Chronic Pain

Chronic pain is also known as persistent pain. It is a pain that lasts longer than 12 weeks, the pain may take months or even years despite taking medication or being treated. Most of these chronic pains result from injuries or after one has come out of an operation or sometimes the pain may result from a health condition, as indicated from a case report by Bawany published in 2020.

After some time, the pain may go away but sometimes may become worse making it chronic. Chronic pain may occur without any history of injury and can sometimes come about due to illnesses such as: 

  • Diabetes
  • Arthritis
  • Backpain
  • Fibromyalgia
  • Irritable bowel

The pain usually originates from the nervous system in the body that sends signals to the brain, warning that a certain part of the body is in pain. Chronic pain ranges from mild to severe pain.

There are 5 types of chronic pains in Kenya:

  1. Somatic pain

    A type of nociceptive pain that is detected in the body’s muscle tissues and even the skin. It is detected by the sensory nerves known as nociceptors which are the pain receptors and are easy to locate.

  2. Visceral pain

    A type of nociceptive pain but is hard to locate unlike somatic pain. They include:

  3. Neuropathic pain

    Often caused by nerve disturbance when there are pain signals to the spinal cord and brain. This pain is always described as sharp, electrical, stabbing and shooting.

  4. Psychogenic pain

    Usually caused as a result of psychological disorders such as depression or anxiety.

  5. Idiopathic pain

     Pain that has no possible known cause.

Causative and Risk Factors of Chronic Pains

Some of these chronic pains result from injuries like bone fractures where the bones break and the pain takes a long time before it fades away.

Another causative factor of chronic pain is pregnancy, which leads to pelvic pains. Statistics have shown that 25% of pregnant women experience this pain which results when the pelvic girdle muscles become tired trying to accommodate the baby.

The other risk factors of chronic pain include:

  • Biological risk factors
  • Psychological risk factor
  • Lifestyle

Biological risk factors include:

  • Genetic factor: this involves chronic pains that are genetic like migraines which is a chronic headache and is somatic pain that needs medical attention.
  • Race: Africans have a high percentage of having chronic pains as studies show since Africans have poor lifestyle, hence poor health when compared to white people.
  • Earlier injuries: someone who has been in an accident or had an operation is likely to suffer from chronic pain.

Psychological factors include:

This involves psychological disorders such as trauma, depression, or anxiety.

Lifestyles factors:

  • Job: most construction jobs in Kenya involve, lifting heavy objects that can lead to back and joint aches, which may lead to chronic pain.
  • Stress: having too much stress may lead to trauma, hence, psychological chronic pain.
  • Drugs: a 2015 report published by WHO showed, young people who abuse drugs are in great danger of having chronic pains as the drugs interfere with the nervous systems. 

Preference of Chronic Pain by Demographic in Kenya

 A report on Palliative medicine in 2013, conducted on behalf of the government of Kenya, based in western Kenya, shows that from a sample of 400 hospitalized patients that were administered analgesics (pain killer) to relieve chronic pains. 80% of the patients reported a non-zero level of pain while the rest reported having mild to severe pain. The elderly, those living with HIV, and those with cancer reported having a high number of patients with chronic pains.

Statistics show that old aged people mostly in Kenya are likely to suffer from chronic pain. This includes people from the age of 35 to 55 and both male and female.

The journal of palliative medicine published in 2019 on behalf of the government of Kenya. A statistic carried out at the University of Nairobi from a sample of 136 teachers 95% were reported having Lower back pains (LBP). This was due to office chairs without lamber support and high stress from work.

In a journal of chronic pain and management published in 2019 from Gavin publishers. It shows that females are more prone to chronic pain than males, females have a high percentage of endometriosis and pregnant women having a high chance of having chronic pains like pelvic pains.  

There is minimal cases of chronic pain in children and adolescents, however those affected are diagnosed with chronic pediatric pain.

Treatment, Prevention, and Control Measures of Chronic Pains

Prevention and control measures involve factors that can be considered to avoid having chronic pains, these include:

  • Eating healthy foods to avoid having health conditions that may lead to the chronic pains
  • Exercising to strengthen muscles and releasing endorphins.
  • Avoid jobs that require heavy lifting, to avoid the fatigue of muscles.
  • Seeking counselling in times of depression or anxiety, shock, or unstable moods.
  • Avoid drug abuse.  
  • Learning to control oneself and relaxing when under high pressure/stress.
  • Ensuring that you are on the right track to avoid accidents
  • Sitting and always sleeping in the right postures to avoid muscle fatigue.
  • Joining a support group

Treatment of chronic pains may be through the following methods:

  1. Drug therapy - the patient may be given over the counter medication to relieve the pains such as acetaminophen or lotions, creams, and oil given to the patient to relieve the pain in the skin and muscles.
  2. Psychological treatment - in the case of the patient having depression, anxiety, and lack of sleep, therapy comes in hand with medication whereby the patient is administered drugs while on therapy.
  3. Surgical implants - when drug and therapy treamtent fails, the patients are implanted with medicine, that delivers or pumps medicines such as morphine or muscle relaxers direct to the spinal cord.
  4. Bioelectric therapy - relieves the patient by blocking the pain signals being sent to the brain.
  5. Exercise - a report published in 2015 by WHO showed, that endorphins are released during exercise, can block pain being sent to the brain from an aching part of the body. 

Economic and Social Impact of Chronic Pain in Kenya

  • Economic impacts of chronic pain in Kenya include the financial side, such as cost that arise for the country, individuals affected, and families of those affected. Chronic pain in Kenya have called for the need of the government to intervene and help those affected, who cannot help themselves. Old aged people, those with other health conditions, and children have raised the need for the government and other health organization to treat them. The government of Kenya has spent millions of money trying to help those suffering with chronic pain.
  • Most of the people affected by chronic pain are breadwinners who cannot work since they are in pain and their muscles cannot do a lot of work, hence, they have to beg from others leading to poverty. Other organizations like WHO have also provided support and invested in the country.
  • The social impact of chronic pain includes, people in the society who are discriminated against due to suffering form chronic pain. As indicated by a report published in 2015 by WHO, society sees chronic pain as a disability, however in reality it is a condition that can be treated.