What Is Intractable Pain? How To Define It – Muscle MX
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What Is Intractable Pain? How To Define It
Chronic Pain
Mental Health
Pain Management

 

What Is Intractable Pain? How To Define It

If you can imagine severe pain that goes on for weeks, months, and even years, then you’re close to imagining what it feels like to suffer from intractable pain.

Millions of people are living with chronic pain (intractable and chronic pain are sometimes used interchangeably). In fact, more than one-fifth of the nation reports struggling with pain on a routine basis.

Within this number is a group of people whose pain could also be categorized as intractable. These people live in nearly constant agony from what they’re feeling physically, which can also adversely affect their mental health and overall quality of life.

What Is Intractable Pain?

The source of intractable pain is not always known, but there are a number of conditions that often lead to long-term, severe pain that is often considered intractable.

The following conditions have the potential to cause severe, intractable pain:

  • Reflex sympathetic dystrophy (RSD)
  • Neuropathy
  • Cancer
  • Congenial skeletal disease
  • Migraine vascular headaches
  • Intestinal cystitis
  • Fibromyalgia
  • Cardiovascular disease

These and similar conditions can often lead to pain that doesn’t go away on its own and even gets worse over time.

What Makes Pain Intractable?

A major difference that those with intractable pain experience from other types of pain is that their pain doesn’t respond well to medical care treatments that are typically used to treat pain. When treatments like muscle relaxers, opioids, anti-inflammatory medication (NSAIDS), or even cortisone injections fail to provide any significant relief, then you may be dealing with intractable pain.

Because traditional pain management interventions don’t typically work on intractable pain, trying to treat it can be very difficult and complicated. Depending on how severe the pain is, treatment may be much more intense than it would be for less painful conditions.

What Are the Different Types of Pain?

Before we dig more into understanding intractable pain, we should go over some of the basic pain types.

Understanding what kinds of pain there are can help us narrow down where our pain might be coming from, and then figure out what kind of treatments might help us feel better.

There are a number of different ways to categorize pain. One way is by how deep it’s felt in the body:

  • Somatic pain: This pain is felt in the body tissue, so you will generally feel it at a specific place. If you cut or burn yourself, you’ll experience somatic pain.
  • Visceral pain: This type of pain is felt deeper because of damage to the internal organs of your body is called — this pain is typically felt in the chest, head, or stomach area, because it affects your central nervous system more than somatic pain does.

Pain By Duration

Another way to categorize pain is by how long it affects you. Thinking of pain in this way can actually help determine what the root cause of the pain might be. The two main types in this category are acute and chronic pain.

Acute Pain

When you have pain that’s acute, it usually starts off as very painful, but gets better over time. For example, if you sprain your ankle, you’ll be limping around for a few days or weeks, but every day, it will generally continue to get slightly better.

Acute pain will usually eventually go away in the short term. In the meantime, though, you may be recommended to take nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen or aspirin to mediate the pain.

There are plenty of medical conditions and factors that can lead to acute pain, including:

  • Broken bones
  • Cuts or lacerations
  • Post-surgery healing
  • Concussions
  • Sprained ankles
  • Pulled muscles

Chronic Pain

The difference with chronic pain is that it goes on for long periods of time. Sometimes it may be weeks or months, but often chronic pain can be felt for years or even decades. Chronic, persistent pain patients will often spend a lot of money and time trying to deal with it. Trying to deal with long-term pain can also end up in health care providers prescribing long-term opioid medications to help patients remain functional.

By definition, intractable pain is also chronic pain, because it doesn’t get better over time. Instead, often chronic pain can even get worse over time, especially if there’s further damage to the parts of the body that are causing the pain. Because chronic pain doesn’t always go away, the treatment of chronic pain usually has more to do with managing pain rather than trying to eliminate it.

Neuropathic Pain

One kind of pain that is very common and can be chronic or intractable is the pain caused by neuropathy. This is an extremely uncomfortable and often frustrating pain syndrome that arises when your body’s nervous system is damaged, and its pain receptors aren’t working properly.

If you struggle with neuropathic pain due to confused pain signals, you probably have or will experience uncomfortable sensations, especially in the hands and feet, that include:

  • Numbness
  • Tingling
  • Feeling of extreme cold
  • Burning
  • Sharp stinging
  • Feeling of pricking

Neuropathic pain can often be considered intractable if it isn’t improved after trying traditional treatments, like medication, topical balms, transcutaneous electric nerve stimulation (TENS), or physical therapy.

Sometimes these treatments can add a temporary ease in discomfort, but the intense pain of neuropathy can far outweigh any relief.

What Makes Intractable Pain Distinct?

The major difference between intractable pain and all other pain types is that intractable pain cannot be cured, at least that we know of.

For example, if you’ve had intense low back pain for 30 years and you’ve tried surgery, chiropractic care, medications, supplements, or other treatments to no avail, you have a chance of being diagnosed with intractable pain.

If you have intractable pain, you will typically be dealing with daily, severe discomfort, and there can also be a negative effect on your overall outlook on life. The stress about potential flare-ups of pain can be nearly as bad as the physical discomfort itself.

How Can You Treat Intractable Pain?

When doctors or pain management specialists attempt to treat intractable pain, the point usually isn’t to cure the condition, but rather to get as much pain relief as possible.

For those who are diagnosed with intractable pain, there are several treatments that doctors will use to try and lessen the discomfort so that the pain is a little more bearable. Some of these treatments are a bit drastic, but they show how severe intractable pain is:

  • Surgical procedures: Some conditions are painful and serious enough that a surgical operation is deemed necessary. An example of using surgery is when the vagus nerve, the nerve that regulates acid in the stomach, is surgically cut so that less acid is created. This might be done if someone is suffering from intense pain and damage from persistent acid reflux.
  • Prescription opioids: One practice for treating particularly severe intractable pain is by prescribing opioid pain medications such as oxycodone, often combined with acetaminophen. This may be done for the mental as well as physical effects of these drugs. The danger of opioid use, however, is that it can sometimes lead to addiction.
  • Antidepressants: Because of the effects of severe pain on the mental state, sometimes antidepressants are prescribed to try and boost someone’s mood and overall well-being, which can also affect their perception of their level of pain.
  • Nerve blocking: A procedure that stops a nerve from sensing pain is called a nerve block. This might be done for serious pain, as that level of discomfort can get to a point where it’s better to feel nothing at all. A commonly used nerve block is the epidural, an injection in the spine that’s used to stop nerve feeling in different parts of the body. Others commonly used are nerve root and trigger point corticosteroid injections.
  • Physical therapy: Another way to try and alleviate intense pain is by using a targeted physical therapy program. For example, if you suffer from chronic or even intractable knee pain, then trying to maintain your mobility may be the most important part of managing your pain.

What Are Other Options for Treating Pain?

In this day and age, many are seeking alternative ways of dealing with their painful conditions that might even be outside of the typical treatment plans. Some have found relief through chiropractic care. Others try acupuncture or herbal supplements, and other options include topical plants, herbs, and spices like turmeric, eucalyptus, and peppermint.

Discovering New Ways To Deal With Discomfort

If you suffer from a particular type of discomfort, you might be interested in new options for easing your stress and tension so you can keep doing what you love! Muscle MX’s mission is to help you maintain optimal quality of life so you can keep your head in the game.

Sources:

Prevalence of chronic pain among adults in the United States | International Association for the Study of Pain

Acute vs Chronic Pain | Cleveland Clinic

Chronic pain: Medication decisions | Mayo Clinic

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