Chronic Wound Pain: Is it Really Such a Problem?

A wealth of academic research has been devoted to the assessment, diagnosis and management of wound pain. A review of the resulting literature reveals the full scale of the problem, indicating that the vast majority of patients with chronic wounds, such as pressure ulcers and venous leg ulcers suffer from pain at the wound site ranging from moderate to severe in intensity. Such pain may be experienced constantly or periodically during procedures such as wound cleansing, dressing changes or debridement.

Affecting the Lives of Sufferers

Pain and seeking relief from pain tends to be the primary concern of most patients suffering from a chronic wound. While some wound care practitioners may overlook the management of wound pain, research suggests that a patient’s natural inclination to focus on pain is actually well founded, for two important reasons. First, uncontrolled pain is the most significant predictor of impaired quality of life, and second, pain may actually have a negative effect on wound healing, through a complex process involving several mechanisms.

Sleep & Everyday Activities

As everyday activities, such as working, walking, standing and stair climbing, can exacerbate wound pain, people living with chronic wounds tend to limit their mobility and social activities and suffer a more restricted life. Furthermore, as pain often occurs or worsens at night, it can become a source of debilitating sleep deprivation leading to fatigue and exhaustion.

Increased Pain Sensitivity

The depression and anxiety that may result from chronic wound pain can actually exacerbate the sensation of pain, leading to a spiral of depression and increased pain sensitivity. Anxiety and depression have been shown to be significantly associated with increased pain in patients with leg ulcers and diabetic neuropathy. Roth and colleagues have also demonstrated a correlation between the extent of catastrophic thinking in patients with chronic wounds and the level of wound-related pain experienced.

From a physiological point of view, wound-related pain is thought to activate the sympathetic nervous system leading to vasoconstriction and a reduction in oxygen levels in the tissue. Thus, the experience of pain can itself have a negative impact on wound healing.

Be sure to read next week’s blog post where we will be discussing the various types of wound pain. We also raise the awareness of wound pain by providing latest research, therapies, protocols and best practice in wound pain management.

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