Chronic Pain Syndromes

Chronic pain syndrome is an umbrella term covering a wide range of conditions which are characterised by long term pain.  The most common conditions are Fibromyalgia and Complex Regional Pain Syndrome (CRPS). Chronic Fatigue Syndrome / ME is quite commonly associated with these pain syndromes.  These conditions are similar in that none have a known cause, unlike chronic pain caused by structural deformities such as arthritis, nerve irritation, disc bulges, etc.

Chronic persistent pain takes a multi-disciplinary approach to manage the symptoms to allow sufferers to continue with as much as they can of their usual activities.  Pacing of activity plays a large part in the management of symptoms, with a little and often approach rather than a boom-bust cycle.  In most cases, sufferers benefit from psychological input too as mood and emotion can have huge effects on pain symptoms as these are processed by closely related areas of the brain.

Benefits of Aquatic Therapy

Aquatic therapy is a great way to manage all types of pain. 

• The warmth of the water helps to reduce sensation of pain and therefore make it easier to exercise and improve muscle strength and joint ROM
• The buoyancy of the water helps offload bodyweight, especially from those painful joints, making exercise more comfortable than on land
• Due to the reduced impact of exercising in water, those with chronic pain syndromes are able to better pace their activity
• Exercise is known for its mood enhancing properties due to hormone release, this is particularly useful for those with chronic pain syndromes where mood can influence their pain symptoms.

Fibromyalgia

Symptoms include widespread pain, increased sensitivity to pain, fatigue, muscle stiffness, alterations to sleep patterns, problems with memory and concentration, headaches and in some cases IBS.

Causes are not clear, but it is thought to be due to a change in chemical levels within the brain which affects the way the brain processes pain signals.

Quite often the syndrome is triggered by a physically or emotionally stressful event such as injury/infection, giving birth, operations, break-down of a relationship or the death of a loved one.

Typically the condition first arises in people aged 30-50 and is more prevalent in women than men, however there are cases of fibromyalgia diagnoses in all age groups including children.

Chronic Fatigue Syndrome / ME

Sufferers experience extreme exhaustion which can last 6 months or more, making everyday tasks very difficult to manage.  No amount of sleep or rest can help alleviate the symptoms.

Graded physiotherapy is part of the treatment programme, hydrotherapy works well for this as it can be very gentle using buoyancy to assist movement.

CRPS

A nerve-related pain syndrome, most commonly affecting an arm or leg.  There are a common set of symptoms associated with this condition:

• Persistent burning pain, often intense
• Sensitivity to touch (+/- cold)
• Changes in skin tone – red/purple
• Swelling
• Changes in skin temperature
• Changes in nail and hair growth

The cause is unknown but is likely to involve the sympathetic nervous system and affects function of the immune system.  Although cause is unknown, it quite often occurs after surgery or an injury, particularly if part of the limb was immobilised in a cast.

There are 2 types of CRPS:

• Complex regional pain syndrome I: Presumed injury to the sympathetic nervous system in the affected body part. This type used to be called ‘reflex sympathetic dystrophy (RSD)’ and is the most common form.
• Complex regional pain syndrome II: Actual injury to a nerve in the affected body part due to a surgery or injury. This type used to be called ‘causalgia.’

Sufferers often limit activity in the affected limb, holding it rigid and motionless.