What Is Chronic Pain? Here Are the Symptoms, Causes, and Treatments
Pain affects everyone, but what works for one person's pain may not help yours. Here's what you need to know about the causes of chronic pain, how to prevent it, and treatment options that can provide relief to those living with chronic pain.
laflor/Getty ImagesWhat is Chronic Pain?
Chronic pain is any pain that persists or recurs for 3 to 6 months or longer. Acute pain, such as flu-related body aches or pain due to an injury, can be mild or severe but generally goes away relatively quickly—either almost immediately or at least within a few days or weeks. Generally acute pain subsides when the original trigger, such as an infection, injury, or surgery, resolves or heals.
After that it gets complicated, because there are many conditions, such as cancer and multiple sclerosis, which have pain as a secondary symptom, according to the World Health Organization’s International Classification of Diseases.
Unfortunately, there’s also pain no one can explain. What is known, however, is that chronic pain is common. About 20 percent of people worldwide are thought to be in chronic pain, and it accounts for 15 percent to 20 percent of doctor’s visits.
Symptoms of Pain
There are all types of pain: dull or throbbing, popping or burning, widespread or limited to a one spot or area.
No matter the source, common signs and symptoms that someone is in pain include:
- Frowning or grimacing
- Writhing or inability to get comfortable
- Noises such as moaning, whimpering, or shouting
- Reduced range of motion
- Sudden movements, such as kicking or clenching
- Inability to focus
Symptoms that occur with pain include:
- Apathy or depression
- Flu-like symptoms, such as fever
- Appetite loss
- Muscle spasms
- Numbness in other parts of the body
- Inability to sleep
What Causes Pain?
The most common causes of pain are tension, stress, overuse, and minor injuries. Pain that racks your whole body—systemic pain—is more likely caused by an illness or condition, like fibromyalgia, cancer, infection, or even emotional distress.
Pain can also be a side effect of a medicine you’re taking—cancer drugs, or statins for high cholesterol, for example, sometimes can cause painful side effects. And pain may be linked to a chronic condition, like osteoarthritis, an autoimmune disease, like the joint-damaging rheumatoid arthritis, or nerve problems.
For example, shingles, a reactivation of the chickenpox virus that can happen later in life, can sometimes trigger postherpetic neuralgia, a condition marked by ongoing, excruciating nerve pain that can last months or even years. And conditions like diabetes can cause peripheral neuropathy, which is damage to nerves (often in the hands or feet) that can cause tingling, burning, and stabbing sensations.
How to Prevent Pain
There’s little you can do to prevent pain caused by a serious condition like cancer or lupus, but simple lifestyle changes can help stave off many other types of chronic pain. Exercise regularly, and try not to spend your life hunched over a computer or phone, which can increase the risk of repetitive strain injuries like carpal tunnel syndrome and overuse syndromes like text neck.
Practice good posture and make sure your desk, keyboard, and monitor are properly aligned and at the right height so you don’t strain your neck and back. Or if your job has you lifting, bending a lot or standing for long periods, be sure to protect your joints, lift from your knees, try to limit twisting, and wear supportive shoes. This can help you avoid back pain or foot pain.
Eat a healthy, high fiber diet to keep belly aches at bay. If you’re prone to head pain, try hot or cold packs on your head or eyes or dimming the lights. Also, stress is a known pain-inducer, and whatever pain you’re feeling is likely to be worse when you’re stressed. It’s easier said than done, but if you can take steps to minimize the many emotional, mental and physical stressors in your life, you’re less likely to be burdened with chronic pain or at least reduce the risk of developing it.
Chronic Pain Management Tips
The most important thing to know about managing or treating pain is that some types need immediate attention. If you have a sudden high fever, bleeding, chest pain, nausea, or vomiting, head for an ER or urgent care center right away. While it may be nothing, only a healthcare professional can rule out something serious, such as meningitis or a heart attack. Here are the types of pain you should never ignore.
Chronic pain can be managed or sometimes even eliminated, usually with a trial and error approach. There are several types of medications available to treat chronic pain. Each of these has varying degrees of effectiveness and may cause side effects, so it’s important to speak with your doctor before using them.
Commonly used pain medications include:
- Nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen. Many of these are available over-the-counter (OTC), but some are prescribed. When these are used often, they can cause cause stomach and other problems, so talk to your doctor.
- Antidepressants. Even if you’re not clinically depressed, experts find that some antidepressants can effectively manage nerve and migraine pain.
- Muscle relaxers. If your chronic pain is caused by cramps or other types of muscle pain, these might provide relief. Some muscle relaxers are available over-the-counter, while others require a prescription.
- Opioids. This class of pain medication shouldn’t be your first choice, but if you have chronic pain they can literally be life-saving. If you take prescription opioids exactly as your doctor recommends, and follow a plan to get off when your pain abates, you reduce your risk of becoming addicted, according to the U.S. Department of Health and Human Services.
Not everyone wants to—or can—take medication. Fortunately there are many self-care and alternative medical treatments that can reduce pain. Many people find the most effective relief comes from combining prescription, OTC, and natural or complementary treatments, including:
- Acupuncture. Research shows that this practice, a staple of traditional Chinese medicine, can provide relief for many types of chronic pain, including migraine, arthritis, and musculoskeletal pain, and some medical centers are even incorporating this approach into their pain relief programs.
- Medical cannabis. More people are turning to this treatment for relief from many chronic health issues, including pain.
- CBD products. CBD or cannabidiol, is one of the hundreds of compounds found in the marijuana or hemp plant. Unlike THC, the psychoactive compound in marijuana, it doesn’t make you feel high. It may help with problems related to sleep, anxiety, dental pain, peripheral neuropathy, rheumatoid arthritis, and more.
- Yoga and other types of stretching. OK, the last thing you feel like doing is exercising when you have chronic pain. Do it anyway—gently—because, studies show, it can help. A 2019 review of yoga-for-pain studies in the journal Medicine concluded that yoga can relieve pain intensity, improve pain-related disability, and boost mood.
- Breath exercises. Stress can make chronic pain worse, and deep breathing exercises are an easy and accessible way to try to reduce both pain and stress.
- Anti-inflammatory foods. Switching up your eating habits won’t immediately turn off your pain symptoms, but a diet high in fruit and vegetables, whole grains, fish, and lean protein might reduce pain related to an autoimmune condition over the long term. These foods to manage pain also happen to be delicious!
Don’t suffer in silence. It’s important to recognize when your pain management options are no longer working and speak to your doctor to find something that will. Here’s how to tell if you should get a cortisone shot.
The Science of Pain
When someone complains of persistent pain long after the healing process ends, some assume it’s all in their head. New research into how pain affects the brain supports this theory, but not in the way you might expect. Many studies have found a high correlation between depression and pain, and people with both have poorer outcomes. But is depression a symptom of chronic pain? Yes and no.
Chronic pain doesn’t just come from neurological signals. It might create its own, finds a 2019 study in the International Journal of Molecular Sciences that reviewed brain imaging studies. In other words, pain may be a driving force that changes the brain, carving pathways in the area called the prefrontal cortex and potentially altering a sufferer’s personality.
Specifically, chronic pain and depression cause similar changes in neuroplasticity, or the ways the brain forms new connections. For example, both alter levels of neurotransmitters such as serotonin, dopamine, and norepinephrine, which regulate mood. It’s also worth exploring the fact that brain regions that control pain, including the prefrontal cortex, hippocampus, and amygdala, also control mood disorders, according to a 2017 study published in the journal Neuroplasticity.
There are many holes in our understanding of the brain in pain. Scientists don’t yet know if brain reorganization is a response to pain, or a pre-existing factor that puts you at risk. Why can one person with an injured hip fully heal, while another with the same injury develops a chronic pain condition and a mood disorder? Future research will address these questions. Meanwhile, rest assured: your chronic pain is not your imagination. But it is in your head.
- Kristin Chenoweth: How I Cope With Chronic Pain
- I Tried CBD Cream for My Pain: Here’s How It Worked
- I Lost My Job and My House to Opiate Addiction — Here’s What Saved Me
- CBD and Rheumatoid Arthritis: How It Worked for Me
- Living in a Box: Stories of Chronic Pain
- Living With, and Managing, Chronic Pain: A Patient’s Story
If you need additional help with chronic pain, where do you go next? Here are some foundations, support groups, medical societies, and a Facebook group that may help.
- The American Chronic Pain Association
- The U.S. Pain Foundation
- Chronic Pain Anonymous
- American Academy of Pain Medicine
- American Society of Regional Anesthesia and Pain Medicine
- Facebook: Surviving Chronic Pain Support Group
- Arthritis Foundation: "Inflammatory joint pain."
- National Institute of Neurological Disorders and Stroke: "Low back pain fact sheet."
- Mayo Clinic: "Muscle Pain."
- National Institute of Arthritis and Musculoskeletal and Skin Diseases: "Back pain."
- Pain Medicine. The Impact of Massage Therapy on Function in Pain Populations—A Systematic Review and Meta-Analysis of Randomized Controlled Trials: Part I, Patients Experiencing Pain in the General Population.
- American College of Rheumatology: "Fibromyalgia."
- Johns Hopkins Lyme Disease Research Center: "Lyme Disease Signs & Symptoms."
- U.S. National Library of Medicine: "Rhabdomyolysis."
- American College of Rheumatology: "Polymyalgia Rheumatica."
- Mayo Clinic: "Influenza."
- Hospital Nutrition: "Consumption of Cherries as a Strategy to Attenuate Exercise-Induced Muscle Damage andIn Inflammation in Humans."
- Biomedical Reports: "Potential role of bromelain in clinical and therapeutic applications."
- Nutrients: "Quercetin, Inflammation and Immunity."
- The American Journal of Clinical Nutrition: "Associations between nut consumption and inflammatory biomarkers."
- Arthritis Foundation: "Best Nuts and Seeds for Arthritis."
- Journal of Atherosclerosis and and Thrombosis: "Attenuation of meal-induced inflammatory and thrombotic responses in overweight men and women after 6-week daily strawberry (Fragaria) intake. A randomized placebo-controlled trial."
- National Institute of Neurological Disorders and Stroke: "Peripheral Neuropathy Fact Sheet."
- Pain Medicine: "A Comprehensive Algorithm for the Management of Neuropathic Pain."
- Journal of Inflammation: "Effect of Sulforaphane on NOD2 via NF-κB: implications for Crohn's disease."
- Pain: A classification of chronic pain for ICD-11