KNOW YOUR PAIN
WHAT IS CHRONIC PAIN?
Chronic pain is pain that lasts or recurs (goes away and reappears) for longer than 3 months.1 It can exist after an injury or disease has healed and often serves no useful purpose.2 The pain is caused by the body incorrectly signalling to the brain that there is pain when, in reality, the original cause of the pain is no longer present. Chronic pain can occur in one or more regions in the body and may cause significant emotional distress and/or disrupt activities of daily life.1 There are different types of chronic pain:3
- pain caused by an injury to the body (known as nociceptive pain)
- pain caused by nerve damage (known as neuropathic pain)
- pain caused by an increased response to a stimulus compared with what would normally be felt (known as nociplastic pain)
- mixed pain (a combination of any or all of the above)
WHAT CAUSES CHRONIC PAIN?
Chronic pain can be caused by many different factors. Conditions that accompany normal ageing often affect bones and joints in ways that cause chronic pain (for example, osteoarthritis). Other common causes are nerve damage (which causes neuropathic pain) and injuries that fail to heal properly. To make things more complicated, some kinds of chronic pain have numerous causes.1
Many chronic diseases or infections can also cause chronic pain. These include rheumatoid arthritis, diabetes, cancer, multiple sclerosis, fibromyalgia, migraine, irritable bowel syndrome, shingles and human immunodeficiency virus (HIV) infection.1,4 In many cases, however, the source of chronic pain can be very complex and may not be identifiable.1 Although it may begin with an injury or illness, chronic pain and its psychological burden continue even after the physical problem has healed.5
WHAT ARE TYPICAL SYMPTOMS OF CHRONIC PAIN?
People with chronic pain describe it in many different ways, such as ‘aching’, ‘burning’, ‘shooting’, ‘squeezing’, ‘stiffness’, ‘stinging’ or ‘throbbing’.
Chronic pain can often lead to other symptoms/problems, including anxiety, depression, fatigue (feeling overly tired most of the time), insomnia (trouble falling asleep) or mood swings.6,7
In addition to having an impact on a person’s mental health, chronic pain can reduce physical activity and cause disability.5 People who suffer with chronic pain can miss work or social interactions due to the symptoms.8,9 Chronic pain can also impact a person’s family members, who may undertake care duties and become involved in decision-making regarding medical treatment.9 If you take care of someone with chronic pain, read our caregiver’s self-care guide for recommendations on self-care.
HOW IS CHRONIC PAIN DIAGNOSED?
A correct and early diagnosis is crucial to find the right treatment and relieve chronic pain symptoms. It is therefore important that people describe their symptoms in as much detail as possible to their doctor to facilitate identification of the actual cause of the chronic pain condition.10 A thorough assessment of a person’s health, including medical history, a physical examination and emotional/psychological status, is essential to accurately evaluate an individual’s pain. A doctor might also ask about pain intensity (using a pain scale), duration, frequency and other observations in your daily life.11
WHAT CAN YOU DO?
Like other chronic conditions, and due to the many factors that cause chronic pain, it may not be curable but there are several treatment options available to help control and manage pain so that a person can continue with important daily activities. However, it is important to see a healthcare professional for advice regarding the condition.
If you have pain that has lasted for more than 3 months, please fill out the My Pain Questionnaire and make an appointment to see a doctor. The questionnaire is a very useful tool to help with communicating pain more effectively with a doctor and supports them in making an accurate diagnosis of the cause of chronic pain. It will help with describing pain, where it occurs on the body and if it is triggered by anything in particular. Once completed online, print out the results of the questionnaire and discuss them with a doctor.
In addition, the Pain Diary can be used to help document and keep track of a person’s pain condition; how they feel each day, whether they are coping, their current level of pain and any side effects of treatment(s) prescribed/recommended.It is also important to be realistic about the expectations of any treatment. Although most would like to completely eliminate their pain, reducing pain to a level that is manageable to enable a person to (re-)start activities that will lead a fulfilling life is perhaps a more achievable goal for many patients.
Chronic pain can be difficult to understand and manage on an everyday basis. The CHANGE PAIN Pain Toolkit provides handy tips and skills about self-management
1. Treede RD, Rief W, Barke A, et al. Chronic pain as a symptom or a disease: The IASP Classification of Chronic Pain for the International Classification of Diseases (ICD-11). Pain 2019; 160: 19–27.
2. Orr PM, et al. Crit Care Nurs Clin North Am. 2017;29:407–18.
3. Clauw DJ, Essex MN, Pitman V, Jones KD. Reframing chronic pain as a disease, not a symptom: Rationale and implications for pain management. Postgrad Med 2019; 131: 185–98.
4. Parker R et al. J Int AIDS Soc. 2014;17:18719.
5. Dueñas M et al. J Pain Res. 2016;9:457–67.
6. Hüllemann P et al. Pain Pract. 2018;18:1011–23.
7. Colloca L et al. Nat Rev Dis Primers. 2017;3:17002.
8. Breivik H et al. BMC Public Health 2013; 13.
9. Morlion B & Freynhagen R. Hospital Pharm Eur 2019;1–12.
10. Morlion B et al. Curr Med Res Opin 2018;34:1169–78.
11. Kress HG, Aldington D, Alon E, et al. Curr Med Res Opin 2015;31:1743–54.