Pacifica Pain Management Services, Inc.

The Pain Syndrome

Contact us for your pain management questions & concerns

Chronic pain does not disable.

A chronic pain syndrome does!

By syndrome we mean a collection of difficult, interacting problems (symptoms) that when added together with the pain experience result in significant suffering and disability. These problems grow out of our physical, psychological, and behavioral reactions to pain. Typical symptoms of a pain syndrome can include:

• Persistent pain
• Insomnia
• Depression

• Each year, chronic pain disabilities result in the loss of an estimated 60 million dollars for employees nationwide.

  Medication dependence and addiction
• Weight gain
• Decreased sex drive
• Muscle wasting
• Social withdrawal
• Loss of employment
• Litigation

Acute vs. Chronic Pain

The first several months of pain we typically refer to as the "acute" period. In the early stages of pain onset, pain is clearly defined and normal medical recommendations for rest, drugs, and sometimes surgery may be indicated and applied.

As time passes, and pain persists, a few symptoms of the pain syndrome emerge and unless effective action is taken, the pain will transition into a full chronic pain syndrome or long-standing collection of disabling symptoms. These symptoms are not only the result of the pain experience but they can actually provoke the pain that created them.

Take the example of muscle wasting or "atrophy." It results from inactivity and often increases pain with movement. Depression, too, can lead to lowered self-esteem resulting in increased pain sensitivity (hyperesthesia). This "sensitization" to pain is possibly the result of neurological events taking place in the spinal cord and brain. With some chronic pain syndromes even non-painful stimuli can produce a painful experience (allodynia).

How does acute pain develop into a chronic pain syndrome?  The figure below demonstrates the process:

Figure 1: Chronic pain syndrome development

At Pacifica, we work with you to reduce the symptoms that contribute to chronic pain syndrome.  While pain may persist, once the pain syndrome is managed, our patients report improved functioning and reduced pain awareness.

Treatment: The good, bad, and ugly

Acute pain is typically treated with acute methods medically, including diagnostic procedures such as radiological imaging (i.e., x-ray, MRI, CT scan, etc.) to determine what is wrong structurally.

Medications for pain, muscle spasms, tension and sleep (i.e., narcotics and benzodiazepines) are often prescribed in the acute phase of the pain experience to block awareness of pain and assist with the other problems mentioned above.

In addition to medications, rest of the painful area, if not entire body,  is advised during the acute period of pain experience. In some instances, surgical correction is recommended to facilitate the ultimate reduction in pain.

Thus, rest, drugs, and surgery can be useful acute interventions in some cases of acute pain. However, if these acute methods of medical management fail to "cure" the problem and pain persists, then continuing these acute treatment methods for many months and perhaps years can be harmful. Continuing these methods into the chronic stages of the pain experience can result in the following chronic pain syndrome.

Table 1: Effects of rest, drugs, and surgery when taken into the chronic phase of pain.

At Pacifica, we consider chronic pain syndromes most effectively treated with safe non-acute methods.
Using acute treatments repeatedly over long periods of time risks creating more problems than are solved.

Our approach to treating intractable chronic pain syndromes involves methods from rehabilitation. In place of addictive medications such as narcotics, we work with safer categories of medications such as:

• non-steroidal anti-depressants,
• channel blockers,
• anti-convulsants, and
• several other non-addicting categories of medications.

Our whole approach however, is to avoid prescription medications altogether by using powerful, non-drug techniques.

Your pain issues are unique and specific.  We are the leading non-narcotic clinic in Northern California, at the cutting edge of healthy pain management. With over 25 years of experience, our staff understands and implements the best approaches to helping each of our patients manage their own difficult and complex set of disabling problems. 

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