Understanding Chronic Pain
Chronic pain is defined as pain persisting beyond three months — longer than the expected healing time for the underlying injury or illness. It affects an estimated 20–25% of adults and is one of the leading causes of disability worldwide. Unlike acute pain, which serves as a protective warning signal, chronic pain often continues or amplifies even after the original tissue injury has resolved.
This persistence is partly explained by central sensitization — a state in which the nervous system becomes hypersensitized, amplifying pain signals that would not normally be painful. Chronic pain is therefore not simply prolonged acute pain; it involves neurological, psychological, and behavioral dimensions that require a comprehensive treatment approach.
Conditions That Cause Chronic Pain
- Chronic lower back pain and lumbar radiculopathy
- Cervicogenic headache and chronic neck pain
- Osteoarthritis — knee, hip, spine, and shoulder
- Myofascial pain syndrome and fibromyalgia
- Neuropathic pain — diabetic neuropathy, post-herpetic neuralgia, complex regional pain syndrome
- Post-surgical pain and failed back surgery syndrome
- Spinal stenosis and degenerative disc disease
Treatment Approach at CHLMD
Effective chronic pain management begins with a precise diagnosis. Dr. Lichtblau conducts a thorough clinical and, when indicated, electrodiagnostic evaluation to identify the structural pain generators and neurological contributors to each patient's pain. This diagnostic foundation guides selection of the most appropriate interventions.
Treatment draws from a multimodal toolkit:
- Therapeutic exercise — graded exercise programs that reverse deconditioning, reduce central sensitization, and restore function
- Trigger point injections — targeted release of myofascial pain generators contributing to the chronic pain cycle
- Joint injections — corticosteroid or viscosupplementation injections for structural joint contributors
- Physical rehabilitation — comprehensive programs addressing strength, endurance, movement quality, and functional capacity
- Pharmacological management — nonopioid medications selected for specific pain mechanisms (neuropathic, inflammatory, myofascial)
Living with Chronic Pain: The Path Forward
Chronic pain rarely has a single cure, but it can be effectively managed. The goal at CHLMD is not the elimination of all pain — an unrealistic expectation for many patients — but a meaningful reduction in pain intensity and a significant improvement in function. Most patients who engage consistently with their treatment program experience measurable improvements in their capacity to work, exercise, sleep, and participate in daily life.
