Patient education: Chronic pain (The Basics)

What is chronic pain? — This 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.

Pain can affect the body in different ways. For example, pain can be:

●An ache deep inside the muscle or bone

●Stabbing or shooting, often with tingling or numbness

●Dull and throbbing

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. It can also cause problems with sleep.

What causes chronic pain? — It is not always clear. Sometimes, it is caused by an ongoing medical problem, such as arthritis or 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.

Will I need tests? — Your doctor might do tests to figure out the cause of your pain. For example, you might get:

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

●X-rays or other imaging tests – Imaging tests create pictures of the inside of the body. They can check for bone fractures, joint damage, cancer, or other changes in your body that could cause pain.

●Nerve tests – These are ways 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? — There are many different ways to manage chronic pain. Most people need to try different combinations. The right approach for you depends on your pain as well as your lifestyle and preferences.

Treatment options include:

●Non-medicine techniques – Doctors recommend first trying to manage pain without medicines. This can involve lots of different things, such as:

•Working with a counselor or therapist

•Physical therapy or an exercise program

•Lifestyle and behavior changes to improve your mood, sleep, diet, and stress level

•Acupuncture

•Massage

•Ice or heat

•Devices that affect nerve signals

●Medicines – When the above methods are not enough to relieve pain, doctors can recommend medicines. Different medicines work in different ways. Some pain medicines, like opioids, are not recommended for treating chronic pain in most cases. That's because they come with serious risks. Doctors usually try other medicines first.

If your doctor suggests a medicine that seems strange, keep an open mind. Sometimes, doctors treat pain with medicines made to treat other medical problems. For example, medicines for depression can help with 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.

●Other treatments – These might include:

•Injections (shots) of numbing or pain-relieving medicines

•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 you can do the activities you like.

Is there anything I can do on my own to feel better? — Yes. It can help to:

●Try things like heat, cold, or massage – Depending on the cause of your pain, these things might help. Check with your doctor to make sure that it is OK for your 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. It can also help to make changes to improve your sleep habits.

●Stay as active as possible – Walking, swimming, tai chi (a kind of martial art), or biking can all help ease muscle and joint pain. Even gentle forms of exercise are good for your health. 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 makes your pain worse, talk with your doctor. They might recommend a program that can help you get more active.

What medical care will I need? — 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, like a social worker or counselor

Your team will probably want to see you regularly:

●They will ask you questions about your pain and other symptoms. They will also work with you to learn how treatment is working and make changes if needed.

●They will ask you about your mood and your mental health. Depression and chronic pain can make each other worse. If you have depression, they might suggest treatment for it.

As you get better at managing your pain, you might see your team less frequently.

More on this topic

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