Understanding Chronic Pain

Did you know that around 15.5 million people in England are living with chronic pain? That’s nearly 35% of the population. Chronic pain refers to persistent, recurrent pain which the person has been experiencing consistently for at least three months.

Living with chronic pain can be debilitating and make it hard to carry out daily activities, and is additionally frustrating because it’s an invisible condition. This means that others cannot see it from the outside, which can make it harder for people living with chronic pain to feel understood by those around them.

“Arthritis pain is relentless,” says Sarah Dillingham, CEO and Co-Founder of Grace & Able, who has been living with rheumatoid arthritis for over 20 years. “It feels like my knees and wrists are being prised apart from the inside. I experience arthritis pain daily. A good day for me is a pain level of 2 out of 10, while a bad day can be an excruciating 8 or 9.”

Chronic pain is persistent pain which has lasted for at least three months. Chronic pain is different from acute pain, which is pain that happens suddenly - as a result of injury, for example - and goes away when the body heals itself. Acute pain is a normal response to tissue damage or potential harm, and it often serves as a warning sign to alert you to notice the danger and do something about it. If you touch a hot stove, you will feel acute pain and quickly withdraw your hand. This pain helps you avoid further injury. The course of acute pain is usually identifiable and often doesn’t last longer than a few days or weeks. Acute pain can turn into chronic pain if it persists after the body has healed.

Chronic pain can sometimes indicate an underlying health condition, which may or may not be treatable. Examples of some of the causes of chronic pain include arthritis, fibromyalgia, migraine or cancer. Sometimes, chronic pain can occur without any apparent cause or trigger. If the source of the pain is understood, your doctor can help reduce or eliminate the cause directly. If it’s unclear what is causing the pain, doctors may focus on the symptoms rather than the cause to help make the sensations more manageable.

If you’re not sure what is causing the pain, speak to your doctor so they can run some tests, rule out potential causes and hopefully find the root of the pain. It can be helpful to keep a pain diary so you can start to identify possible triggers.

Arthritis is a common cause of chronic pain, which can affect anyone at any age, although certain types, like osteoarthritis, are typically associated with older people. “Arthritis is an umbrella term that covers over 100 different conditions linked by the common symptom of chronic joint pain, inflammation or damage in the joints that causes pain, stiffness, and reduced mobility,” says Sarah Dillingham.

There are many types of arthritis, such as osteoarthritis, rheumatoid arthritis, gout, and psoriatic arthritis. Arthritis can affect any joint in the body, but it is most common in the hips, knees, hands, and spine.

Diagnosing chronic pain can be challenging, as it can be hard to identify the cause. Your doctor may ask you about your medical history, your symptoms, and how the pain affects your life. They may also perform a physical examination and order some tests to rule out other conditions or identify the underlying cause of the pain.

It is important to describe your pain clearly and accurately to your doctor - including how it feels and where it is located in the body - as this can help them diagnose you more effectively. You may want to keep a pain diary where you record the following information:

• The location, intensity, and how the pain feels (e.g. aching, sharp, stabbing)

• The frequency and duration of your pain episodes

• What seems to trigger or relieve your pain

• The impact of your pain on your mood, sleep, activity, and relationships

• Any medications you use for your pain and how you feel after taking them

There is no cure for chronic pain, but there are various ways to manage it. Depending on the type and severity of your chronic pain, you may use a combination of medical treatments, psychological therapies, physical therapies, and self-management strategies. Here are some options for managing chronic pain:

• Medications: These include over-the-counter or prescription drugs that can help reduce inflammation and manage your experience of pain. Consult your doctor before taking pain medication and always read the instructions.

• Physical therapies: These include exercises, massage, acupuncture, electrical stimulation, heat or cold therapy, and transcutaneous electrical nerve stimulation (TENS). These therapies may help improve blood circulation, muscle strength, joint mobility, and pain relief.

• Psychological therapies: Chronic pain can take a toll on your mental health, which should be addressed alongside any physical symptoms. Possible avenues to explore regarding mental health difficulties include cognitive-behavioural therapy (CBT), mindfulness-based stress reduction (MBSR), relaxation techniques, talking therapy and peer support groups. These therapies can help you cope with stress, anxiety, depression, anger, and fear that can affect your quality of life. There are also a host of apps that can help you get started with things like mindfulness like Headspace or Moodkit.

• Self-management strategies: These include education, goal setting, pacing activities, life-adapting techniques, social support, and lifestyle changes. These strategies can help you take an active role in managing your pain.

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