What is Chronic Pain?

Chronic pain is common, affecting over a quarter of the UK’s adult population at any one time. It is generally defined as pain that has been present for 3 months or longer.

Chronic pain can arise for number of reasons including degenerative conditions such as arthritis, previous surgery, cancer and it’s treatment or nerve damage due to infection, diabetes or injury.

Whilst pain that follows an injury serves a biological purpose and is useful – it stops you from developing further injury, chronic pain does not.

Beyond the physical discomfort, chronic pain can impact on every aspect of daily life, affecting mood, relationships, work, and overall well-being.

Functionally, chronic pain can limit mobility, making even simple tasks like walking, standing, or sitting unbearable. Commonly this leads to a reduction in physical activity, which can contribute to muscle weakness, joint stiffness, and further exacerbate the pain cycle. Sleep disturbances are also common, as discomfort can interfere with falling and staying asleep, leading to fatigue and cognitive impairments.

The psychological toll of chronic pain is significant, resulting in depression, anxiety, and feelings of helplessness or frustration. Constant pain can erode an individual’s sense of self-worth and identity, leading to social withdrawal and isolation. Relationships may suffer as individuals struggle to communicate their experience and loved ones may find it challenging to understand the condition.

Having chronic pain commonly impacts on work and financial stability; absenteeism and reduced productivity are common among those experiencing chronic pain.

Overall, chronic pain is not just a physical ailment but a complex condition that affects every aspect of an individual's life. Therefore, it is important that chronic pain is fully assessed and treated - an approach requiring comprehensive management strategies that address both the physical and emotional components.

When a pain specialist sees a patient with chronic pain in clinic, we start by taking a history to gain a full understanding of the type of pain the patient is experiencing and how it is affecting them. This is normally followed by a physical examination focused on the painful area and a review of any relevant scans and other investigations. Further tests may be arranged. Education and explanation is really important in managing pain successfully – if someone understands why they are experiencing pain, the symptoms are often less distressing and I spend a lot of time chatting with my patients, explaining my findings and coming up with a management plan.

A combination of approaches can be used to treat pain, often these address not only the physical effects of the pain but also the psychological and social effects. Approaches can include pain-killing medications ranging from simple drugs like paracetamol through to stronger agents like anti-nerve pain medicines that need specialist knowledge to prescribe safely. Pain specialists also perform injections to block nerves and can perform more advanced procedures such as neuromodulation and complementary therapies like acupuncture. Combining a number of different treatments often leads to a better result – the overall aim of treatment is to rehabilitate patients increasing their functional levels and quality of life.