Chronic Pain

Overview

What is chronic pain?

Chronic pain is pain that lasts for a long time — months or years. It can happen anywhere in the body. The pain can be there all the time, or it may come and go.

Chronic pain can interfere with your daily activities, such as working, having a social life and taking care of yourself or others. It can lead to depression, anxiety and trouble sleeping, which can make pain worse. This response creates a cycle that’s difficult to break.

What’s the difference between chronic pain and other pain?

Chronic pain differs from another type of pain called acute pain. Acute pain happens when something hurts you. It doesn’t last long, and it goes away after your body heals from whatever caused the pain. In contrast, chronic pain continues long after you recover from an injury or illness. Sometimes it even happens for no obvious reason.

Symptoms and Causes

What causes chronic pain?

Sometimes chronic pain has an obvious cause. You may have a long-lasting illness such as arthritis or cancer that can cause ongoing pain.

But injuries and diseases can also cause changes to your body that leave you more sensitive to pain. These changes can stay in place even after you’ve healed from the original injury or disease. So something like a sprain, a broken bone or a brief infection can leave you with chronic pain.

Some people also have chronic pain that’s not tied to an injury or physical illness. Healthcare providers call this response psychogenic pain or psychosomatic pain. It’s caused by psychological factors such as stress, anxiety and depression. Many scientists believe this connection comes from low levels of endorphins in the blood. Endorphins are natural chemicals that trigger positive feelings.

It’s possible to have several causes of pain overlap. You could have two different diseases, for example. Or you could have something like migraines and psychogenic pain together.

Where do people have chronic pain?

Chronic pain can come in many different forms and appear across the body:

What does chronic pain feel like?

People with chronic pain describe it in many different ways, such as:

  • Aching.
  • Burning.
  • Shooting.
  • Squeezing.
  • Stiffness.
  • Stinging.
  • Throbbing.

Chronic pain often leads to other symptoms and problems, too:

Diagnosis and Tests

How is chronic pain diagnosed?

Pain is subjective — only the person experiencing it can identify and describe it. If you have long-lasting pain, seek medical attention. A healthcare provider will want to know:

  • Where the pain is.
  • How intense it is, on a scale of 0 to 10.
  • How often it occurs.
  • How much it’s affecting your life and work.
  • What makes it worse or better.
  • Whether you have a lot of stress or anxiety in your life.
  • Whether you’ve had any illnesses or surgeries.

Your healthcare provider may examine your body and order tests to look for the cause of the pain:

  • Blood tests.
  • Electromyography to test muscle activity.
  • Imaging tests, such as X-rays and MRI.
  • Nerve conduction studies to see if your nerves are reacting properly.
  • Reflex and balance tests.
  • Spinal fluid tests.
  • Urine tests.

Management and Treatment

How is chronic pain treated?

To relieve chronic pain, healthcare providers first try to identify and treat the cause. But sometimes they can’t find the source. If so, they turn to treating, or managing, the pain.

Healthcare providers treat chronic pain many different ways. The approach depends on the type of pain, its cause (if known) and other factors that vary from person to person. The best treatment plans use a variety of strategies — medications, lifestyle changes and therapies.

What medications can treat chronic pain?

Your healthcare provider may recommend certain medications to relieve chronic pain:

  • Anticonvulsants (medications that prevent seizures) for nerve pain.
  • Antidepressants such as tricyclic antidepressants.
  • Corticosteroids.
  • Muscle relaxers.
  • Opioids (narcotics), which can be addictive and should be used carefully.
  • Nonsteroidal anti-inflammatory drugs (NSAIDs) or acetaminophen.
  • Topical products (applied to the skin) that contain pain relievers or ingredients that create soothing heat or cold.
  • Sedatives to help with anxiety or insomnia.

Can therapy help with chronic pain?

Certain therapies also may help you manage chronic pain:

  • Cognitive-behavioral therapy (CBT): This counseling method helps you think differently about pain and teaches you ways to cope.
  • Counseling: Talk therapy can help you manage chronic pain, especially psychogenic pain.
  • Occupational therapy: Activities teach you how to do everyday tasks differently to lessen pain or avoid injury.
  • Physical therapy: Exercises stretch and strengthen your body.

What alternative treatments are available for chronic pain?

Certain lifestyle changes and types of alternative medicine have also been shown to relieve chronic pain over time:

  • Acupuncture, which uses small needs placed in the body.
  • Aromatherapy, which uses crushed plants.
  • Biofeedback, which teaches you how to tweak the way your body works, influencing such things as heart rate, breathing and muscle tension.
  • Exercise such as walking, swimming, yoga and tai chi.
  • Hypnotherapy, or hypnosis.
  • Mindfulness training, which teaches you how to calm yourself.
  • Music, art or pet therapy.
  • Reiki or Healing Touch™, with a therapist using touch to change energy fields in your body.
  • Relaxation techniques, such as massage, meditation and guided imagery.
  • Stress reduction.

What other medical treatments are available?

Your healthcare provider may also try:

Is there a cure for chronic pain?

There is no cure for chronic pain, other than to identify and treat its cause. For example, treating arthritis can sometimes stop joint pain.

But many people with chronic pain don’t know its cause and can’t find a cure. They use a combination of medications, therapies and lifestyle changes to lessen pain.

Prevention

Can chronic pain be prevented?

You may be able to prevent certain conditions that lead to chronic pain. For example, you can quit smoking to lower your risk of lung cancer. But nothing has been proven to prevent chronic pain more broadly.

Outlook / Prognosis

What is the outlook for people with chronic pain?

Chronic pain usually doesn’t go away, but you can manage it with a combination of strategies that work for you.

Researchers continue to study pain disorders. Advances in neuroscience and better understanding of the human body should lead to more effective treatments.

Living With

How can I cope with chronic pain?

Besides taking medications, getting therapy and making lifestyle changes, take good care of yourself:

  • Avoid smoking.
  • Don’t try to do too much. Create a daily schedule that includes a few priorities and time for rest and self-care.
  • Eat a healthy diet.
  • Exercise regularly.
  • Get enough sleep.
  • Join a support group for chronic pain to learn from other people with similar conditions.
  • Limit alcohol, which can cause more problems with sleep and pain.
  • Think positively.
  • Try relaxation techniques, like deep breathing and meditation.

What questions should I ask my healthcare provider?

Consider asking your healthcare provider:

  • What’s causing my pain?
  • Will it go away? If no, why not?
  • What kinds of medications can I take? What are their side effects?
  • Should I try any kinds of therapy?
  • Is it safe to exercise?
  • What else can I do to relieve my chronic pain?
  • Should I call you if it gets worse?

A note from Cleveland Clinic

Chronic pain lasts weeks or years and interferes with your ability to work, enjoy activities and take care of yourself or others. If you have chronic pain, please talk to a healthcare provider or pain specialist. There are ways to manage your pain to help you toward a more comfortable life.

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Cleveland Clinic is a non-profit academic medical center. Advertising on our site helps support our mission. We do not endorse non-Cleveland Clinic products or services. Policy

Cleveland Clinic is a non-profit academic medical center. Advertising on our site helps support our mission. We do not endorse non-Cleveland Clinic products or services. Policy

Cleveland Clinic is a non-profit academic medical center. Advertising on our site helps support our mission. We do not endorse non-Cleveland Clinic products or services. Policy