In a report which looked into the prevalence of chronic pain in the UK, it was estimated that one-third to one-half of the UK’s population is affected by chronic pain issues and that this number will increase as the population gets older (Fayaz, 2016).
Chronic pain is a debilitating, long term condition which can arise from long term health problems such as arthritis, back problems or Crohn’s disease. For those affected, living with chronic pain can have a significant impact on their quality of life—affecting sleep patterns, the ability to work and pursue leisure activities.
Chronic pain is not just a physical response whereby we feel pain, but a complex interplay between the body and the mind. The mind is significant in affecting how we process pain and the emotional impact of pain can have a knock on effect on how we process further pain, growing into what can feel like an intolerable, vicious cycle.
Nerve cells regulate our perception of pain by carrying information from receptors found in the skin and throughout the body, to the spinal cord, before being sent forth to the brain for processing. The brain then interprets these signals and the body reacts to this stimuli in the form of pain.
The increasing use of prescription opioids to relieve this pain is posing a threat to public health. According to a recent BBC report, around 28.3 million opioids were prescribed by GP’s in 2017, the equivalent of 2,700 prescriptions an hour (Rhodes, 2018).
Continuous use of opioids can lead to various adverse health complications which in themselves can be debilitating. Such conditions could be:
- Stomach ulcers
- A weakened immune system (Sacerdote, 2006)
Hormone imbalance: Levels of testosterone or oestrogen are often lowered by the use of opioids which can lead to erectile dysfunction, irregular menstruation, weight gain and depression.
Hyperalgesia: It may seem ironic, but whilst opiates are, in the first instance, used to block feelings of pain, continued usage can lead not only to increased sensitivity to pain, but even non-painful stimulus can become painful.
However, there are other alternatives to pain management that do not have the same health implications associated with sustained opioid usage. Using topical pain relief either as an alternative or as a break from pain killers can have significant benefits.
Topical Pain Relief
Topical pain relief can take the form of both hot or cold therapy, but there is often confusion around which method should be used and for what complaint. The table below outlines when each therapy should be used:
- Use before exercise to relax tight muscles and improve movement
- Heat increases blood flow to the affected area, bringing with it oxygen and nutrients needed for repair
- Improves symptoms of muscle pain, spasms & joint stiffness
- Use after exercise to reduce swelling
- Cold relief reduces blood flow to the affected area in order to ease swelling and minimise damage to soft tissues
- Improves symptoms of bruising, inflammation, muscle strains and sprains.
Cold Therapy uses the powerful natural ingredient Menthol to override pain signals before they are sent to the brain for processing. Gate Control Theory states that when bodily tissues are damaged, pain signals cannot automatically reach the brain. Instead, they have to pass through ‘gates’. Topical pain relief products which feature menthol, block pain signals from passing these ‘gates’ leading to the central nervous system. The user instead feels a cooling sensation without the temperature physically changing at the site of pain.
Not only does menthol cool the pain, but it also has an analgesic effect. Molecules called ligands attach to opioid receptors in the body, altering the cells to produce a numbing sensation.
In addition, a somewhat unknown benefit of mentholated topical pain relief is its ability to promote cellular repair because menthol is an effective vasodilator. This means that when a mentholated product is applied to and absorbed by the skin, blood vessels widen to allow greater levels of oxygen to flood the source of pain; thus bringing with it vital nutrients needed to promote the healing of damaged cells.
How to alleviate chronic pain
In addition to topical pain relief, there are other ways to help improve symptoms and indeed to prevent the onset of these symptoms in the first place.
Seek help early: When you have an injury, prompt care from professionals such as physiotherapists, chiropractors or osteopaths can help treat injuries and relieve symptoms.
Education: Understanding interactions between the body, brain and nerves in processing pain can help in managing it. Furthermore, everyone experiences pain differently. Gaining an understanding of the various treatment options available from your GP or specialist pain nurse will enable you to develop a pain management plan which sets goals and tracks your progress to recovery.
Keep active: Alongside topical pain relief, maintaining a healthy, active lifestyle can mitigate the effects of chronic pain issues. Movement and exercise is shown to be instrumental in improving patient outcomes in terms of function and pain for people suffering with musculoskeletal pain (Kroll, 2015).
Be mindful: Scientists now know that pain doesn’t manifest itself in bodily tissues. The existence of pain is based on our brain’s interpretation of signals from the body as ‘painful’ .This means our perception of pain can be influenced in part by our emotional state. Anxiety or depression can exacerbate chronic pain issues; therefore addressing any psychosocial concerns, can have a positive impact on your levels of pain.
For support networks and further information on living with pain, visit the following websites:
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- Fayaz, A. (2016). Prevalence of chronic pain in the UK: a systematic review and meta-analysis of population studies. BMJ .
- Kroll. (2015). Exercise therapy for chronic pain. PubMed.
- Rhodes, D. (2018, March 15th). NHS Accused of fuelling rise in opioid addiction. Retrieved from BBC News: https://www.bbc.co.uk/news/uk-england-43304375
- Sacerdote. (2006). Opioids and the immune system. PubMed.