Murray J. McAllister, PsyD
Murray J. McAllister, PsyD, is the editor and founder of the Institute for Chronic Pain (ICP). The ICP is an educational and public policy think tank. Its mission is to lead the field in making pain management more empirically supported. Additionally, the ICP provides Academic quality information on chronic pain that is approachable to patients and their families. Dr. McAllister is also the clinical director of pain services for Courage Kenny Rehabilitation Institute (CKRI), part of Allina Health, in Minneapolis, MN. Among other services, CKRI provides chronic pain rehabilitation services on a residential and outpatient basis.
Opioid, or narcotic, pain medications are beneficial in a number of ways. Terminal cancer patients, for instance, benefit from their use. The short-term use of opioid pain medications is beneficial, especially while recovering from an acute injury or a surgery. However, the long-term use of opioid medications for chronic, noncancer, pain remains controversial. While a number of issues contribute to this controversy, the main reason for the controversy is addiction. Opioid pain medications are addictive.
This controversy makes opioid pain medications a highly sensitive issue for patients who take them.
What is trauma?
Trauma is the psychological and bodily response to experiencing an overwhelmingly terrible event. Some examples of events that can lead to trauma are the following:
What is a sleep disturbance?
Patients with chronic pain frequently experience sleep disturbances. Sleep disturbance is a catchall phrase for any type of problem in sleeping. The most common forms of sleep disturbances in patients with chronic pain are the following:
What is depression?
From time to time, most people feel down, blue, unhappy, or irritable. These kinds of depressed moods come and go in response to the normal problems of life.
What is anxiety?
Anxiety is a normal emotion. Everyone has anxiety on occasion. It is the emotion that people have when something dangerous might happen. Anxiety is closely related to fear. Fear occurs when something dangerous is happening. Anxiety, though, occurs when something dangerous is pending, and hasn’t happened yet, though it could.
What are complications to pain?
A number of problems are associated with living with chronic pain.
What is stigma?
Stigma is the social disapproval of a characteristic of a person and, typically, the characteristic is not changeable or not easily changeable. The disapproval is a critical judgment that an individual is not normal and has less worth than those in the norm. A natural response to stigma is shame and shame-based defensive anger.
Central sensitization is a condition of the nervous system that is associated with the development and maintenance of chronic pain. When central sensitization occurs, the nervous system goes through a process called wind-up and gets regulated in a persistent state of high reactivity. This persistent, or regulated, state of reactivity lowers the threshold for what causes pain and subsequently comes to maintain pain even after the initial injury might have healed.
What is a chronic pain syndrome?
Your doctor has told you that you have a chronic pain syndrome. What does it mean?
In most cases, chronic pain starts with an acute injury or illness. If the pain of this injury or illness lasts longer than six months, it’s then considered chronic pain. Sometimes, chronic pain subsequently causes complications. These complications, in turn, can make the pain worse. A chronic pain syndrome is the combination of chronic pain and the secondary complications that are making the original pain worse.
Patients and healthcare providers commonly think of pain as a symptom of an underlying injury or illness. Say, for example, you hurt your low back while lifting. Perhaps, you’ve injured a muscle or ligament, or perhaps it’s an injury to the spine, like a disc bulge or herniation. Either way, you now have pain and the pain is the symptom of the injury. The same might be true for any health condition that causes pain, particularly when it first starts.
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