Description:
Hydragun looked at how
chronic pain affects aspects of health including feelings of depression,
sleep, and physical function, citing data from a
University of Pittsburgh Medical Center study.
Written by: Nicole Johnson

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From sleep to depression: How different types of chronic pain impact health
While pain hurts, it is also the body’s way of telling us that something
is wrong—but not all pain is created equal. Acute pain is brief, comes
on suddenly, and usually has a specific cause, which, when identified
and treated, disappears. Chronic pain lasts normally three months or
longer, and it can stick around even after recovery. It often occurs
with other chronic health conditions.
It is estimated that
1.5 billion people globally live with chronic pain and prevalence
increases as people age. The leading causes of chronic pain include
nerve damage, arthritis, and cancer. Chronic pain can—and often
does—interfere with daily life, and can impact both mental and physical
health.
Citing data from a
University of Pittsburgh Medical Center study
on chronic pain among over 20,000 patients,
Hydragun looked at
how different types of chronic pain affect other aspects of health
including feelings of depression, ability to sleep soundly, and physical
function.
The types of pain were classified by creating
groups of pain points that were identified by study participants. While
there is overlap in some of the groups of pain, the study’s authors
found clinically relevant distinctions among each of the nine pain
groups listed below.
Hydragun also cited health measures
developed by Northwestern University’s Patient-Reported Outcomes
Measurement Information System (PROMIS), which offer context on what the study’s various health measures mean
for patients. Data on overall mental and physical health are included to
offer a picture of the patient’s general health in that category.
The
original University of Pittsburgh Medical Center study calculated the
mean T-scores, a scientific method for measuring the severity of
different functions and symptoms based on a baseline comparison to the
general population.
Depending on the health metric, a score
above or below 50 represents increased severity compared to the rest of
the population. For example, a high T-score for sleep disruption means
someone faces more difficulties falling asleep than the average person.
A lower T-score on physical function means someone struggles with daily
activities more than the average person.
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All types of chronic pain
● Physical function: 35.3 (moderate)
● Pain interference: 66.4
(moderate)
● Sleep disturbance: 59.7 (mild)- Anxiety: 56.3 (mild)-
Depression: 55.2 (mild)
● Overall physical health: 35.6 (fair)
●
Overall mental health: 43.4 (good)
According to data
from the National Health Interview Survey, 50.2 million or 20.5% of
adults in the U.S. alone experience chronic pain. Not only does this
impact physical and mental health, but those suffering from chronic pain
miss more work than those who don’t (10.3 days versus 2.8 days), and the
value of lost productivity thanks to chronic pain is close to $300
billion annually.
Several chronic conditions such as cluster
headaches, arthritis, fibromyalgia, endometriosis, sickle cell disease,
and migraine headaches show chronic pain as a major symptom. Chronic
pain can include aching, burning, throbbing, stiffness, shooting, and
squeezing, and can have a major impact on a person’s daily functioning.
Among the other conditions and symptoms that may arise in individuals
suffering from chronic pain include anxiety, fatigue, insomnia,
depression, and mood swings.

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Neck and shoulder pain
● Physical function: 39.0 (moderate)
● Pain interference: 65.1
(moderate)
● Sleep disturbance: 59.6 (mild)
● Anxiety: 56.7
(mild)
● Depression: 54.9 (within normal limits)
● Overall
physical health: 37.5 (fair)
● Overall mental health: 43.4
(good)
It is quite common for neck and shoulder pain to
simultaneously occur. This type of chronic pain can be due to soft
tissue injuries, rotator cuff tears, bursitis, cervical spondylosis,
whiplash, frozen shoulder, tension headaches, and a herniated disk.
Chronic neck and shoulder pain can also indicate a serious condition
like coronary artery disease. Clinical recommendations for pain
management may include physical therapy, stretching and exercise, pain
medication, steroid injections, and heat or ice. Specific conditions,
like cervical spondylosis, may benefit from a specific treatment, such
as wearing a cervical collar.

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Neck, shoulder, and low back pain
● Physical function: 35.3 (moderate)
● Pain interference: 66.4
(moderate)
● Sleep disturbance: 61.0 (moderate)
● Anxiety:
57.3 (mild)
● Depression: 56.1 (mild)
● Overall physical
health: 35.1 (fair)
● Overall mental health: 41.7 (good)
Those
who struggle with chronic neck, shoulder, and lower back pain seem to
show more intense sleep disturbance than those who deal with other types
of chronic neck and back pain. There are several ways to mitigate this
type of pain when it comes to dealing with sleep, among them include
sleep positioning and using additional support by placing a pillow
between the knees or under the pelvis to offer relief. Sleeping with a
small pillow under the sore shoulder or with a towel under the small of
the back is another way to provide more support to painful areas. It is
also essential to maintain
proper sleep hygiene
and to sleep on a medium-firm or firm mattress.

pixelheadphoto digitalskillet // Shutterstock
Upper and lower back pain
● Physical function: 35.3 (moderate)
● Pain
interference: 66.2 (moderate)
● Sleep disturbance: 59.1
(mild)
● Anxiety: 55.5 (mild)
● Depression: 54.7
(within normal limits)
● Overall physical health: 36.1
(fair)
● Overall mental health: 43.9 (good)
In
many cases, chronic back pain is age-related, though it can also be
from a past injury. Common causes of chronic upper and lower back pain
can include years of poor posture, compression fractures, arthritis,
degenerative disc disease, and a herniated disc. Poor workspace design
and sedentary lifestyles also have a significant impact on overall
back health. Several factors can increase the risk for back pain such
as genetics, fitness level, and weight. Smoking can also have a
significant impact on the back because it can restrict oxygen and
blood flow to discs, which causes faster disc degeneration.

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Abdominal pain
● Physical function: 37.1 (moderate)
● Pain
interference: 65.9 (moderate)
● Sleep disturbance: 59.4
(mild)
● Anxiety: 56.4 (mild)
● Depression: 55.2
(mild)
● Overall physical health: 36.3 (fair)
●
Overall mental health: 42.9 (good)
Chronic abdominal
pain (CAP) is a common complaint and is described as pain in the
abdomen lasting for longer than three months. CAP affects
approximately 2% of adults
and more women than men experience this type of pain. There can be
several causes for this type of pain including constipation, lactose
intolerance, peptic ulcers, menopause, and certain types of cancer
including ovarian and cervical cancer, as well as irritable bowel
syndrome. The most common symptoms of chronic abdominal pain can vary
for individuals and include dull or sharp pain, which can last for
minutes or hours; pain that may or may not happen when eating and can
occur at any time; and pain that can occur with headaches or vomiting,
though more severe symptoms like blood in the stool or weight loss
require evaluation by a doctor.Treatment options depend on the
condition causing the abdominal pain. Among the possible treatments
include medications to reduce stress and anxiety, biofeedback,
hypnosis, relaxation techniques, pain medications, changes to a diet,
including the addition of or an increase in fiber-rich foods or a
supplement, or the elimination of certain types of food, such as
dairy, for those whose pain is caused by lactose intolerance.

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Axial low back pain
● Physical function: 37.2 (moderate)
● Pain
interference: 64.0 (moderate)
● Sleep disturbance: 55.6
(mild)
● Anxiety: 52.4 (within normal limits)
●
Depression: 50.9 (within normal limits)
● Overall
physical health: 38.6 (fair)
● Overall mental health: 47.3
(good)
Axial pain is described as pain confined to one spot
or region. Figuring out the exact cause of axial low back pain can be
challenging because it is caused by a number of things, including
facet joint problems, soft tissue damage, or a degenerated disc. The
most common type of axial back pain, mechanical pain, gets worse with
certain activities and positions.There are several ways to treat this
type of chronic pain including brief periods of rest, stretching, and
exercise that can include physical therapy, ice or heat application,
or pain medications like acetaminophen or ibuprofen.
According to a review of several studies
looking at the overall prevalence of chronic low back pain concerning
gender and age, “Chronic low back pain prevalence increases linearly
from the third decade of life on, until the 60 years of age, being
more prevalent in women.”

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Lower back pain radiating to the thigh
● Physical function: 35.6 (moderate)
● Pain
interference: 65.3 (moderate)
● Sleep disturbance: 57.1
(mild)
● Anxiety: 54.0 (within normal limits)
●
Depression: 53.3 (within normal limits)
● Overall
physical health: 36.8 (fair)
● Overall mental health: 45.3
(good)
Normally, lower back pain that travels down the
front of the thigh or back but does not spread to the knee is due to a
pinched nerve. Possible causes of a pinched nerve include an arthritic
facet joint, a herniated or bulging disc, or bony material that is
overgrown, like a bone spur. A pinched nerve can also lead to
permanent nerve damage. Among the preventative measures that can be
key for a pinched nerve include maintaining correct posture,
exercising safely and stretching, not sitting or standing for too
long, and taking breaks from tasks that require repetitive
motion.Another cause of this type of chronic pain may be the presence
of chronic illnesses like fibromyalgia and arthritis. Treatment
recommendations are similar to those of other chronic pain conditions
impacting the lower half of the body and include gentle stretching,
massages, physical therapy, nonsteroidal anti-inflammatory drugs for
pain relief, and corticosteroid injections, which reduce swelling and
inflammation around the pinched nerve.

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Lower back pain radiating below the knee
● Physical function: 34.4 (moderate)
● Pain
interference: 66.5 (moderate)
● Sleep disturbance: 59.2
(mild)
● Anxiety: 55.6 (mild)
● Depression: 54.7
(within normal limits)
● Overall physical health: 35.8
(fair)
● Overall mental health: 44.6 (good)
The
most common condition presenting with chronic lower back pain
radiating below the knee is sciatica, which begins in the lower back
as a shooting pain and spreads to the buttocks and down the back of
one leg. This pain is frequently caused by pressure on the sciatic
nerve, which may be from a bone spur, herniated disc, trauma,
stenosis, or muscle strain. Nerve damage, arthritis, and tissue
scarring may also be contributing factors.Sacroiliac joint dysfunction
can cause this type of chronic pain, which can be treated with rest,
physical therapy, injections, and in more extreme cases, surgery.
Radiating lower back pain, particularly with pain radiating below the
knee, has a
less favorable prognosis
than non-radiating lower back pain.

Mladen Mitrinovic // Shutterstock
Widespread pain, light
● Physical function: 35.3 (moderate)
● Pain
interference: 67.0 (moderate)
● Sleep disturbance: 61.7
(moderate)
● Anxiety: 57.9 (mild)
● Depression:
56.6 (mild)
● Overall physical health: 34.7 (poor)
●
Overall mental health: 42.0 (good)
Chronic widespread
pain can co-occur with several conditions, including headache,
irritable bowel syndrome, chronic fatigue syndrome, joint pain, and
psychiatric disorders. It is also a major symptom of fibromyalgia and
one of the symptoms used in the diagnosis of the condition.
According to a 2016 study
on the prevalence of chronic widespread pain, which is a long-lasting
pain in multiple areas of the body, its prevalence lies at 10% within
the general population. It is commonly associated with symptoms like
concentration problems, fatigue, and psychological distress.
Clinical
recommendations for the treatment of chronic widespread pain include a
combination of psychological, pharmacological, and physical treatments
like cognitive behavioral therapy, pain medications, exercise, and
physical therapy.

Khetsophon Thong-in // Shutterstock
Widespread pain, heavy
● Physical function: 32.5 (moderate)
● Pain
interference: 69.3 (moderate)
● Sleep disturbance: 64.0
(moderate)
● Anxiety: 60.8 (moderate)
●
Depression: 60.1 (moderate)
● Overall physical
health: 31.2 (poor)
● Overall mental health: 38.3 (fair)
Heavy
or high-impact chronic pain is an intense form of chronic pain that
impacts 4.8% of the adult population in the United States. Those
affected by this type of pain have difficulty with normal daily tasks
and functions and approximately 83% of those suffering from
high-impact chronic pain cannot hold down jobs. In about a third of
these cases, the pain is so intense that self-care activities like
washing and getting dressed become extremely difficult.
Age,
ethnicity, education level, and marital status are important factors
in
determining the likelihood
of suffering from this type of pain. Individuals with high impact
chronic pain have higher levels of depression and anxiety and poorer
overall mental and physical health outcomes globally than those living
with regular chronic pain.
Conclusion
Overall, this study shows that the impact of chronic pain can diverge
significantly depending on type. For instance, neck and shoulder pain
caused the least physical impact of all the groups, but caused
significant anxiety; while lower back pain (radiating below the knee)
caused the most severe problems with physical functioning but had far
less mental health impact. These results could be useful in
determining highly personalized treatment for chronic pain
sufferers.
While chronic pain can be overwhelming,
there are solutions to help manage it. Reducing stress with the help
of meditation and relaxation-based exercises like gentle yoga and tai
chi can be helpful. Mindfulness and positive thinking can also go a
long way toward managing chronic pain, especially when paired with
physical therapy and massages. Staying active, getting an adequate
amount of sleep, and remaining connected to others are also invaluable
and effective tools for dealing with chronic pain. Managing
co-occurring conditions like depression and anxiety helps people gain
control over their pain, and there are many therapeutic options that
can ease chronic pain as well, including biofeedback, hypnosis, and
cognitive-behavioral therapy (CBT).