Mastering Successful Strategies for Advancing Chronic Pain Cases

By Richard Bogoroch and Melinda Baxter

February 21, 2007

Chronic Pain Syndrome

Chronic pain is defined as pain that persists past one month or past the usual time for the particular disorder to heal. The patient usually does not demonstrate evidence of autonomic hyperactivity (pallor, sweating, increased heart rate and breathing).¹
Others have specifically outlined a timeline in association with the onset of symptoms. Dr. David Corey in his article entitled “Chronic Pain Syndrome: Identification and Management” defines chronic pain as pain that has persisted for more than six months from onset and which has the following symptoms (emphasis added):

1. The chief complaint is of severe and prolonged pain in excess of what could be expected on the basis of organic findings.
2. At least six of the factors listed below are exhibited:
   1. Diagnosis of soft tissue injury;
   2. Multiple symptom complaints, e.g. headaches, fatigue;
   3. An unsuccessful attempt to return to work;
   4. Guarded movements or avoidance of many activities, e.g. an invalid like life-style;
   5. Ingestion of multiple analgesics, tranquilizers, etc.;
   6. Frequent and multiple physician contacts;
   7. Development of family and marital problems;
   8. A reduction in or loss of libido;
   9. Diffuse anger, frustration and irritability;
   10. Anxiety and/or depressive symptoms;
   11. Sleep disturbance.²

Chronic Pain Syndrome is a condition in which chronic pain has persisted over a period of time and is intense enough that it substantially interferes with a person’s ability to function and to carry on his or her activities of daily living. Chronic pain erodes the sufferer’s confidence, self esteem, and general well-being.³ The defining feature is that chronic pain has rendered the individual vocationally and/or functionally disabled.
Notes:
¹ Dr. Peter N. Watson, “Practical Strategies for Advocates V” (1996) Understanding Chronic Pain, The Advocates Society of Ontario, January 12-13, 1996.
² Corey, David: Chronic Pain Syndrome: Identification and Management 1988, 9 The Advocates’ Quarterly 223.
³ Minnesota Board of Medical Practice Update Newsletter, Spring 1997.
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Mastering Successful Strategies for Advancing Chronic Pain Cases