Pain is your body's way of warning you that something may be wrong. Pain can affect your emotions as well as your body. When pain lasts longer than 3 months, it is called chronic pain.
Chronic pain can occur anywhere in your body. It can range from being mild and annoying to being so bad that it gets in the way of your daily activities.
Anyone can get chronic pain. It's more common in older adults, but it's not a normal part of aging. Older adults are more likely to have long-term medical problems, such as diabetes or arthritis, which can lead to ongoing pain.
Chronic pain can lead to other problems. You may feel depressed or feel anxious and stressed. You may stop doing activities such as going to work or school. You may not be able to sleep, and you may feel very tired.
Chronic pain can develop after a major injury or illness. It may also occur because certain brain chemicals aren't working correctly. Sometimes damaged nerves can cause the pain. Or the brain may become more sensitive to the feeling of pain or touch. Sometimes the cause of chronic pain isn't known.
Your doctor can find out if you have chronic pain by asking about your past illnesses and your overall health. Your doctor will also do a physical exam and look for areas that are tender, weak, or numb.
Your doctor may ask you about your pain including:
Your doctor may also want to know if your pain disrupts your daily activities, sleep, or mood.
You also may be asked to keep a pain diary.
You may have tests to find out if a health problem is causing the pain. Your doctor may check for problems with your nervous system and may order imaging tests.
It's important to make a treatment plan with your doctor. It may take several types or combinations of treatments before you find relief.
There are many treatments you can try to manage your pain. Often people think of taking medicine to treat pain. But there are many non-medicine treatments that may be just as helpful.
Treatment options may include:
When you have an injury or illness, certain nerves send pain signals to your brain. With chronic pain, these pain signals keep going for weeks, months, or even years after you recover.
Chronic pain can develop after a major injury or illness, such as a back injury or shingles. Or it can happen without a known cause. It's also possible that certain brain chemicals that usually suppress pain stop working the way they're supposed to. Or the brain may become more sensitive to the feeling of pain or touch.
The cause of the pain may vary, depending on where it occurs. Pain can affect:
This pain can happen from injuries or muscle strain. Health problems like osteoarthritis, rheumatoid arthritis, and fibromyalgia also can cause it.
This type of pain happens because of pressure on nerves or damage to them from an injury or a health problem. Sometimes pain occurs when something goes wrong with the central nervous system. This can happen with diabetes, shingles, and sciatica, for example.
Pain in your organs occurs because of injuries, infections, or health problems such as inflammatory bowel disease, irritable bowel syndrome, pelvic pain, and stomach ulcers.
You can have more than one kind of pain at the same time. For example, fibromyalgia can cause pain in muscles and nerves.
Risk factors are things that increase your chances of getting sick or having a problem. Risk factors for chronic pain include:
Chronic pain can't always be prevented. But staying in good physical and mental health may be the best way to prevent it or help you cope with it.
Here are some things you can try.
Common symptoms of chronic pain include mild to very bad pain that does not go away as expected after an illness or injury. It may be shooting, burning, or aching. Or it may feel like an electrical shock. You may also feel sore, tight, or stiff.
Chronic pain can lead to other problems, such as:
Chronic pain may be mild to severe. It may come back from time to time over several weeks, months, or years. Or the pain may be constant.
When you have chronic pain, you may avoid activity because you worry about making your pain worse or injuring yourself again. Often being inactive leads to more pain. And it can make it harder to do your daily activities. This can increase your worries even more. But being more active may help with your pain.
Chronic pain can also lead to symptoms of depression and problems sleeping. And depression can make chronic pain worse and harder to treat. Treatment can help you manage other conditions that often come with chronic pain.
The lives of your family members, friends, or caregivers can also be affected. The people you count on to help you may also need some support. Family therapy or involvement in a caregiver support program may help.
Call 911 or other emergency services now if:
If you or someone you know talks about suicide, self-harm, or feeling hopeless, get help right away. Call the National Suicide Prevention Lifeline at 1-800-273-TALK (1-800-273-8255) or text HOME to 741741 to access the Crisis Text Line. Consider saving these numbers in your phone.
Call a doctor about chronic pain if:
Watchful waiting is a wait-and-see approach.
During this period of watchful waiting, your doctor may have you try to get more sleep, work on reducing stress, and get more exercise. If you can control pain with exercise, massage, and pain relievers, you may not need further treatment.
If you have mild to moderate pain that keeps coming back and that you can't manage at home on your own, you may need to see one of the following health professionals:
If your chronic pain is moderate to severe and is constant, or if treatment does not control the pain, you may need to see a specialist, such as one or more of the following:
Often more than one specialist will treat your chronic pain. For example, a primary physician may manage your medicines, and a physical therapist may help you restore function through exercise or other treatments. A professional counselor may help you with coping and depression. Someone else may help you with acupuncture or yoga.
Your doctor will take a detailed medical history. Your doctor will ask you questions about your overall health and past illnesses, surgeries, or injuries.
Your doctor may ask you about your pain including:
Your doctor may also want to know if your pain disrupts your daily activities, sleep, or mood.
You also may be asked to keep a pain diary.
In your physical exam, your doctor will look for areas that are tender, weak, or numb. The doctor will also check for health problems that can lead to chronic pain, such as nervous system problems.
One or more of these tests may help your doctor rule out health problems that can cause chronic pain. These tests may also help your doctor find the cause of your pain. They include:
A small sample of your blood is taken. It's then checked to see if you have an infection or other condition that could be causing your pain.
X-rays or other imaging tests (such as CT scans, MRIs, or ultrasounds) take pictures of the inside structures of your body to look for disease and injury.
Electromyogram (EMG), nerve conduction studies, and other nerve tests measure muscle and nerve function to find out if your chronic pain is related to muscle or nerve problems.
One example of these types of nerve blocks is an injection of a local anesthetic into or around a nerve to find out if that nerve is causing the pain.
Treating chronic pain can be challenging. And it may take several types or combinations of treatments before you find relief. The goals of treatment are to reduce your pain and help you be able to function.
It's important to build a clear treatment plan with your doctor. Part of this plan includes finding ways for you to manage your pain. Only you know how bad your pain is and how it affects your life. Be sure to ask your doctor if you aren't clear about what steps you can take when pain occurs or gets worse.
Be sure to seek treatment early. It may help prevent the pain from getting worse.
There are many treatments you can try to manage your pain. Often people think of taking medicine to treat pain. But there are many non-medicine treatments that may be just as helpful. They may include:
Your doctor may recommend these treatments with or without medicine.
You may be able to manage your pain with over-the-counter pain medicines such as acetaminophen or ibuprofen.
If over-the-counter medicines aren't enough, other treatments may be needed. They include:
If your chronic pain isn't relieved after you have tried numerous treatments, you may want to think about going to a pain management clinic. Treatment is provided by a team of doctors who work together to address all the things that may cause your chronic pain.
You can care for yourself when you have chronic pain. Here are some things to try.
Treat medical conditions and mental health concerns early, before they get worse and become harder to treat. Chronic pain can lead to symptoms of depression. And depression can make chronic pain harder to treat.
Assistive devices, such as walking canes or doorknob extenders, may help you do your daily activities. These devices can help you to be more mobile and independent.
With self-massage you can help relax your own back muscles using a tennis ball.
Medicines can often help control chronic pain. In some cases, it may take several weeks for the medicine to work.
Medicine may work best when it's used along with other types of treatment, such as physical therapy and counseling, to address the different causes of chronic pain.
Sometimes a medicine loses some or all of its ability to work when it is used daily over a long period of time. Your body forms a tolerance to it. If this happens, you may need to take more of the medicine, change medicines, or add another medicine. Your doctor can work with you to do this.
You will likely start with medicines that cause the fewest side effects (such as acetaminophen). The dose will be increased, or the medicines will be changed as needed. Be safe with medicines. Read and follow all instructions on the label. Pills for pain include:
In some cases, an opioid pain medicine may be tried.
A variety of creams, gels, sprays, and patches may be used to relieve chronic pain. These include:
These are pain relievers that you apply directly to the skin. Examples include some forms of nonsterodial anti-inflammatory drugs and lidocaine. Some may contain capsaicin.
One example is Biofreeze. You spray it directly on the skin. This may be repeated several times.
Injected medicines—shots—may be used to treat chronic pain. These include:
Steroids are injected around the spine.
A corticosteroid is injected into the painful joint or joints.
Surgery for chronic pain isn't common. It's usually an option only after other treatments haven't worked or if it's thought to be medically necessary.
Surgery may provide pain relief. But it also may permanently make you less able to feel other sensations, such as light touch and temperature changes. It can also cause a different pain to occur.
Implanted pain control systems involve inserting devices under your skin or elsewhere in your body. For example, intrathecal drug delivery sends medicine to the area of your pain.
Other procedures include:
Physical treatments can be an important part of managing chronic pain. You may find that combining more than one treatment helps the most.
These treatments can include:
If you get physical therapy, make sure to do any home exercises or stretching your therapist has prescribed. Stay as active as you can. Try to get some physical activity every day.
You can manage chronic pain by using things other than medicines or physical treatments. For example, you can keep track of your pain in a pain diary. It can help you understand how the things you do affect your pain.
Reducing stress and tension can reduce pain. And being more aware of your thought patterns can be helpful. In some cases, shifting how you think about pain can affect how you feel.
Here are some options to think about:
If what you're doing to control your pain isn't working, or if you're feeling depressed, talk to your doctor. He or she can help you change your pain management plan and find resources for emotional support.
Current as of: February 23, 2022
Author: Healthwise Staff
Medical Review:Anne C. Poinier MD - Internal Medicine & E. Gregory Thompson MD - Internal Medicine & Adam Husney MD - Family Medicine & Martin J. Gabica MD - Family Medicine & Kathleen Romito MD - Family Medicine & Nancy Greenwald MD - Physical Medicine and Rehabilitation
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