Pain Management

Complex Regional Pain Syndrome (CRPS) Study

Studies of an amputated arm and leg have shed some light on the cause or effects of complex regional pain syndrome (CRPS). This painful condition of the extremities occurs after trauma to the area. It begins after something as minor as a mosquito bite. Major trauma such as injury or surgery for joint replacement can also bring it on.

I hear doctors aren't treating low back pain like they used to. I saw a TV special that said most low back pain is caused by psychosocial issues. Just exactly what does that mean anyway? Do I have back pain because I am a social misfit?

Not at all. The new understanding of low back pain looks at the total person -- not just the biology and biomechanics of your spine. Back pain whether from an injury or unknown cause is very real. But the stresses and strains of the body as well as the stress on the mind are both part of the picture.

My doctor told me not to seek treatment for low back pain unless it lasts more than six weeks. This is very distressing because I want to do something about it now.

Your doctor is following the latest guidelines on the treatment of acute (new) back pain. Research shows most people get better on their own in the first two or three weeks. The best advice is to keep moving and active despite the pain.

Sometimes when a friend or family member is hurt, I actually feel physical pain too. It doesn't last long and it isn't as intense as their pain. Am I just imagining this or is it really possible?

It's really possible. Scientists using MRIs have been able to show that when an outside observer is with someone in pain, similar neurons in the brain are activated in both people. This process has been called a mirror neuron/circuit system.

Somehow the mind, body (felt sensations), and emotions are all linked together. As you've noticed, the sensations are not exactly the same for both people.

What is the purpose of physical pain in someone who doesn't really seem to have anything wrong with them?

At first pain has the purpose of warning the person. It protects us from further injury or harm. The body is saying, "Stop whatever you are doing -- it hurts." Escape is the next step: get away from whatever is causing the pain. This is also a protective mechanism.

My wife has had three back surgeries and is in the hospital for her fourth. She's had constant pain but the nurses refuse to give her an increase in her pain meds. How can they watch patients suffer like this and not respond?

Please understand that nurses can only dispense drugs for pain according to the doctor's orders. Some pain meds are very addicting. Others can kill a patient if given too often or in too high a dosage. Pain management is often a difficult part of patient care. This is especially true for someone like your wife who already has constant or chronic pain.

Relating to Others in Pain

Empathy has been defined as sensing someone else's pain or distress. In this article researchers from around the world review the effects of pain on others. Models of empathy are presented along with evidence from MRIs to support them.

Surprising Findings About Psychosocial Factors and Low Back Pain

In this paper researchers try to explain why treatment aimed at psychosocial factors did not have better results than usual care for low back pain (LBP) patients. Other studies have already shown there is an effect of psychosocial factors on LBP. It makes sense to think treatment aimed at those factors should be helpful. The results of their first study published earlier in 2005 were a surprise. They were certain a psychosocial approach would make a difference but it didn't.

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