My Spine - Lumbar
During certain stages of deep sleep, an important hormone called serotonin is
released by the body. This is a natural pain killer (endorphin, so-called
because it is the body’s own morphine) and is also important in combating
depression. Reduced sleep leads to fatigue, which makes the perception of
pain more acute and also reduces the levels of endorphins (serotonin) secret-
ed because of lack of sleep. This reduces the body’s ability to fight pain and
causes depression.
Making sure that you sleep properly is therefore of paramount importance.
This can be achieved by ensuring that you have adequate pain relief from
anti-inflammatory medication as well as simple analgesics and that their
administration times allow you to have a good night’s rest. Certain drugs such
as amytriptiline increase the levels of serotonin and are also sedative without
having addictive properties and can be taken on a chronic basis.
In patients where neglected pain is not managed properly and promptly,
chronic pain may develop. The problem with chronic pain is that instead of
becoming used to pain, patients become less able to deal with pain and their
perception of pain changes. This means that instead of being able to tolerate
pain better, they become less tolerant of pain and even if treatment at this
stage is partially successful, the level of pain that would previously have been
perceived as acceptable or tolerable, is now perceived as intolerable.
Action plan to avoid depression and anxiety
associated with pain
1. Know and understand the source of the pain.
2. Understand the consequences of the condition as well as the long-term out-
look.
3. Understand the possible treatment as well as your individual treatment plan
and make sure that you do not have unrealistic expectations.
63