Chronic pain and depression are two of the most common health problems that health professionals encounter, yet only a handful of studies have investigated the relationship between these conditions in the general population (Currie and Wang, 2004). Major depression is thought to be four times greater in people with chronic back pain than in the general population (Sullivan, Reesor, Mikail & Fisher, 1992). In research studies on depression in chronic low back pain patients seeking treatment at pain clinics, prevalence rates are even higher. Thirty two to 82 percent of patients show some type of depression or depressive problem, with an average of 62 percent (Sinel, Deardorff & Goldstein, 1996). In a recent study it was found that the rate of major depression increased in a linear fashion with greater pain severity (Currie and Wang, 2004). It was also found that the combination of chronic back pain and depression was associated with greater disability than either depression or chronic back pain alone.
Acute Pain Usually Lasts a Short Time. Pain that lasts less than 3 to 6 months, or pain directly related to tissue damage, is called acute pain.
Acute pain can become chronic after a crash if not treated promptly, and we recommend that patients come into our office immediately. When pain persists, it becomes more affected by other influences, which can increase the individual’s risk of developing chronic pain. These influences include such things as the pain signal continuing to reach the central nervous system after the tissue has healed, lack of exercise (physical de-conditioning), a person’s thoughts about the pain, as well as emotional states such as depression and anxiety.
Chronic Pain Continues After Tissue Heals. The term “chronic pain” is generally used to describe pain that lasts more than three to six months, or beyond the point of tissue healing. Chronic pain due to cancer is more of an acute or acute-recurrent type of pain since there is ongoing and identifiable tissue damage.
There is also chronic pain due to an identifiable cause, which will be discussed subsequently. Chronic pain is usually less directly related to identifiable tissue damage and structural problems. Chronic back pain without a clearly determined cause, failed back surgery syndrome (continued pain after the surgery has completely healed), and fibromyalgia are all examples of chronic pain. Chronic pain is much less well understood than acute pain.
In a third type of chronic pain, neuropathic pain, no signs of the original injury remain and the pain is unrelated to an observable injury or condition. Certain nerves continue to send pain messages to the brain even though there is no ongoing tissue damage.
Neuropathic pain could be placed in the chronic pain category, but it has a different feel than chronic musculoskeletal pain. The pain is often described as severe, sharp, lightning-like, stabbing, burning, or cold. The individual may also experience ongoing numbness, tingling, or weakness. Pain may be felt along the nerve path from the spine down to the arms/hands or legs/feet.
The medical field defines a herniated disc as, “a problem with one of the rubbery cushions (discs) between the individual bones (vertebrae) that stack up to make your spine. A spinal disc is a little like a jelly donut, with a softer center encased within a tougher exterior”.
Because the spine is so delicate, it is not hard to imagine a violent accident causing compression, stretching, or twisting or tearing of the spine to such a degree as to cause a disc to rupture. When the fluid leaks out of the disc there is no cushion left between the vertebrae and they can rub together causing pain by irritating the spinal nerves. In addition to pain, other symptoms of a herniated disc are numbness, weakness, or a tingling sensation in the arms or legs. A chiropractic examination will include x-rays and an MRI if needed in order to pinpoint the exact location of the herniation. This way, a plan of rehabilitation can be recommended to treat the exact problem.
Our patients seek relief from pain in either specific parts of the body usually the head, neck, and spine. Certain spinal conditions can, however, can present other symptoms in addition to pain such as numbness and tingling or muscle weakness discomfort and can also lead to bladder and bowel dysfunction. One such condition that displays these symptoms is Spinal Stenosis.
The spinal column is made up of spaced vertebrae that are separated by in-vertebral discs and spinal cartilage that can narrow over the decades of one’s life and put pressure on the spinal cord. This pressure can cause the nerves that radiate from the spinal column and travel down and out to the legs and arms.
Sciatic back and leg pain referred to as Sciatica is characterized by numbness and pain on one side of the lower back and buttocks. “Sciatica is the pain, tingling, or numbness produced by an irritation of the nerve roots that lead to the sciatic nerve. The sciatic nerve is formed by the nerve roots coming out of the spinal cord into the lower back.”
Sciatica is usually the result of a repetitive motion, or lack thereof or compression injury and the pain is frequently worsened by sitting. Many people develop sciatic back pain by sitting behind a desk for long hours without taking necessary breaks to walk and stretch. Most of the time sciatic back pain can be temporarily relieved simply by standing up, walking or stretching. The degree Sciatic back pain varies from person to person and can be as minor as occasional discomfort or as extreme as total immobility and incapacitation, although the latter is rare.