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chronic pain

Alternative Names
pain, pain management

Definition
Chronic pain can be described as pain that lasts long enough, or is intense enough, to affect a person's normal activities and well-being. It may continue over a long period of time or come and go. Any area of the body can be affected.

What is the information for this topic?
Pain is the number one reason why people see their doctors. Roughly 1 in 10 people reports having chronic pain. This pain can occur anywhere in the body and may vary throughout the day, month, and seasons.

Chronic pain affects not only the person who has it, but also his or her family. Treating it means paying attention to the emotional, psychological, physical, social, and spiritual needs of the person in pain.

The first step in managing chronic pain is finding its cause. This will help determine treatment options. A doctor must learn:
  • about the person's general health
  • whether the person has had health problems or surgeries that may have contributed to the pain
  • whether any treatments have been tried for the pain
Once these questions have been answered, a plan for managing the pain can be developed.

There is no single way to deal with chronic pain. This is true even for people whose pain is caused by the same disease or condition. Every person has a unique response to pain and pain management. That is why it is important to evaluate the person's needs as well as the physical pain. The person in pain plays an integral role in any treatment plan. He or she needs to understand the reasons for the pain, as well as the ways to manage it.

Most plans for handling chronic pain are multi-disciplined. People may see a variety of healthcare professionals, including:
  • doctors
  • psychiatrists
  • physiotherapists
  • anaesthetists
  • acupuncturists
Pain treatment teams usually meet to share information so that care is coordinated and monitored over time. Treatment options overseen by doctors and other doctors can include:
  • nonsteroidal anti-inflammatory drugs or NSAIDs
  • sympathetic blockades, or nerve blocks
  • corticosteroid injections
  • neurostimulation therapy. These therapies include transcutaneous electrical nerve stimulation or TENS, spinal cord stimulation or SCS, and peripheral nerve stimulation or PNS. The stimulation of nerves, usually through a low electrical current, has been shown to relieve chronic pain.
  • surgery
  • antidepressant drugs
  • opioid or narcotic drugs
Treatment options overseen by complementary doctors may include: New options in conventional and complementary medication arise all the time. This can be both helpful and confusing to the person in pain. That is why managing chronic pain usually involves a team of specialists that understand the variety of options available. It takes patience and time to figure out which treatment or combination of treatments works best. A person's needs for pain control may also change over time. Careful monitoring of pain and pain relief is essential.

The person who has chronic pain plays a key role in pain management. He or she must work with doctors to decide on treatment, then monitor and report on how treatments are working. A person with chronic pain has other responsibilities, too. He or she can:
  • exercise to keep muscles toned. Toned bodies feel less pain.
  • recognise emotions and stress. Stress makes pain worse. Stress management tools improve pain control.
  • focus on personal priorities outside of the pain. It helps to set and meet goals. Successful pain management means learning to make pain part of life, rather than the whole life.
  • understand each patient's rights. A person should settle for nothing less than respectful care and being listened to by all doctors.
Finally, many people with chronic pain find it valuable to speak with others who suffer from it. Many self-help groups allow people to share ideas, strategies, struggles, and successes. Talking with others can offer more help to the person with chronic pain and give him or her a chance to help others.

Author: Terry Mason, MPH
Reviewer: HealthAnswers Australia Medical Review Panel
Editor: Dr David Taylor, Chief Medical Officer HealthAnswers Australia
Last Updated: 1/10/2001
Contributors
Potential conflict of interest information for reviewers available on request


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