The Effects Of Pain

By Deeni Bassam, MD, DABPM

Historically, most of the medical community has viewed pain as just a symptom of underlying pathology. The search for the underlying problem was primary, and little to no attention was paid to the end effects of the pain itself. While waiting for a diagnosis or for effective treatment, patients would often suffer in agonizing pain.

While concentrating on the cure is certainly important, it is also important to understand that the patient’s health can further deteriorate from the pain itself. Thankfully, our understanding has evolved towards an appreciation for pain as a problem unto itself.

Painful stimulus has been shown to elicit a powerful release of ‘stress’-related hormones, including adrenocorticotropic hormone (ACTH), antidiurectic hormone (ADH), angiotensin, glucagon, and catecholamines. Pain stimulates the release of these hormones into the blood stream, which then, in turn, over- stimulate their end-organ targets.

It was the understanding of this basic science that led clinicians to emphasize more direct ways to remove the source of the pain, while, at the same time, aggressively managing the co-existing pain as well. An example of this can perhaps best be seen in advancements in the peri-operative experience over the past two decades.

Chronic pain has been shown to have significant negative effects on the human body and mind. These effects are as varied as they are widespread and include psychological effects, such as depression and irritability. Simple lifestyle disruptions occur in daily activities, such as eating and sleeping. Limitations in mobility compound both the mental and physical suffering over time.

Pain begets disability, which begets further pain, and the cycle deepens. There is often added strain caused by missed work and lost productivity. Finally, lest we forget that for nearly every person suffering with chronic pain, there is at least one family member who loves them and can’t help but be affected as well.

Pain management as a medical specialty has evolved with this rather recent understanding of the role of pain in the disease process.

Armed with a better understanding of the neural and neuro-biologic pathways involved in the propagation of painful signals, modern pain specialists can intervene for the benefit of the patient in many places and in many ways along the pain continuum.

For an individual caught in the vortex of pain and illness, there can come a point when the pain becomes more than they can bear without reaching out for help.

When the pain of a medical burden significantly impacts an individual’s daily abilities, a referral or appointment with a pain specialist may be warranted and certainly can help in many cases.