Question

Explain why problems of fatigue, mental concentration, sleep and depression are commonly associated with chronic pain.

Answer 1

Ans) Sleepiness and fatigue are common problems among chronic pain sufferers.

- Patients on opioids who appear drowsy or tired should be evaluated thoroughly to identify all factors that might be contributing to these symptoms.

- Clinicians should not assume that opioids are causing sedation and fatigue merely because they are being prescribed.

- Sleep apnea, other primary sleep disorders, general medical conditions, neurological disorders, psychiatric syndromes and side effects of medicines and drugs all should be considered. Whenever possible, treat the causes of EDS and fatigue correctively, and always consider palliative arousal and energy management.

- Pain itself often interferes with sleep initiation and restorative sleep. More complete relief of pain improves sleep and may relieve daytime sleepiness, fatigue, apathy and cognitive impairment.

- Chronic pain management has evolved through several eras: cancer pain, non-malignant chronic pain, advances in regional pain management and the development of controlled-release opioids and newer drugs.

- The current era marks the challenges of drug abuse and diversion with institutionalization of risk management strategies.

- It is the author’s hope that the coming era will prioritize behavioral health and quality of life that stream not only from relief of pain but from alert consciousness, full energy and vitality, nimble cognition, and the capacity to experience full joy and gladness.

- Understanding and treating the causes and symptoms of tiredness among chronic pain sufferers helps clinicians restore alertness and vitality, increase mental and physical activity, minimize depression and apathy, and optimize pain management.