Prostatitis is a fairly common form of chronic pelvic pain in men. Prostatitis is caused by inflammation of the prostate gland, and causes symptoms such as pelvic pain or discomfort and urinary problems. It is often difficult to diagnose due to its vague symtoms.

Prostate cancer symptoms are equally vague, and often do not become noticable until prostate cancer has advanced past the initial stages. Prostate cancer symptoms can mimic those of prostatitis, and can cause both urinary problems as well as pain and discomfort during urination. Because prostate cancer symptoms are just as vague as prostatitis symptoms, prostate cancer is often difficult to diagnose in its early stages.

So where does this leave men with chronic pelvic pain? Well, the University of Maryland Medical Center recommends regular screenings for men, especially those over 40, for early symptoms of prostate cancer. Catching prostate cancer symptoms early increases the chance of effective treatment. If you have pelvic pain or urinary symptoms, it is a good idea to have another exam just to be safe.

More from About.com's prostate cancer Guide:

What is Prostate Cancer?

Prostate Cancer Statistics

Prostate Cancer Myths

A recent article in the LA Times reported that Tai Chi may not only relieve arthritis pain in seniors, but may also lead to better mobility. Tai Chi has been known to have many health benefits for a long time, such as lowering blood pressure and increasing flexibility. This new finding, however, is specific to seniors with chronic pain.

Tai Chi is thought to ease the pains of arthritis by increasing balance, leg strength and flexibility. In addition, it is thought to decrease depression, which is common for people who have chronic pain. Tai Chi offers a safe, low-impact form of exercise. Don't think you have to be a senior to notice the health benefits: if this study says anything to me, it's that Tai Chi can help anyone who has chronic pain.

More information on Tai Chi:

History and Style Guide of Tai Chi

Tai Chi as Moving Meditation

Tai Chi for Arthritis

Chronic nerve pain, or neuropathic pain, affects millions of people. Unlike somatic pain, which is detected by nociceptors (pain receptor nerves), neuropathic pain is often caused by damage to or dysfunction in sensory nerves. Neuropathic pain can be caused by a number of conditions, such as diabetes. Nerves can also be damaged during a surgery, causing postoperative nerve pain. Sometimes, nerve tissues even thicken, causing a bundle which may become irritated. This is called a neuroma.

Treating chronic nerve pain often requires a different approach than pain caused by muscular or joint problems. While conventional medications may control some pain symptoms, nerve pain is often best treated with adjuvant analgesics such as anticonvulsants or antidepressants.

Do you have chronic nerve pain? What treatments did or did not work for you?

When you are being diagnosed or treated for a chronic pain conditions, one of the most common things you will be asked to do is to rate your pain. There are many different ways to do this, ranging from choosing a number to filling out a pain questionnaire. Healthcare providers use pain rating scales because pain is subjective - only the person in pain knows how it feels. Changes in pain rating scales tell the practitioners whether or not a pain intervention is working.

Something I try to explain to my patients is that a pain rating scale is not a test. I commonly hear patients respond "it's a twelve" when asked to rate their pain on a scale from zero to ten. Yes, twelve tells us you are in severe pain, but it's clearly not an accurate measure, especially as it is outside the realm of possibility!

How can you make a pain scale work for you? Well, first, be honest. Tell you practitioner how you feel. Is your pain better? Worse? Unchanged? Are you having other symptoms, such as anxiety or fear? Do you need a stronger painkiller? Whatever the case, let your doctor or nurse know how you are honestly feeling. Otherwise, all they can do it make a guess.

A recent study by the American Academy of Anesthesiologists reviewed the prevalence and causes of postoperative pain. They found that there were several potential factors that might predispose a person to developing chronic pain following a surgery. These included nerve injury, depression and age, among others.

While the area is being investigated further, one of the possible outcomes of this study is changing surgical approaches in patients who demonstrate one or more of the identified risk factors. Of course, they are not suggesting that surgeries be denies to these individuals. On the contrary, they feel if a person is a high risk for developing chronic postoperative pain, that less invasive surgical procedures be used when possible. This could potentially cut down on many cases of chronic pain that develop after major surgeries. 

Who do you talk to about your pain? A family member? A close friend? Your spouse?

A study by the Chiara Malformation and Syringomyelia Foundation showed that most people who suffer from chronic pain talk to those who are close to them about how they feel. And yet, the same people reported that this was less satisfying than talking to someone who also suffered from chronic pain. Surprising? Not so much. The people polled in the study reported a phenomenon that I see all to regularly in my therapy practice: that those who have never had chronic pain have no idea what it is like. This includes both loved ones and healthcare providers.

Why is this? Well, because pain is subjective. If you see someone hobbling around in a cast or with their arm in a sling, you can assume they are in pain. But what about the people walking around us every day? Seeing the outside signs of chronic pain can be a challenge, especially if the person who has pain does not exhibit the usual pain behaviors. Maybe they aren't limping or groaning. Maybe they have no visible cuts or casts. In fact, most of the time they look just like anyone else. But they certainly don't feel that way.

One of the most commonly reported complaints in the study was that the people in pain felt that others did not believe them. Over time, this can lead to feelings of hopelessness and eventually even depression for some people who suffer from chronic pain.

So what does this study tell us? People with chronic pain need to find a community of peers. They need to be able to discuss their pain without fear of being labeled or misunderstood. They need to share coping strategies, or just vent their frustrations. Mostly, though, they need to know they are not alone.

A recent study featured in the journal Pain reviewed the association between headaches and several psychiatric disorders. It revealed that people with psychiatric disorders such as depression and anxiety reported more frequent and disabling headaches than those with no psychiatric history. While this may sound bleak, the findings were positive: with proper headache treatment, those with psychiatric disorders improved comparably to those without.

We have long known there is a link between depression and chronic pain. Because the two are often hard to distinguish, finding adequate treatment for both conditions can be a challenge. This study on headaches, however, offers hope. Of interest, the people in the study were all treated by headache specialists - not their primary care doctors. While this is only one study, and not concrete proof that pain specialists are necessary for every patient with a psychiatric disorder, it does offer another option.

How bad would your symptoms have to be before you would see a pain specialist? Or, would you want to see one from the very beginning?

I regularly work with patients who are afraid to ask their doctors for different pain medications. Some people would rather just work through the pain than to take something stronger, or to risk taking something that might have unpleasant side effects. These are some of the common concerns about changing painkillers. While it's understandable, it can also keep you from achieving the quality of life you hope for.

While you may never be pain free, you don't have to be in more pain than necessary. Pain medication works differently for everyone. You may find that your prescription is not strong enough, or that it no longer works like it used to. And while you may be nervous about asking for stronger painkillers, remember this: you have every right to do so. 

If your pain meds are not helping, it's time to see your doctor. See if he can give you something stronger, or even something different. Maybe he can even advise you on what to take for breakthrough pain. Regardless, make sure you communicate exactly what you are feeling, so you can find the best solution for you. After all, why suffer more than you have to?

This week I am trying out a new job at work: talking to people who have just had surgery about rehab. And I think I know why they look at me like I am crazy when I inform them that they will be expected to be up and moving for three hours if they come to my center. Because they are in severe pain!

Postoperative pain is not unusual. In fact, you would expect it. If you have a knee or hip surgery, you are going to be sore afterward. Most of the people I see the day after surgery are highly medicated. But what happens when they wean you off the medication, and you still have severe pain?

Chronic postoperative pain is a bigger problem than most people realize. Chronic postoperative pain occurs when the recovery time for surgical pain passes, and the pain has not gone away. It is difficult to diagnose and treat, because there are so many potential factors that can cause it. It is often unlikely to predict who will develop chronic postoperative pain, and who will recover from their surgery as expected. Still, we do know some of the common causes of the disorder.

Do you or anyone you know suffer from chronic postoperative pain? If so, how long did it last, and what did you do to help it?

A family member told me this morning that she has been diagnosed with degenerative disk disease in her lumbar spine. She wanted to know what she could do about it. Her phone call crushed my heart, because I know exactly what she is in for. I would like to say that after talking to me she was in better spirits, but I don't think that was the case.

Sadly, spinal problems such as hers often lead to chronic back pain. I talked to her a bit about what living with chronic pain is like. I also talked about various coping strategies,  such as relaxation and distraction. Finally, I explained that when you are just starting out, it may take time to find the right medication. Unfortunately, trial and error with treatment approaches often leaves pain lingering.

It's not that I wanted to scare her. I just wanted to be honest. Also, I wanted to warn her in advance that things may get bleak from time to time, but not to give up hope. With a little patience, she can find something that works for her.

What advice would you give?