Patient education: Chronic pain (The Basics)

What is chronic pain? — Chronic pain is pain that lasts longer than 3 to 6 months. In many cases, this means that pain continues even after the injury or condition that first caused it has healed.

What causes chronic pain? — The cause of chronic pain is not always clear. Sometimes, it is caused by an ongoing medical problem, such as arthritis or diabetic neuropathy (a form of nerve damage from diabetes). But doctors cannot always find the cause of chronic pain.

In some cases, people with chronic pain must accept that their pain will never be explained. This means that they have to work with their health care team to address the pain, even if they don't know its cause.

What are the symptoms of chronic pain? — The main symptom of chronic pain is, of course, pain. But the pain can affect the body in different ways. Some people have aches deep inside their muscle or bone. Some people have stabbing or shooting pain, often with tingling or numbness. And others have dull, throbbing pain.

People who have chronic pain might have a hard time doing their usual activities, such as bathing or dressing. This can lead to depression and anxiety, and it can cause problems with sleep.

Will I need tests? — When you first start having pain, your doctor might do tests to figure out the cause. You might get:

●Blood tests to check for infection, signs of inflammation, or diseases that can cause pain

●X-rays or other imaging tests to check for bone fractures, joint damage, cancer, or other changes in your body that could cause pain

●Nerve tests to check whether the nerves are working normally

However, tests cannot always show the cause of pain. Scientists think that in some people, the pain signals in the brain stop working normally. The signals get "stuck" in the on position, even when the source of pain is gone.

How is chronic pain treated? — Treatments for chronic pain include both medicines and activities. No single treatment works for everyone. Your doctor or nurse will help you find the right mix of treatments for you. Treatment options include:

●Medicines to relieve pain, improve sleep, or improve mood

●Physical therapy to learn exercises and stretches

●Working with a counselor

●Relaxation therapy

●Massage therapy

●Injections (shots) of numbing or pain-relieving medicines into the spine or area with pain

●Acupuncture

●Devices that affect nerve signals

●Surgery

To find the best treatment for you:

●Be open to trying new treatments and combinations of treatments. Sometimes, you have to try a few different options before you find one that works best.

●Set realistic goals for your treatment. Even if you can't completely get rid of your pain, you might be able to control it enough so that you can do the things you want to do.

If your doctor suggests a medicine that seems out of place, keep an open mind. Sometimes, doctors treat pain with medicines made to treat other medical problems. For example, doctors can use medicines for depression to treat pain, because they work on areas of the brain that process pain. Doctors can also use medicines for seizures to treat pain, because they help with overactive nerves.

Keep in mind, too, that many people need a team to help manage their care. A treatment team usually includes:

●Doctors or specialists

●A physical therapist

●Someone trained in mental health (such as a social worker or counselor)

Is there anything I can do on my own to feel better? — Yes. Some things to try include:

●Use a heating pad or a cold pack on the painful area. Check with your doctor before trying this to make sure it is OK for your individual condition.

●Practice relaxing. You can learn methods to relax your body, such as doing deep breathing exercises. Ask your doctor or nurse about these methods. Relaxing the mind can help with how the body feels pain. People can learn to quiet their pain or make it less bothersome.

●Stay as active as possible. Walking, swimming, tai chi (a kind of martial art), or biking can all help ease muscle and joint pain. If you are not active, your pain might get worse.

If you haven't been active for a while, start slowly. Make small increases in the intensity and amount of time you spend exercising. If exercising increases your pain, talk with your doctor. They might recommend a program that can help you get more active.

●If you feel depressed, talk to your doctor or nurse about it. Chronic pain and depression often go together, and each can make the other worse. Getting treatment for your depression can make it easier to cope with your pain.

More on this topic

Patient education: Complementary and alternative medicine (The Basics)
Patient education: Managing pain when you have cancer (The Basics)
Patient education: Low back pain in adults (The Basics)
Patient education: Fibromyalgia (The Basics)
Patient education: Neuropathic pain (The Basics)
Patient education: Opioid medicines for short-term treatment of pain (The Basics)

Patient education: Low back pain in adults (Beyond the Basics)