Unlocking The Mystery of Chronic Pain: Why Is It So Hard To Treat?

  • Post on July 22nd, 2015
  • by cbanks
  • at Reducing Pain

unlockingAs a pain management physician, I see patients with acute and chronic pain, resulting from multiple causes, everyday. Acute pain is classified as symptoms lasting from onset to 30 days. Chronic pain is considered to be pain that lasts from 3-6 months and longer. Many times acute pain can resolve on its own, and is typically due to muscle sprains and strains. Simple measures such as rest and time are usually enough to resolve these issues. Many people use over-the-counter remedies, such as anti-inflammatories like ibuprophen, or topical analgesics, like my favorite all natural topical pain reliever, KinetiCream, with good success. By the time I see the patient in acute or chronic pain, the primary care physician has tried simple measures to address the pain and it still persists.

Chronic pain is difficult to treat due to multiple reasons. Long-standing structural and functional problems with the body can lead to chronic pain. It can take a long time to rehabilitate structural problems. Sometimes surgery is not effective in correcting these issues either.

Oftentimes there is an additional psychological component such as depression that complicates the treatment. Being in pain every day can lead to depression. Being depressed can lead to worsened pain. It can be a vicious cycle.

The nervous system is a very complicated part of our bodies. It controls the majority of how our bodies function in daily life. Pain is transmitted by nerves to the spinal cord and ultimately to the brain for processing. If these pain pathways are constantly on, it can be difficult to shut them off. My favorite example of this is leaving a TV on one channel for too long (such as ESPN). When you go to change the channel, you can see an image of the logo burned into the corner of the screen. It takes a while before that image fades away. This type of “burn in” can occur in the nervous system if the pain generator is left untreated. In my opinion, this is a big reason why chronic pain is so difficult to treat. If we address the structural or functional problem too late; the damage may already be done. We then spend a lot of time and effort trying to manage the symptoms of pain.

It is very important to try and address pain before it becomes a chronic condition. If you experience acute pain, it is best to get a good diagnosis for the reason of pain. Treating the underlying reason for pain is the best way to prevent it from becoming a chronic issue.

Preventing injury and medical conditions that cause pain is also an important strategy. This means doing all the things we know we’re supposed to do. Eating healthy, nutritious food and getting regular exercise can be the best preventative medicine in avoiding chronic pain. I know, it is easy to say but hard to do.

I hope you never need me, but if you do, you can find me at: or

-Dr. Ko

Timothy Ko, MD is the Vice-President at Phoenix Bioperformance.  He is board certified in pain management and anesthesiology by the American Board of Anesthesiologists. He currently practices atPinnacle Interventional Pain & Spine Consultants in Ohio.