Ouch! Ouch! Ouch! Ouch! How to Relieve Chronic Pain

How Pain Can Become Permanent

Once the wiring of the nervous system changes in response to prolonged pain, "the pain you feel doesn't correspond to what is going on in your body," says James N. Dillard, MD, a rehabilitation-medicine specialist in New York City and author of The Chronic Pain Solution. A few become so hypersensitive that even the slightest touch or vibration can be excruciating. "Fifteen years ago people who had these complaints were sent to psychiatrists," says Dr. Dillard. "But now we know that the nervous system is very adaptable, and that the pain pathways can ramp up and amplify the signals."

Every person has a unique susceptibility to pain. Some people can be seriously hurt yet recover quickly, while others are incapacitated by a relatively minor mishap. "People may be genetically predisposed, or a past history of injuries may make them more susceptible," says Linda LeResche, ScD, an epidemiologist and professor in the department of oral medicine at the University of Washington, in Seattle.

Unrelenting pain can erode health and age people prematurely. The release of stress hormones in reaction to pain weakens the immune system, which compromises our ability to fight disease. A year or more of chronic pain can cause brain shrinkage that's 5 to 11 percent beyond what normal aging would take away, according to a 2004 Northwestern University study. Researchers suspect that the cumulative stress of coping with pain wears out brain nerve cells. "The long-term damage can trigger a self-perpetuating cycle of pain, making the condition more intractable," says A. Vania Apkarian, PhD, a pain specialist at the Northwestern University Feinberg School of Medicine, in Chicago.

Chronic pain also spawns an escalating cascade of psychological and emotional problems. Pain sufferers can't sleep, which makes them irritable, anxious, and depressed. One-third report they can't function normally and sometimes feel so bad they want to die.