Anxiety and Chronic Pain

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How can you not be anxious about having chronic pain?  Not being in pain is a basic human need.

When you are in chronic pain, you might fantasize that it would be better not to have any pain fibers.  That situation does exist in the human experience.  There is a condition termed “Congenital Indifference to Pain.”  A baby is born without any ability to sense pain.  No matter what has been tried, there is not a way to prevent the child from burning, bruising, cutting, chewing on his or her body until it is disfigured and destroyed.  These unfortunate children have a limited life span.

A similar problem occurs in patients with diabetes who develop a severe peripheral neuropathy.  The elevated levels of blood sugar damage the small sensory nerves to the feet.  As there is not pain to limit the amount of stress placed on the joints, the stress limits of the joints are exceeded.  With repetition the foot can turn into a “bag of bone fragments.”  No pain.  The same problem can occur in the shoulder and spine.  The term is “Charcot joint.”

So when you experience pain, your anxiety is well founded.  Your brain is programmed for you to decrease the stress on the painful body part.  If you continue to stress an injured structural problem, the damage will continue.

In chronic pain, there is usually not an identifiable problem as the source of the pain.  Now you are in a dilemma.  What do you do?  You are programmed to protect yourself until the “injury” has healed.  As there is no “injury” how long are you supposed to protect.  In spite of your doctors performing extensive testing there is always that thought that the doctors might be missing a significant problem.  In fact, they rarely do.  You hear enough of the stories that you cannot completely let it go.

There was one study many years ago that showed a significant percent of patients were relieved when their chronic abdominal pain was diagnosed as pancreatic cancer.

Other anxieties associated with chronic pain might be:

  • How can I support my family?
  • What about my career?
  • My friends and family are not going to believe me
  • Co-workers often are not sympathetic, especially if they have to pick up the slack from your injury
    • One company had their light duty steel workers wear pink hard hats when they were on the work site.
  • Divorce rates are high in families where someone has chronic pain
  • No one is listening, including my doctor

If a patient with chronic pain does not acknowledge he or she has anxiety, I realize I am going have to wait a while before I can help them.  I don’t know what percent remain entrenched in that mind set.