* Degenerative arthritis as referred to here is not the “garden variety” osteoarthritis caused by normal wear, tears, and aging, but severe degeneration of bone coverings and the bone, itself.
In recent years, specific disease treatments have made the following diseases uncommon causes of IP:
Intractable Pain (IP) is characterized by severe, constant, and unrelenting pain, setting it apart from typical chronic pain, which is intermittent, of limited duration, and often lacks significant physiological complications. IP presents with a multitude of medical complexities, so much so that it warrants classification as a syndrome, as defined in "Taber's Cyclopedic Medical Dictionary"*: "a group of symptoms and signs of disordered function related to one another by means of some anatomic, physiologic, or biochemical peculiarity."
The distinctive anatomic, physiologic, and biochemical peculiarity associated with IP lies in a defect within the brain or central nervous system (CNS). Regardless of the initial cause of IP, whether it be adhesive arachnoiditis, pancreatitis, diabetic neuropathy, or another condition, the unifying pathological peculiarity involves one or more anatomic defects within the CNS. These defective CNS sites result from electrical and/or autoimmune attacks on CNS tissue, causing destruction and impairment of its normal physiologic and biochemical functions, including the regulation of pain. These damaged anatomical sites are now detectable through brain scans. Physicians often refer to these abnormalities with the term "centralization" or "central sensitivity," acknowledging their role in exacerbating and failing to terminate pain. Hence, IP with multiple medical complications will ensue.
Recently, some pain specialists have aptly coined the term "High Impact Pain." This descriptor aptly suits IP, as it not only adversely affects the body's physiologic and biochemical systems but also profoundly impacts an individual's mental and social functioning. Furthermore, it inhibits essential activities of daily living, including personal hygiene, mobility, and dietary management.
*Thomas CL, Taber’s Cyclopedic Medical Dictionary, EA Davis CO, Philadelphia, 16Ed: 1989.P1804.