"I Have Chronic Pain"

What Some Headache Sufferers Endure

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Do you suffer from chronic pain?. Andy Lyons/Getty Images

Chronic pain is a medical condition that entails various types and origins of discomfort. For some people, pain is localized to a specific area, like the head or back. Other times, the pain is more generalized. Chronic pain can also have varying levels of disability – ranging from a mild disturbance to totally debilitating. The nature of the pain can be unique as well. For instance, a migraine usually produces a throbbing quality of pain.

This is in contrast to the tightening quality of a tension-type headache or the piercing, stabbing pain of a cluster headache.

Some headache sufferers endure chronic pain – meaning that their head pain occurs on most days of the months for at least three months. Let's review the basics of chronic pain and how this may be related to those who suffer from headaches.

How Common is Chronic Pain?

Chronic pain affects millions of Americans – in fact, chronic pain is the primary complaint in about 20 percent of all visits to the doctor. One article in Pain Medicine describes the prevalence of chronic pain. Based on a questionnaire completed by over 10,000 respondents in the United States, 3.5 percent reported suffering from the chronic pain of headaches. A little over ten percent reported suffering from back pain, 7.1 percent from pain in the legs and feet, and 4.1 percent from pain in the arms and hands.

What Goes Along with Chronic Pain?

The physical suffering endured by those who have chronic pain is often coupled with a mental and emotional burden. Depression and substance abuse are commonly seen in those who have chronic pain. Remember that this association does not mean that one causes the other.

Rather, an association implies a link or potential connection between two conditions. Overall, the negative impact of chronic pain on one’s quality of life and daily functioning is undeniable.

How is Chronic Pain Assessed?

There is a plethora of pain scales. One very short three-item scale used by many doctors to screen for chronic pain is the PEG scale. This scale was developed for doctors to assess not only the severity of their patient’s pain, but the impact, both emotionally and physically, that pain has on their daily lives. The three questions of the PEG scale include the following:

1. What number best describes your pain on average in the past week?

Patients rank their answer on a 0-10 scale with 0 representing “no pain” and 10 representing “pain as bad as you can imagine.”

2. What number best describes how, during the past week, pain has interfered with your enjoyment of life?  

Patients rank their answer on a 0-10 scale with 0 representing “Does not interfere,” and 10 representing “completely interferes.”

3. What number best describes how, during the past week, pain has interfered with your general activity?

Again, patients rank their answer on a 0-10 scale with 0 representing “Does not interfere,” and 10 representing “completely interferes.”

How Do You Treat Chronic Pain?

Treating chronic pain is quite difficult and often requires the close monitoring of a pain specialist. Sufferers of chronic headache disorders – like chronic migraine – are often followed regularly by a neurologist or headache specialist. Treatment typically involves both medication and behavioral therapy, like cognitive-behavioral therapy. Additionally, alternative treatments, like acupuncture, are sometimes utilized.

How Is This Related to Headaches?

While most of us think of headaches as episodic occurrences, they can also be chronic. A chronic daily headache (CDH) is a headache that occurs for fifteen or more days per month for longer than 3 months. Examples of chronic daily headache include chronic migraine and chronic tension-type headache. Chronic head pain can be just as debilitating as other sources of chronic pain. If you suffer from chronic pain – whether it be due to headaches or not – please seek the advice and care of a specialist.

Take Home Message

Chronic pain is a disabling medical condition that affects millions of Americans. You are not alone if you find yourself managing pain on a daily basis. Using proper coping mechanisms and treatment regimens for your pain is imperative to your physical and mental health. Remain proactive in your health and do not be discouraged.

Sources

Alford DP, Krebs EE, Chen IA, Nicolaidis C, Bair MJ, & Liebschutz J. Update in Pain Medicine. J Gen Intern Med. Nov 2010;25(11):1222-26.

Hardt J, Jacobsen C, Goldberg J, Nickel R, & Buchwald D. Prevalence of chronic pain in a representative sample in the United States. Pain Med. 2008 Oct;9(7):803-12.

National Institute of Neurological Disorders and Stroke. Pain: Hope Through Research. Retrieved April 23rd 2014, from http://www.ninds.nih.gov/disorders/chronic_pain/detail_chronic_pain.htm.

Krebs EE, et al. Development and Initial Validation of the PEG, a Three-item Scale Assessing Pain Intensity and Interference. J Gen Intern Med. Jun 2009; 24(6): 733–738.

Schappert SM. National Ambulatory Medical Care Survey: 1989 summary. Vital Health Stat. 1992;13:1–80.

DISCLAIMER: The information in this site is for educational purposes only. It should not be used as a substitute for personal care by a licensed physician. Please see your doctor for diagnosis and treatment of any concerning symptoms or medical condition.

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