Chronic Pain Syndrome

When the nervous system detects potential damage to the body either through injury or disease, it sends a warning in the form of an acute pain sensation. By contrast, chronic pain syndrome occurs when pain signals continue to fire even after the cause of pain has been resolved; it can also occur as an idiopathic (unknown cause) condition in which no injury occurred and your body suffered no observable damage.

Any pain experienced without a trigger that lasts for three months or longer is considered chronic. If the pain has been triggered by an illness or injury, the neurology team at Houston Methodist would consider the average recovery rate for that condition before determining if the pain was chronic.

Chronic pain conditions often affect older adults. Symptoms may include headache, low back pain, cancer pain, arthritis pain, pain resulting from damage to the peripheral nerves or central nervous system (neurogenic pain) or pain resulting from prolonged stressful situations (psychogenic pain).

Chronic pain conditions include chronic fatigue, endometriosis, inflammatory bowel disease , fibromyalgia , interstitial cystitis and temporomandibular joint (TMJ) dysfunction.

Although chronic pain syndrome can resolve with treatment, it is not common for it to be completely resolved, so long-term pain management should be a major component of a treatment plan.

Diagnosing Chronic Pain Syndrome
Our team starts with a physical examination and medical history. We may recommend tests — imaging, bodily fluids, nervous system, muscles, joints and bones — to determine any underlying causes for the particular pain being experienced.

Treating Chronic Pain Syndrome
In addition to such methods as desensitization therapy, acupuncture, meditation and hypnosis, Houston Methodist doctors may recommend a variety of medications to manage the symptoms of chronic pain syndrome.

• Over-the-counter pain relievers such as acetaminophen, aspirin, ibuprofen and naproxen may ease pain and inflammation.
• Opioids such as fentanyl, morphine and oxycodone may be prescribed for more severe pain, but must be dosed properly to manage side effects.
• Anesthetics have been shown to alleviate pain, but also present a high risk of side effects if not dosed properly.
• Corticosteroids (cortisone, prednisone) may reduce inflammation and help relieve pain and stiffness from arthritis.
• Sympathetic nerve blocks are injected to determine potential damage to the sympathetic nerve chain in the spine.
• Antidepressants and anticonvulsants are used to treat neuropathic pain (damaged nerve fibers).
• Bisphosphonates (bone-loss medications) are sometimes recommended to help treat or prevent osteoporosis .