like you were saying, with pain for so long will even fixing the mechanical problem help?

Its just weird that 3 years ago I felt fine. My migraines were better and I started exercising. I think whatever underlying condition or misalignment I had just flared when I began exercising and I was never been led in the right path.

Right now I still have questions on whether another surgery is warranted.

My pain is caused by nerves being compressed in my brachial plexus. There are sooo many things that can cause that and I display many of them. My concern now is where do they go to release the compressed nerves.

My surgeon is planning now to do a pectorial release. However, in researching I also learned the same nerves can be released through a scalene muscles in neck) release. You can definitely see asymmetrical pattern to my neck. AND, these nerves lead from C-4 thru T1 and I have some cervicial things going on there also... AND, lets throw another wrench in this... it hasn't been mentioned except in some films that I have some calcification on my right lung as shown by imaging on my right shoulder.

Now I've read there can be a mass on your lung that can also impinge the brachial complex. Since this "dense calcification" is at the top of my lung, I'm thinking - HEY, here is another thing that may be contributing to this.

All of the above can cause nerve pain in the shoulder. I just feel like I am this HUGE vessel of pain and I can't find out the reason for any of it.

Will surgery work? I'm just terrified it wont be my solution.

Sorry for long post... kinda got off the topic. Was just yappin and speaking out loud to myself...

Pain is a pain no matter how you get there........

Barb

 
Old 04-06-2006, 07:09 PM   #6
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Re: Longterm untreated chronic pain...

Long term untreated pain has also been shown to lead to an early death due to cancer, says a study in the British Medical Journall, 2001, 323:662. I think it is also fair to say that untreated pain contributes to psychological problems like depression.

All this and it is still too hard for too many of us to get adequate pain relief. Hard to understand. Isn't it?

Last edited by Amarylis; 04-06-2006 at 07:10 PM.

 
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