Chronic Pain

Overview

What is chronic pain?

There are 2 types of pain: acute and chronic. Acute pain lets you know that your body is injured and usually doesn’t last long. It should go away as your body heals. Chronic pain lasts much longer. Chronic pain may last months or even years. Chronic pain may interfere with your daily activities. And because the pain lasts so long, people who have chronic pain may also have low self-esteem, depression, and anger.

Causes & Risk Factors

What causes chronic pain?

Sometimes, chronic pain is caused by an old injury or infection, or by a disease. Sometimes there is no known cause for the pain.

Conditions that may trigger or cause chronic pain include:

Depression and stress tend to make pain worse, including chronic pain.

  • Infections
  • Headaches or migraines
  • Back problems
  • Cancer
  • Arthritis
  • Fibromyalgia
  • Nerve damage
  • Previous surgery

Diagnosis & Tests

What should I tell my doctor about my pain?

Telling your doctor about your pain will help him or her find the right treatment for you. Tell your doctor where the pain is, how bad it is and how often your pain occurs. Also talk about what makes the pain better or worse.

How will my doctor diagnose the cause of my pain?

Your doctor probably will ask you about your medical history, do a physical exam, and may run tests to help determine the cause of your pain. Your doctor will also review other health problems you may have (such as breathing problems and heart conditions) because these may keep you from doing some types of therapy. Your doctor may also ask if you have had any problems with sleep, mood, or anxiety.

Treatment

How is chronic pain treated?

Treatment of chronic pain usually involves medicines and therapy. Chronic pain treatments will usually not take away all of your pain. Instead, treatment should reduce how much pain you have and how often it occurs. Talk to your doctor to learn how to best control your pain.

Medicines used for chronic pain include pain relievers, antidepressants, and anticonvulsants. Different types of medicines help people who have different types of pain. Your doctor usually will recommend long-acting medicines for constant pain. Short-acting medicines treat pain that comes and goes. If your doctor recommends an over-the-counter pain reliever, read and follow the instructions on the box. If your doctor recommends a prescription pain reliever, be sure to follow your doctor’s instructions for how to take the medicine. Taking certain prescription pain relievers improperly may increase your risk for side effects or addiction.

Are drugs the only way to treat chronic pain?

No. You can do many other things to help relieve your pain. Almost anything you do to relax or get your mind off your problems may help control pain. It’s important to include relaxing activities in your daily life, even if you are already taking medicine for pain. Relaxation can actually change the body’s chemicals that produce pain. You might have to use stress-reduction methods for several weeks before you notice a decrease in pain. Your doctor can give you tips about stress reduction and relaxation methods.

Several types of therapy can help ease your pain. Physical therapy (such as stretching and strengthening activities) and low-impact exercise (such as walking, swimming, or biking) can help reduce the pain. However, exercising too much or not at all can hurt patients with chronic pain.

Some types of chronic pain can be helped by osteopathic manipulation therapy (OMT) or acupuncture. Occupational therapy teaches you how to pace yourself and how to do ordinary tasks differently so that you reduce your pain or avoid reinjuring yourself. Behavioral therapy can reduce your pain through methods that help you relax, such as meditation, tai chi, and yoga. It can also help decrease stress.

Lifestyle changes are an important part of treatment for chronic pain. Getting regular sleep at night and not taking daytime naps should help. Stopping smoking also helps because the nicotine in cigarettes can make some medicines less effective. Smokers also tend to have more pain than nonsmokers.

Questions to Ask Your Doctor

  • What is the likely cause of my pain?
  • Why won’t it go away?
  • What is the best treatment option for me? Will I need medicine?
  • Will physical, occupational or behavioral therapy help relieve my pain?
  • What about alternative therapies, such as yoga, massage or acupuncture?
  • Is it safe for me to exercise? What kind of exercise should I do?
  • Do I need to make any lifestyle changes?

Bibliography

Citations

  • Treatment of Nonmalignant Chronic Pain by DA Marcus(American Family Physician 03/01/00, http://www.aafp.org/afp/20000301/1331.html)
  • American Academy of Pain Medicine. AAPM Facts and Figures on Pain. Accessed 08/15/12