I wanted to take time to share with all of you about the many faces of chronic pain. For many, like Ruth Holm, a follower of this blog, most people wave us off like we are the boy who cried, “Wolf!” Forgive me for being blunt, but this really ticks me off. This wolf is very real, and though it sometimes does not show on our exterior like cancer or other diseases, it is just as deadly. How? The human body and mind can only take so much pain until ending your own life seems like the one and only option. And, no, taking a pill, intense physical therapy, or even using the high powered stuff does not solve our problem!

Recently, a fellow chronic pain fighter, Rosemary, was in a car accident and was rushed to the hospital with a plethora of broken bones, many of them in her lower back and neck. She was in so much pain, not even the pain meds they gave her touched it. The only way she was able to get relief was for them to put her under. Before the accident, Rosemary was on several pain meds, but had maxed out on all of them. Between the medication, the pain, and other stresses, she was considering taking her own life. Then, the accident happened.

This monster has many faces and, yes, it is very real. Here is a list and brief synopsis of some of pain’s vicious names, so that you can be well informed and know that we do not cry “Wolf!” for attention.

Chronic Regional Pain Syndrome (CRPS)

Complex regional pain syndrome (CRPS) is a chronic pain condition most often affecting one of the limbs (arms, legs, hands, or feet), usually after an injury or trauma to that limb.  CRPS is believed to be caused by damage to, or malfunction of, the peripheral and central nervous systems.  The central nervous system is composed of the brain and spinal cord, and the peripheral nervous system involves nerve signaling from the brain and spinal cord to the rest of the body.  CRPS is characterized by prolonged or excessive pain and mild or dramatic changes in skin color, temperature, and/or swelling in the affected area.

There are two similar forms, called CRPS-I and CRPS-II, with the same symptoms and treatments. CRPS-II (previously called causalgia) is the term used for patients with confirmed nerve injuries. Individuals without confirmed nerve injury are classified as having CRPS-I (previously called reflex sympathetic dystrophy syndrome).  Some research has identified evidence of nerve injury in CRPS-I, so the validity of the two different forms is being investigated.

CRPS symptoms vary in severity and duration. Studies of the incidence and prevalence of the disease show that most cases are mild and individuals recover gradually with time. In more severe cases, individuals may not recover and may have long-term disability.

For more info, go to https://www.ninds.nih.gov/Disorders/Patient-Caregiver-Education/Fact-Sheets/Complex-Regional-Pain-Syndrome-Fact-Sheet#What is complex regional pain syndrome?

Reflex Sympathetic Dystrophy

Reflex sympathetic dystrophy (RSD) is a condition that features a group of typical symptoms, including pain (often “burning” type), tenderness, and swelling of an extremity associated with varying degrees of sweating, warmth and/or coolness, flushing, discoloration, and shiny skin. RSD is also referred to as “complex regional pain syndrome,” “the shoulder-hand syndrome,” “causalgia,” and “Sudeck’s atrophy.”

For more info, go to http://www.medicinenet.com/reflex_sympathetic_dystrophy_syndrome/article.htm#reflex_sympathetic_dystrophy_rsd_facts

The exact mechanism of how RSD develops is poorly understood. The theories include irritation and abnormal excitation of nervous tissue, leading to abnormal impulses along nerves that affect blood vessels and skin. The involuntary nervous system, peripheral nerves, and brain seem to be involved.

A variety of events can trigger the RSD, including:

  • injury,
  • surgery,
  • heart disease,
  • degenerative arthritis of the neck,
  • stroke or other brain diseases,
  • nerve irritation by entrapment (such as carpal tunnel syndrome),
  • shingles,
  • shoulder problems,
  • breast cancer, and
  • drugs for tuberculosis and barbiturates

For more info, go to http://www.medicinenet.com/reflex_sympathetic_dystrophy_syndrome/page2.htm#what_causes_reflex_sympathetic_dystrophy_rsd

Amplified Musculoskeletal Pain Syndrome (AMPS)

Amplified Musculoskeletal Pain Syndrome (AMPS) is a medical condition in which an individual develops an abnormal pain reflex.  This overactive reflex causes constriction of blood vessels which deprives oxygen to muscles, bones and skin causing lactic acid build-up. In turn, a mild pain signal is amplified into a very painful signal. The pain can be consistent or intermittent.

Often children with AMPS will also have allodynia, which is pain caused by a stimulus that normally should not be painful such as light touch. Other symptoms may include: pain in one or multiple limbs, whole body, abdomen, and /or headaches; skin temperature changes; skin color changes (blue, purple, red); swelling of the affected extremity; vascular changes; and/or conversions.  Conversions are a physical response to emotional stress.

For more info, go to http://www.providencemedical.com/vnews/display.v/ART/53d98b09b8cb3

Reflex Neurovascular Dystrophy (RND)

Reflex neurovascular dystrophy (RND) is a painful condition that leads to severe pain in the joints and muscles in children. The pain may be described as sharp, burning, achy, crampy, a pounding hammer, or cutting like a knife. The pain is caused by a nerve sensitivity whereby the nerves in the body send pain signals to the brain inappropriately. RND affects girls more than boys (80 percent girls).

RND can be associated with other symptoms including:

  • headaches
  • stomach pains
  • chest pain
  • painful menses
  • poor concentration
  • memory loss
  • insomnia
  • ringing in the ears
  • swelling
  • skin color changes
  • skin temperature changes
  • dizziness
  • loss of appetite
  • weight loss or weight gain
  • waking in the night
  • fatigue
  • extended napping
  • decreased performance in school

RND can also occur in children with growth plate fractures. The pain from RND typically is not helped by pain medications, and medical testing usually shows normal results.

– See more at: http://www.chp.edu/our-services/rheumatology/conditions/reflex-neurovascular-dystrophy#sthash.XMjZVZV1.dpuf

 

Fibromyalgia

Fibromyalgia is a disorder characterized by widespread severe, often debilitating pain, abnormal pain processing, sleep disturbance and fatigue. The cause or causes or these symptoms has not been proven.

Symptoms include:

  • Fatigue
  • Morning stiffness
  • Tingling or numbness in hands and feet
  • Headaches, including migraines
  • Irritable bowel syndrome
  • Sleep disturbances/insomnia
  • Cognitive dysfunction with thinking and memory (sometimes called “fibro fog”)
  • Painful menstrual periods and other pain syndromes
  • Sound sensitivity, light sensitivity, temperature sensitivity
  • Sharp and aching pain in connective tissue areas (next to joints)
  • Muscle twitches
  • And more

For more info, go to http://www.openmedicinefoundation.org/what-is-mecfs/fibromyalgia/?gclid=CPCcpP-j4NECFdgXgQod_8EJQQ

Even though someone’s pain issue does not fit exactly under one of these already established labels, it does not mean their pain is not real. More research needs to be done in order to help those battling this wolf on a daily basis.