## What is chronic pain? [Chronic](https://ul.orna.me/KOge/librarydisease?id=78) pain is defined as pain that lasts for three months or longer. At this stage it becomes a psychophysiological problem: the body gets used to it and the central nervous system produces pain. This is called central sensitization of the pain syndrome. Chronic pain occurs mainly in musculoskeletal structures or is associated with nerve compression. ## Types of chronic pain – Nociceptive — appears when an organ, joint, or soft tissue is damaged. – Neuropathic — burning or shooting, occurs when the nerve suffers, for example, with intervertebral hernia, which pinches the nerve root. – Dysfunctional — associated with mental disorders or disorders such as depression. ## How to deal with it Medication: This is the first thing prescribed. Depending on the type of pain, medications include non-steroidal anti-inflammatory drugs, myorelaxants, muscle relaxants, anticonvulsants, and antidepressants. Therapeutic and diagnostic blockade: This is done through ===the injection of a local anesthetic and hormone into the site of pain under ultrasound or Х-Ray guidance. It is considered a positive response if the pain decreases by 30-50 % or goes away for a while. Radiofrequency ablation: This can be pulsed or thermal. Under ultrasound or Х-Ray control, an electrode is inserted through a puncture with a special needle, which affects the desired nerve, disrupting pain transmission. > Shock-wave therapy can help, as it is prescribed for joint and muscle-tendon pain. ## Pain and antidepressants Chronic pain is often accompanied by depression, and depression can cause chronic pain. Therefore, tricyclic antidepressants or antidepressants from the group of serotonin and norepinephrine reuptake inhibitors are often prescribed for chronic pain. There is no need to be afraid of this as modern medications are improving. When taking them it is possible to drive or drink alcohol in small amounts. Additionally, they do not cause withdrawal syndrome. > In 90 % of cases, the pain can be managed if the patient follows recommendations. ## When the pain comes from the head Deep feelings can cause pain in the body. To distinguish it from all other types of pain, the doctor talks to the patient in detail, interviews the patient on anxiety and depression scales, and may make a referral to a psychiatrist. This is the kind of pain a person can visualize and describe. It can be "volatile," which manifests in one part of the body and goes to another. It often spreads down the body in the intestines, pelvis, small pelvis, or the face. Psychogenic pain is not relieved by painkillers. There are usually unexpected ways to help, which you can find with your doctor. These can include relaxation practices, deep breathing, and psychotherapy to help eliminate triggers. ## Who treats chronic pain? A pain management specialist deals with chronic pain. It is worth turning to this type of doctor when the treatment prescribed by other doctors has not helped. In the USA and Europe, pain management is a medical specialty, while in other parts of the world, doctors such as neurologists and anesthesiologists have advanced training in it.