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Manage Chronic Pain

Chronic pain affects approximately 20.4% of all adults, making it an extremely common condition, with prevalence increasing with age. 7.4% of adults had chronic pain so severe that it limited their ability to work as well as their quality of life.

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Chronic Pain in Singapore

In 2009, the prevalence of chronic pain in Singapore was reported to be 8.7%. Considering our ageing population as well as global trends, it is likely that this number has risen significantly in today’s Singapore. Furthermore, with the recent COVID-19 pandemic related lockdowns alongside the rise in popularity of work from home or hybrid work arrangements, more Singaporeans have found themselves experiencing chronic pain due to prolonged periods of sitting and physical inactivity.

chronic pain in singapore

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What is Chronic Pain?

Chronic pain is defined as pain that persists over a period that is longer than three months. The pain can come and go or be there all the time, in any parts of your body. Chronic pains can appear anywhere in the body and exist in many different forms. It is a very common problem and is one of the most common reasons for patients to seek medical care. Chronic pains could be caused by chronic illnesses or underlying health conditions, or in some cases, could be unrelated to any injuries or physical illnesses. These types of chronic pains are sometimes referred to as psychogenic pain or psychosomatic pain. These pains are caused by psychological factors such as stress, anxiety and depression.

Types of Chronic Pain

As mentioned earlier, chronic pains can come in many forms. These can include:

  • Joint pain
  • Back pain
  • Neck pain
  • Cancer pain
  • Headaches
  • Testicular pain
  • Muscle pain
  • Neurogenic pain

It is important to know what type of chronic pain you have in order to treat and manage it effectively. For some patients, it is possible to have more than one type of chronic pain.

Symptoms of Chronic Pain

Symptoms of chronic pain can differ amongst individuals, depending on the cause of their pain.
Symptoms can include:

  • Joint pain
  • Muscle aches
  • Burning pain
  • Fatigue
  • Loss of sleep, decrease in sleep quantity or quality
  • Loss of stamina and flexibility, due to decreased physical activity
  • Psychological problems, including depression, anxiety, and irritability

Risk Factors of Chronic Pain

Some groups of people are more likely to develop chronic pain. Risk factors of chronic pain include:

  • Chronic conditions. Chronic conditions such as arthritis have chronic pain as one of its symptoms.
  • Depression. While it is unclear why, experts suggest that depression alters how your brain receives and interprets messages from your nervous system.
  • Smoking. While the reason for the link is unclear, smoking has been heavily associated with chronic pain disorders.
  • Obesity. Obesity has been heavily associated with chronic pain.
  • Sex. Women are naturally more sensitive to pain.
  • Age. Those above 65 are at greater risk of developing chronic pain due to their susceptibility to health conditions that can cause chronic pain.

Common causes of chronic pain

Chronic pain can be caused by many different reasons but is typically the symptom of other health conditions that you may be suffering from. Chronic conditions, in particular, tend to cause chronic pain in patients. Common chronic conditions that can result in chronic pain include:

  • Arthritis. Arthritis can cause chronic joint pain. Approximately half of adults with arthritis experience chronic joint pain.
  • Migraine. Chronic migraines can cause chronic headaches. In severe cases, the pain can radiate to your neck and shoulders.
  • Slipped disc. A slipped disc can put pressure on your nerves, causing chronic back pain.
  • Gout. Chronic gout can cause damage to your joints, resulting in chronic pain.
  • Sciatica. Sciatica pain can be chronic, persisting for more than 8 weeks and is unresponsive to self-management.

Complications of Chronic Pain

Complications of chronic pain can be rather severe as chronic pain can worsen quickly if left untreated. It can also be very difficult to treat and manage. Complications may include:

  • A loss in quality of life. Chronic pain undeniably affects your quality of life because it inhibits your ability to carry out everyday tasks. Even activities that you used to enjoy can become extremely painful to go through if you are suffering from chronic pain.
  • Depression. Chronic pain can be very stressful to deal with, affecting your sleep cycles and causing your body to be more sensitive to pain. This can lead to depression if not handled well.
  • Anxiety. Chronic pain can cause you to be constantly tensed and stressed, being easily irritated. This can lead to anxiety if not managed well.
  • Substance abuse. Chronic pain may be so severe that you seek alternative options that can distract you from the pain. This includes abusing substances which can lead to very severe health consequences.

Preventing Carpal Tunnel Syndrome

While there are no known prevention methods for carpal tunnel syndrome, there are ways in which you can minimise stress on your hands and wrists while you carry out your daily activities.
These include:

  • Reducing your force and relaxing your grip
  • Reducing your force and relaxing your grip
  • Adopt good form and posture
  • Use a mouse that is comfortable for your wrist
  • Keeping your hands warm

Treatment Methods for Chronic Pain

Due to the multitude of reasons behind chronic pain, the treatment methods for chronic pain will differ greatly depending on your type of pain and will as the severity of your condition.

NSAIDs (nonsteroidal anti-inflammatory drugs)

NSAIDs are the most common type of pain-relieving drugs. Examples of NSAIDs include aspirin, ibuprofen, and naproxen. These drugs help to relieve pain caused by muscle aches and stiffness. It also reduces inflammation in the body. These can be consumed orally.

Topical Pain-relieving Creams

Topical painkillers, or analgesics can be sprayed on, applied on, or put on as patches onto the skin over the affected muscles or joints. This can be used for pain caused by arthritis.

Muscle Relaxants

Muscle relaxants can be prescribed by a doctor if the usual over-the-counter drugs are unable to relieve your pain.

Trigger Point Injections

Trigger points, commonly referred to as muscle knots, cause pain as the affected muscles are unable to relax. A local anaesthetic which sometimes can include a steroid is injected into the trigger point, forcing it to relax and therefore alleviate pain.

Botox

OnabotulinumtoxinA (Botox) blocks signals from the nerves to the brain. While it is more commonly known as part of a cosmetic procedure that prevents wrinkles, Botox injections can also be used to alleviate pain for a period of up to three months. However, it is only used when traditional pain treatment methods have been ineffective.

Dry Needling

Dry needling is a form of therapy that uses thin, sterile needles to penetrate the skin, targeting trigger points in your muscle and tissue. In doing so, the trigger points are released, relieving muscle tension, pain and muscle spasms.

Deep Tissue Massage

A deep tissue massage is a form of massage therapy that targets the deeper layers of your muscle to relieve and treat muscle and tendon pain, stiffness and injuries. Deep tissue massage also stimulates blood circulation and promotes your body’s recovery process.

Extracorporeal Shockwave Therapy (ESWT)

ESWT is a non-invasive, non-surgical, and risk-free treatment that uses shockwaves to target your damaged muscle, tendons, ligaments, or joints to relieve pain, reduce inflammation, and stimulate recovery.

Magnetic Resonance Therapy

Magnetic resonance therapy is a non-invasive, non-surgical, and risk-free treatment that uses three different electromagnetic fields that transfer energy into your damaged cells to stimulate your cell regeneration process. In doing so, cartilage and ligament regeneration is stimulated and reactivated, alleviating chronic pain and discomfort.

Psychological Treatment

Some patients may experience chronic pain that is triggered by stress or certain feelings such as anger, anxiety or sadness. Psychological problems such as anxiety and depression, or a lack of sleep, can all contribute to aggravating symptoms of pain.

Physiotherapy

Physiotherapy employs stretching, strengthening, and pain-relieving techniques to aid treatment for injuries or disabilities. While your first thought when experiencing pain might be that your body needs rest, rest may sometimes not be beneficial to the body as it increases stiffening and weakness, potentially worsening the symptoms of pain that you are trying to avoid. Correcting improper posture can also help to reduce strain on tensed muscle groups. Professional physiotherapists will be able to design exercise programs suitable for your condition, strengthening your body so that it is able to cope with the pain better, and reducing the chances of painful flare-ups in the future.
Depending on the cause of your chronic pain, your physiotherapist may recommend various treatment methods in conjuncture with your physiotherapy treatment for optimal results.

Manage Chronic Pain with Regis Wellness

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Sources

Ambardekar, Nayana. “Do I Have Chronic Pain?” What Is Chronic Pain Management? Symptoms and Reasons to Control Chronic Pain, WebMD, 12 May 2021, https://www.webmd.com/pain-management/guide/understanding-pain-management-chronic-pain.

Bruce, Debra. “Depression and Chronic Pain.” Depression and Chronic Pain: Causes and Treatments, WebMD, 21 Sept. 2021, https://www.webmd.com/depression/guide/depression-chronic-pain.

Christiano, Donna. “What Is Chronic Pain Syndrome?” Chronic Pain Syndrome: Symptoms, Treatment, and More, Healthline Media, 1 Dec. 2018, https://www.healthline.com/health/chronic-pain-syndrome.

“Chronic Pain.” Chronic Pain: What Is It, Causes, Symptoms & Treatment, Cleveland Clinic, 9 Jan. 2021, https://my.clevelandclinic.org/health/diseases/4798-chronic-pain.

Elder, Charles et al. “Reductions in pain medication use associated with traditional Chinese medicine for chronic pain.” The Permanente journal vol. 16,3 (2012): 18-23. doi:10.7812/TPP/12.967

Griffin, R. Morgan. “Pain Relief: How NSAIDs Work.” NSAIDs for Pain Relief, WebMD, 2005, https://www.webmd.com/arthritis/features/pain-relief-how-nsaids-work.

Khalili-Mahani, Najmeh. Commentary: Stress-Related Chronic Pain Can't Just Be Diagnosed and Medicated Away, CNA, 5 June 2022, https://www.channelnewsasia.com/commentary/chronic-stress-illness-pain-stigma-medication-therapy-approach-2725156

Lee, Bernard. “Chronic Pain Management in General Practice.” Singapore Medical Association - For Doctors, For Patients, Singapore Medical Association, May 2021, https://www.sma.org.sg/news/2021/May/chronic-pain-management-in-general-practice.

“Pain Management.” Pain Management Department, SKH, https://www.skh.com.sg/patient-care/specialties-services/pain-management.

“Physiotherapy for Chronic Pain Management.” Physiotherapy for Pain Management, Singapore General Hospital, 19 Aug. 2019, https://www.sgh.com.sg/patient-care/specialties-services/physiotherapy/pages/physiotherapy-for-pain-management.aspx.

Preventing Pain: An Introduction, International Association for the Study of Pain (IASP), 9 July 2021, https://www.iasp-pain.org/resources/fact-sheets/preventing-pain-an-introduction/.

Sachdev, Poonam. “Pain Management: Treatment Overview.” 18 Treatment Types to Help You Manage Chronic Pain, WebMD, 21 Apr. 2022, https://www.webmd.com/pain-management/guide/pain-management-treatment-overview.

Shurtleff, David. “Chronic Pain: In Depth.” National Center for Complementary and Integrative Health, U.S. Department of Health and Human Services, Sept. 2018, https://www.nccih.nih.gov/health/chronic-pain-in-depth.

Wee, Justin. Commentary: More People Are in Pain – from Sitting at Their Desks All Day, CNA, 13 Jan. 2022, https://www.channelnewsasia.com/commentary/exercise-backache-musculoskeletal-conditions-health-2427671.

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