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Chronic Pain

site policy and disclaimer

Pain is an unpleasant sensory and emotional experience associated with actual or potential tissue damage, or described in terms of such damage. The emotional component of pain is called suffering. Pain is familiar to everyone and yet so complex and subjective it cannot be easily described or treated.

Pain is the body's mechanism of self-preservation. It acts as a warning to indicate harm or potential danger to tissues in our bodies. However, when pain persists or reoccurs over a long period of time (more than six months), it is said to be chronic pain. Because this pain is not protective, and not a result of a continuing injury, it is "pathological" nerve injury pain and, therefore, treated as an end and not as a symptom.

More than 75 million Americans suffer chronic, handicapping pain. Approximately 75 to 80 million people in the United States are estimated to suffer chronic pain, and this is generally considered a conservative estimate. Chronic low back pain, for example, affects nearly 31 million Americans and represents the most common cause of disability in persons less than 45 years of age.

Persons with chronic pain fall into two groups -- those with ongoing tissue injury, as occurs with cancer-related pain; and those without ongoing tissue damage, perhaps as a result of a previous injury.

Neurosurgeons can treat chronic pain by augmenting, or stimulating, functional parts of the nervous system, especially the spinal cord. Candidates for such surgery must undergo a trial consisting of temporary implantation of an electrode over the spinal dura. When successfully positioned, this electrode produces a pleasurable sensation that overlaps the regions of pain in the body. If it alleviates pain adequately, a permanent battery or "pulse generator" is connected and implanted surgically, much like a heart pacemaker. This generator can be frequently reprogrammed using a computer without resorting to further surgery.

Other surgical options include a number of ablative procedures. Ablative operations involve creating an injury to the sensory portion of the central or peripheral nervous system.