Types of Pain

Chronic Pain

Osteoarthritis
Osteoarthritis (OA) is by far the most common joint disorder in the United States and throughout the world, and is one of the leading causes of disability in the elderly. People with OA account for one of every eight days of restricted activity among the elderly in the United States. Although the disease commonly affects the cervical and lumbar spine, most epidemiologic studies report that it has a predilection for weight-bearing joints in the leg and certain joints in the hand. The prevalence of OA in all joints correlates strikingly with age. One-third of people aged 65 years and older have knee OA that is evident by radiograph. Before the age of 50, men are more likely to have OA than women, but after age 50, it is women who are more likely to be affected.

Osteoarthritis (OS-tee-oh-are-THRY-tis) (OA) is one of the oldest and most common forms of arthritis. Known as the "wear-and-tear" kind of arthritis, OA is a chronic condition characterized by the breakdown of the joint's cartilage. Cartilage is the part of the joint that cushions the ends of the bones and allows easy movement of joints. The breakdown of cartilage causes the bones to rub against each other, causing stiffness, pain and loss of movement in the joint.

It is thought that osteoarthritis dates back to ancient humans. Evidence of osteoarthritis has been found in ice-aged skeletons. Today, an estimated 21 million Americans live with OA. Despite the longevity and frequency of the disease, the cause is still not completely known and there is no cure. In fact, many different factors may play a role in whether or not you get OA, including age, obesity, injury or overuse and genetics. Your OA could be caused by any one or by a combination of any of these factors.

There are several stages of osteoarthritis:

1. Cartilage loses elasticity and is more easily damaged by injury or use.
2. Wear of cartilage causes changes to underlying bone. The bone thickens and cysts may occur under the cartilage. Bony growths, called spurs or osteophytes, develop near the end of the bone at the affected joint.
3. Bits of bone or cartilage float loosely in the joint space.
4. The joint lining, or the synovium, becomes inflamed due to cartilage breakdown causing cytokines (inflammation proteins) and enzymes that damage cartilage further.

Changes in the cartilage and bones of the joint can lead to pain, stiffness and use limitations. Deterioration of cartilage can:

• Affect the shape and makeup of the joint so it doesn't function smoothly. This can mean that you limp when you walk or have trouble going up and down stairs.
• Cause fragments of bone and cartilage to float in joint fluid causing irritation and pain.
• Cause bony spurs, called osteophytes, to develop near the ends of bones.
• Mean the joint fluid doesn't have enough hyaluronan, which affects the joint's ability to absorb shock.
• Result in inflammation.

Osteoarthritis most commonly occurs in the weight-bearing joints of the hips, knees and lower back. It also affects the neck, small finger joints, the base of the thumb and the big toe. OA rarely affects other joints except when injury or stress is involved.

Source: http://www.arthritis.org/conditions/Fact_Sheets/OA_Fact_Sheet.asp

Rheumatoid Arthritis
Rheumatoid arthritis (rue-ma-TOYD arth-write-tis) is a chronic disease, mainly characterized by inflammation of the lining, or synovium, of the joints. It can lead to long-term joint damage, resulting in chronic pain, loss of function and disability.

Rheumatoid arthritis (RA) progresses in three stages. The first stage is the swelling of the synovial lining, causing pain, warmth, stiffness, redness and swelling around the joint. Second is the rapid division and growth of cells, or pannus, which causes the synovium to thicken. In the third stage, the inflamed cells release enzymes that may digest bone and cartilage, often causing the involved joint to lose its shape and alignment, more pain, and loss of movement.

Because it is a chronic disease, RA continues indefinitely and may not go away. Frequent flares in disease activity can occur. RA is a systemic disease, which means it can affect other organs in the body. Early diagnosis and treatment of RA is critical if you want to continue living a productive lifestyle. Studies have shown that early aggressive treatment of RA can limit joint damage, which in turn limits loss of movement, decreased ability to work, higher medical costs and potential surgery.

RA affects 1 percent of the U.S. population or 2.1 million Americans. Currently, the cause of RA is unknown, although there are several theories. And while there is no cure, it is easier than ever to control RA through the use of new drugs, exercise, joint protection techniques and self-management techniques. While there is no good time to have rheumatoid arthritis, advancements in research and drug development mean that more people with RA are living happier, healthier and more fulfilling lives.

Source: http://www.arthritis.org/conditions/diseasecenter/RA/ra_overview.asp

Acute Pain

Acute pain may be mild or severe and can last for a just a few minutes or for weeks or months. In general, acute pain does not last longer than six months and disappears when the underlying condition sugsides. Acute pain can be triggered by many events or conditions, which are temporary in nature and include the following:

• Sprains and strains
• Surgery
• Broken bones
• Headaches
• Burns or lacerations
• Labor and delivery

Sprains and Strains

A significant proportion of acute pain originates from amateur sports injuries, and sprains and strains are among the most common injuries. rA sprain is a stretching or tearing of ligaments,whereas a strain is astretching or tearing of muscle tissue

WebMD Medical Reference

What Causes Sprains and Strains?

Anything that places unusual stress on joints or muscles may cause a sprain or strain. Overexertion in an unfamiliar sport is a common cause, particularly in the aging Baby Boomer and Weekend Warrior populations. Falls and lifting heavy objects, are also common causes of sprains and strains. Being overweight, inactive, or in poor physical condition boosts the likelihood of injury. Improperly warming up and not stretching muscles before intense physical activity can also result in injury.

Symptoms associated with pulled or torn muscels and ligaments often include pain and swelling at the site of the injury resulting in inflammation, pain and sometimes stiffness.

What Are the Treatments for Sprains and Strains?

Treatment of both sprains and strains focuses on control of the initial pain and swelling, followed by adequate rest to allow healing.

Most sprains and strains heal in two to three weeks. Doctors routinely prescribe the RICE treatment -- rest, ice, compression and elevation immediately following the injury. NSAIDs (non-steroidal anti-inflammatory drugs),such as aspirin or ibuprofen are often taken to reduce the inflammation and pain.

WebMD Medical Reference

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