Chronic pain affects approximately 20.4% of all adults, making it an extremely common condition, with prevalence increasing with age. 7.4% of adults had chronic pain so severe that it limited their ability to work as well as their quality of life.
In 2009, the prevalence of chronic pain in Singapore was reported to be 8.7%. Considering our ageing population as well as global trends, it is likely that this number has risen significantly in today’s Singapore. Furthermore, with the recent COVID-19 pandemic related lockdowns alongside the rise in popularity of work from home or hybrid work arrangements, more Singaporeans have found themselves experiencing chronic pain due to prolonged periods of sitting and physical inactivity.
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Chronic pain is defined as pain that persists over a period that is longer than three months. The pain can come and go or be there all the time, in any parts of your body. Chronic pains can appear anywhere in the body and exist in many different forms. It is a very common problem and is one of the most common reasons for patients to seek medical care. Chronic pains could be caused by chronic illnesses or underlying health conditions, or in some cases, could be unrelated to any injuries or physical illnesses. These types of chronic pains are sometimes referred to as psychogenic pain or psychosomatic pain. These pains are caused by psychological factors such as stress, anxiety and depression.
As mentioned earlier, chronic pains can come in many forms. These can include:
It is important to know what type of chronic pain you have in order to treat and manage it effectively. For some patients, it is possible to have more than one type of chronic pain.
Symptoms of chronic pain can differ amongst individuals, depending on the cause of their pain.
Symptoms can include:
Some groups of people are more likely to develop chronic pain. Risk factors of chronic pain include:
Chronic pain can be caused by many different reasons but is typically the symptom of other health conditions that you may be suffering from. Chronic conditions, in particular, tend to cause chronic pain in patients. Common chronic conditions that can result in chronic pain include:
Complications of chronic pain can be rather severe as chronic pain can worsen quickly if left untreated. It can also be very difficult to treat and manage. Complications may include:
While there are no known prevention methods for carpal tunnel syndrome, there are ways in which you can minimise stress on your hands and wrists while you carry out your daily activities.
These include:
Due to the multitude of reasons behind chronic pain, the treatment methods for chronic pain will differ greatly depending on your type of pain and will as the severity of your condition.
NSAIDs (nonsteroidal anti-inflammatory drugs)
NSAIDs are the most common type of pain-relieving drugs. Examples of NSAIDs include aspirin, ibuprofen, and naproxen. These drugs help to relieve pain caused by muscle aches and stiffness. It also reduces inflammation in the body. These can be consumed orally.
Topical Pain-relieving Creams
Topical painkillers, or analgesics can be sprayed on, applied on, or put on as patches onto the skin over the affected muscles or joints. This can be used for pain caused by arthritis.
Muscle Relaxants
Muscle relaxants can be prescribed by a doctor if the usual over-the-counter drugs are unable to relieve your pain.
Trigger Point Injections
Trigger points, commonly referred to as muscle knots, cause pain as the affected muscles are unable to relax. A local anaesthetic which sometimes can include a steroid is injected into the trigger point, forcing it to relax and therefore alleviate pain.
Botox
OnabotulinumtoxinA (Botox) blocks signals from the nerves to the brain. While it is more commonly known as part of a cosmetic procedure that prevents wrinkles, Botox injections can also be used to alleviate pain for a period of up to three months. However, it is only used when traditional pain treatment methods have been ineffective.
Dry Needling
Dry needling is a form of therapy that uses thin, sterile needles to penetrate the skin, targeting trigger points in your muscle and tissue. In doing so, the trigger points are released, relieving muscle tension, pain and muscle spasms.
Deep Tissue Massage
A deep tissue massage is a form of massage therapy that targets the deeper layers of your muscle to relieve and treat muscle and tendon pain, stiffness and injuries. Deep tissue massage also stimulates blood circulation and promotes your body’s recovery process.
Extracorporeal Shockwave Therapy (ESWT)
ESWT is a non-invasive, non-surgical, and risk-free treatment that uses shockwaves to target your damaged muscle, tendons, ligaments, or joints to relieve pain, reduce inflammation, and stimulate recovery.
Magnetic Resonance Therapy
Magnetic resonance therapy is a non-invasive, non-surgical, and risk-free treatment that uses three different electromagnetic fields that transfer energy into your damaged cells to stimulate your cell regeneration process. In doing so, cartilage and ligament regeneration is stimulated and reactivated, alleviating chronic pain and discomfort.
Psychological Treatment
Some patients may experience chronic pain that is triggered by stress or certain feelings such as anger, anxiety or sadness. Psychological problems such as anxiety and depression, or a lack of sleep, can all contribute to aggravating symptoms of pain.
Physiotherapy
Physiotherapy employs stretching, strengthening, and pain-relieving techniques to aid treatment for injuries or disabilities. While your first thought when experiencing pain might be that your body needs rest, rest may sometimes not be beneficial to the body as it increases stiffening and weakness, potentially worsening the symptoms of pain that you are trying to avoid. Correcting improper posture can also help to reduce strain on tensed muscle groups. Professional physiotherapists will be able to design exercise programs suitable for your condition, strengthening your body so that it is able to cope with the pain better, and reducing the chances of painful flare-ups in the future.
Depending on the cause of your chronic pain, your physiotherapist may recommend various treatment methods in conjuncture with your physiotherapy treatment for optimal results.
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