This is Part 2 of a Dr. Wang’s Migraine series.  Please click here for Part 1.

With a myriad of changes, the diagnoses of chronic pain become very complex.  When so many symptoms are presenting themselves, and tests show imbalance in areas of physiological, chemical and psychological, sometimes it is hard to determine which is the cause and which is the effect.  That is why patients with chronic pain are often treated for their symptoms.

Migraine is one of those pain diseases that is usually chronic, and can have many different sources of origin or cause.

It is complex because there are many contributing factors that will culminate in a migraine attack, however the cause of the migraine is sometimes illusive.  What most people refer to as migraine can have its origin from disease or injury to different systems.  It can be a disease of the vascular system, or nervous system, immune system, or muscular or soft tissue injuries, or even psychological system.  The fact that there are so many symptoms reported by migraine sufferers, and so many different triggers that precede a migraine attack, it shows that some cases of migraine can be multi-factorial.  As stated before, when different treatment through different doctors are tried and are not successful, the fallback position is symptomatic treatment.  Control of pain is attempted by giving all kinds of pain killers, muscle symptoms by muscle relaxants, sleep disorder by sleeping pills, depression that inevitably appear is controlled by anti depressants.  The rest of the symptoms are addressed by using anti-psychotic drugs, or anti-anxiety drugs, or even blood pressure medications.

The challenge of these patients and their families face each day is the prospect of unknown.  Is this going to be a good day or bad day?  Should I go out or not?  Should I meet with my friends and socialize, or is it even worth it?  They have been through so much treatment that have given them hope but end up letting them down.  It is the physical pain that is limiting their daily activity or quality of life, but it is psychological drain that eventually makes them lose hope.  My analogy for chronic pain is the situation of sleep deprivation; it is an unsustainable situation.  The physical psychological impact on a person will eventually drag them into the abyss.  Therefore it is really important to have a good support system.  Our medical system need to give them the proper diagnosis and treatment if possible.  It will only benefit the sufferer and provide them the opportunity to live a full life without having to change their habits because of chronic pain.  While the patient is the main sufferer, his/her family can feel the emotional effects as well. Pain BC is one of a few organized support groups for chronic pain patients and their family.