At Novus Medical Detox Center, many of our
patients tell us that they came to us because
their lives were being ruined by highly addictive
narcotic painkillers like OxyContin, Lortab,
Percocet, oxycodone or even, in a few instances,
methadone that was prescribed by medical doctors
to treat pain. When our
patients arrive at Novus on these painkillers they
normally complain of two or more of the following
conditions:
*
Anxiety
*
Depression
* Inability to
concentrate
* Slowed reaction
times
* Decreased or no sex
drive
*
Fear
*
Hopelessness
*
Anger
* Insomnia or other sleep
problems
*
Pain
Some of our patients are not addicted to
the drugs, in the classic sense, but merely
dependent, meaning that they experience severe
withdrawal symptoms if they try to stop taking the
painkiller.
Let's examine what is pain, the way it is
sensed and some of the more common
types.
WHAT IS
PAIN?
At one time or another all of us have
experienced pain. We have
all touched a hot object, fell and banged our
elbow or scraped our knee, gotten a headache, or
ached the next day after helping someone move to a
new apartment.
All of the above uncomfortable sensations
we call pain. Almost always, the pain will go away
in a few hours to as much as a day or
so.
For some, though, their pain doesn't go
away in a day but stays with them for the rest of
their lives until they can find a way to deal with
it.
The Encarta Dictionary defines pain as:
"Unpleasant physical sensation--the acutely
unpleasant physical discomfort experienced by
somebody who is violently struck, injured, or
ill."
The International Association for the Study
of Pain defines it as: "An
unpleasant sensory and emotional experience
associated with actual or potential tissue damage
or described in terms of such
damage."
HOW DO WE PERCEIVE
PAIN?
This is not an easy
answer, but most scientists believe that pain
signals originate in the thalamus (either of a
pair of egg-shaped masses of gray matter in the
brain that relay sensory information) and are sent
from there to the cerebral cortex (the
headquarters for complex thoughts). It is also
theorized by some scientists that the thalamus is
where images, like those of injuries to the body,
are stored for recall by the
brain.
Apparently, a
neurotransmitter (a chemical that carries messages
between different nerve cells or between nerve
cells and muscles) stimulates a receptor (a part
of an adjoining nerve cell) to send out a distress
signal that something is wrong, and this is the
way that our brain senses
pain.
Scientists have
identified a type of receptor that responds to
painful stimuli called a nociceptor. A
nociceptor is a thin nerve fiber in the skin,
muscle, and other body tissues that, when
stimulated, carries pain signals to the spinal
cord and brain. While normally nociceptors only
respond to physical pain, they can be made more
sensitive because infections or sunburns or
other things that would not have necessarily
caused pain will now-like patting someone on their
sunburned
back.
WHAT IS THE
PURPOSE OF
PAIN?
Most scientists
agree that pain is used by the body to warn of a
non-optimum situation or danger to the body and to
signal that immediate action must be
taken.
For example, holding your finger on the hot
plate will be very destructive if not removed
quickly.
Lifting too heavy a load can permanently
injure the back, so your body sends out an
immediate warning by making you feel pain and
then you set the load down. Looking at
too bright a light is painful and if you don't
look away it could cause permanent damage to
your optic nerve.
Of course, some
people will react to pain like the cat described
by Mark Twain. They will
never jump on a hot stove again but they also will
not jump on a cold stove. We all
know people who have had a relatively minor
bicycle accident who will never ride a bike
again.
This is an example of their body's pain
mechanism actually interfering with them doing
some things that might add pleasure to their
lives.
If the condition
causing the pain is not corrected, the pain can
become so severe that it takes over the person's
life.
HOW IS PAIN
DIAGNOSED?
While it is extremely frustrating to
patients, medical professionals and insurance
companies, there is no test that can accurately
measure the intensity of pain and often no way to
accurately diagnose the real cause of the
pain.
Of course, if the pain is due to a
trauma or something shows up on a
magnetic resonance image (MRI) or simple X-ray,
then the cause can be
located.
ACUTE AND
CHRONIC
PAIN
Pain is generally divided into two
areas-acute and chronic.
Acute
Pain
Generally acute
(severe and of a short duration) pain is normally
caused by disease, inflammation, or injury. It
generally comes on suddenly and though it may be
severe it generally will start to lessen and will
eventually go away.
Chronic
Pain
Chronic (long
lasting) pain may vary in intensity but it
persists over a longer period of time than acute
pain.
By definition, chronic pain is pain that
has not been successfully treated. Our
patients who come to Novus to get off painkillers
prescribed by doctors are suffering from chronic
pain and that is what we will
discuss.
COMMON
TYPES OF CHRONIC PAIN
While not a
complete list of the types of chronic pain
suffered by Novus patients, most of them have pain
derived from one of the following
types:
Arachnoiditis
The arachnoid is
the middle of the three membranes that envelop the
brain and spinal cord. The suffix
"-itis" means inflammation or disease. (Some
confuse arachnoid with arachnids-spiders, but this
is not the same thing.) Arachnoiditis is the
inflammation of the membrane that surrounds and
protects the nerves of the spinal cord (a thick
whitish cord of nerve tissue extending from the
bottom of the brain through the spinal column,
which together with the brain forms the
central nervous system).
The arachnoid can become inflamed in the
following way:
* Because of an irritation
from chemicals such as the dye used to
provide contrast to x-rays, CT or MRI scans or
from steroid
injections;
* Because of an infection
from bacteria or
viruses;
* Because of direct injury
to the spine such as from an
accident;
* Because of complications
from spinal surgery or other invasive spinal
procedures.
Inflammation of the arachnoid often leads
to the formation of scar tissue and adhesions
which cause the spinal nerves to "stick" together
and this can cause a number of symptoms such
as:
*
Numbness
*
Tingling
* Stinging, shooting and
burning pain in the lower back or legs
* Debilitating muscle
cramps, twitches, or
spasms
* Impairment in bladder,
bowel, and sexual
function
* Paralysis of the lower
limbs.
Back
Pain
While arachnoiditis
certainly is a cause of back pain, there are other
causes including:
* Sciatica--pain that
spreads to the legs
