What is Chronic Pain?

Author| The Pain Project

Chronic (long-standing) pain is different from acute (short-term) pain.

The Pain Project, representing people who suffer from chronic pain—and those who care for them, has produced a chronic pain patient self-management resource, What Chronic Pain Is and How to Manage It. Please feel free to use this resource and share it with your colleagues.

Chronic pain is commonly defined as non-cancer pain lasting more than 3-6 months or pain that persists longer than expected for a typical injury to heal. There are many types of chronic pain including back pain, neck pain, headache, abdominal pain, joint pain, fibromyalgia and many others. Chronic pain is similar to other chronic conditions like diabetes and high blood pressure. Chronic pain is real; however, tests such as X-rays, CT scans, MRIs are often normal and do not show abnormalities as they do with acute pain.

Acute pain is a form of pain that usually lasts a relatively short period of time and is the direct result of some kind of injury with tissue damage, like a bruised finger that has gotten caught in a car door.

While acute pain is normal, and can even be helpful in that it alerts a person to a possible injury, chronic pain is very different and is not helpful. Chronic pain may arise from an initial injury, however, there may also be no clear cause. Other symptoms such as fatigue, sleep disturbance, decreased appetite and mood changes accompany chronic pain. Chronic pain may reduce physical activity, flexibility, strength, and stamina, making enjoyable activities challenging. This can lead to frustration, fear, anger, and sadness.

Chronic pain and emotions: Pain is an individual and emotional experience, and no two people experience pain in exactly the same way. Therefore, the correlation between pain and actual bodily damage varies widely. This reality is often underappreciated. Many tend to view pain as a purely sensory experience only representing underlying injury. This does not mean your chronic pain is not real, it just means that there are multiple factors responsible for it.

Chronic pain and medications: Your healthcare practitioner may prescribe one or more various medications for your chronic pain. Different medications work for different people and different types of
pain. All medications have risks and benefits that must be weighed individually. You should only take medications exactly as prescribed and never share them with anyone else. Opioid medications are often used to help people with cancer-related pain. However, cancer pain is different from chronic pain. Pain associated with cancer can be due to many different causes and requires the care of skilled practitioners  to assure cancer patients receive appropriate and compassionate pain control.

Other chronic pain treatments: There are multiple non-drug treatments that can help to safely and effectively manage chronic pain. Chronic pain therapies that show the most long-term benefits are those in which the person is actively engaged in their treatment. Physical activity is good and activities such as walking, hiking, dancing, playing sports, and yoga decrease stress and build confidence. The key is to remain as active as possible.

Things to Remember If You Have Chronic Pain:

1. It’s not in your head, it’s in your brain. The brain is the master organ that process signals from the body. The brain processes pain signals as sensations, emotions, and thoughts (not just pure sensation).

2. Thoughts and emotions can make the experience of pain much worse, or much more manageable. Thoughts and emotions directly influence the pain signals coming into the body.

3. Short-term pain can often be completely eliminated with medical treatment (surgery, medication). Chronic pain is much more complex and sometimes cannot be completely eliminated.

4. The brain becomes more sensitive to pain signals with chronic pain. This is why you might be more sensitive to pain signals than other people after living with pain for a long time. But you can learn ways to help lower the “pain thermostat” of the brain.

5. Chronic pain is a chronic illness like diabetes, high blood pressure, or asthma. Similar to these conditions, chronic pain needs long-term management, including lifestyle changes.

6. Managing chronic pain requires a team of healthcare professionals who have special training in chronic disease management. Behavioral healthcare providers (sucn as specially trained psychologists, psychiatrists, counselors, or social workers) understand the impact that thoughts, emotions, and lifestyle management can have on chronic pain.

7. Learning to pace your activities -- but staying active, and making sure you continue enjoyable activities -- is an important part of lifestyle management.

8. Depression, anxiety, and anger are common emotions in response to chronic pain. Getting help coping with these emotions is an important part of managing chronic pain.

9. Negative thoughts in response to chronic pain are very common. Learning to notice unhelpful thoughts and change your  relationship to those thoughts is important to chronic pain management.

10. Remember, you are not alone. It is estimated that about 1 out of 3 people in the U.S. have some form of chronic pain that negatively impacts their life. You’re not “crazy” -- you have a chronic illness called chronic pain. Managing that illness takes a team of involved and caring experts, including you!