Chronic Pain

Overview

Chronic Pain

Chronic pain is defined as pain lasting more than 6 months or longer than the time expected for tissue healing. Distinction is made clinically between cancer pain and non-cancer pain, as cancer pain usually worsens as the cancer spreads and increasing medications are required for palliative care. Chronic non-cancer pain (CNCP), on the other hand, is a condition where pain perception is driven by persistent pain signals coming from specific areas of the body and/or there is amplification of pain perception in the central nervous system of the brain. 

It is important to appreciate that pain is an inherently subjective experience and the emotional state of an individual has a great effect on the perception of pain. Fear, anger and shame are commonly associated with amplification of chronic pain.

Chronic pain has major debilitating effects that have major repercussions for the individual, their family life and ability to be productive at work. Chronic pain patients are often prescribed opioid medications as a solution that can become part of the problem because of their abuse liability and dependence (addiction) potential.
Addiction involving alcohol is a chronic medical condition that requires assessment and treatment, as manifestations of it vary in different individuals. With Addiction involving alcohol, the ability to make healthy choices regarding alcohol is impaired. Alcohol begins to start controlling one’s life, making life more unmanageable. With Addiction, the problematic alcohol use is a symptom of what is happening in the brain and the person is seeking escape, relief or reward. Unfortunately there is no off switch and there is an ever increasing desire for more. It is critical to understand what is happening in the brain as our brain is involved in everything we do, including our thoughts, feelings, perceptions and behaviors as well as how we view ourselves and we get along with others.

Symptoms

Chronic pain takes a toll on both physical and mental health. While the pain can be near-constant, there may be flares of more intense pain due to increases in stress or activity.

Symptoms include:

  • joint pain
  • muscle aches
  • burning pain
  • fatigue
  • sleep problems
  • loss of stamina and flexibility, due to decreased activity
  • mood problems, including depression, anxiety, and irritability

How we treat this issue:

When pain persists and becomes chronic it also becomes more complex and requires continuing care. Chronic pain always has a physical health component and a mental health component. We treat both aspects with or without medications. Addiction and mental health issues require a detailed assessment and then treatment with psychotherapy that includes individual sessions and at times couples or family sessions. 

Psychotherapy is done from a variety of therapeutic approaches and incorporates aspects of Cognitive-Behavioural Therapy, Solution-Focused Therapy, Rational Emotive Therapy, Gestalt Therapy, and/or Family Systems Therapy. We initially gather information about who you are and where you are at to be able to provide targeted recommendations to support you in your journey of growth despite the limitations chronic pain may impose on you.

The Available Services For This Issue:

It is recommended to start with HUM’s comprehensive assessment. The assessment includes 3 appointments and is designed to get to know you, the acuity of your issues and appropriate treatment recommendations. The 3 appointments include an initial nursing assessment, an assessment with a registered psychologist or social worker and thirdly with a medical doctor. Following these three appointments, treatment options will be discussed that are based on your needs and current situation.

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At HUM, we use a range of techniques based on experiential relationship building, dialogue, communication and behavior change that are designed to improve the mental health of an individual,and improve relationships with others (eg. family). Our goal is to provide an open, supportive, and confidential environment for you to address the issues that are concerning you. These principles can also be provided through couples/family sessions.

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This provides the opportunity to clarify boundaries, identify what may be individual issues for people to work on, while addressing issues jointly without telling each other what to do.

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All medications that an individual may be on including prescribed or over-the-counter are reviewed to determine their efficacy and interactions. Medications may be prescribed during withdrawal management, tapering or maintenance treatment. We consider symptom triggered withdrawal management that is individualized to be more beneficial than protocol driven prescriptions. There are a variety of medications – opioids and non-opioids – for chronic pain that would be discussed individually.