What is Chronic Pain?

Pain is your body’s way of alerting you to an ongoing injury somewhere in your body. Sudden onset pain comes in the stead of an acute injury. Chronic pain is, however, another story altogether. This article talks in detail about chronic pain. Read on!
So what is chronic pain?
Chronic pain is the pain that lasts for more than 12 months despite using medications and other treatment modalities. Chronic pain has become nothing short of a global health concern due to a high percentage of people suffering from it around the globe. It has been linked with high healthcare costs around the world as it is one of the biggest causes of morbidity worldwide
What causes chronic pain?
Pain signals are generated as a response to injury which are carried by sensory nerves to the brain. Brain interprets these signals and the pain is felt in the areas supplied by these nerves. Chronic pain, however, may or may not be preceded by an injury. Sometimes, chronic pain can persist even after an injury has healed. Chronic pain may originate from
● Nerves
● Muscles
● Bones, tendons or ligaments
● Viscera (deeper body organs like gut etc.)
Some times, chronic pain may be the result of diseases like fibromyalgia or chronic fatigue syndrome which are diagnoses of exclusion where no other apparent cause of pain is found.
People who are more prone to suffer from chronic pain include
● Eldelry people
● Diabetics
● People with chronic inflammatory conditions like arthritis, IBD etc.
● Cancer patients
Managing the chronic pain
What makes chronic pain management particularly challenging is the fact that pain patterns and manifestation differs from one patient to another or even for a single patient. A patient may describe pain as a burning sensation at one time and as stabbing in character at another.
These variations can make the treatment and management of chronic pain an arduous task even for pain specialists. Some treatment strategies1 employed for the management of chronic pain include
Lifestyle changes
These include
● Rest
● Hot or cold packs
● Relaxation techniques like yoga or meditation
● Controlling underlying disease like diabetes
Starting right at the bottom of the pain ladder, chronic pain is managed at first by simple paracetamol. If that does not work non-steroidal anti-inflammatory drugs (NSAIDs) are used. Then come the weak opioids. If the pain is still not controlled, pain specialists may prescribe stronger opioids.
If medications fail to exert a significant effect, pain specialists may go for nerve blocks where local anesthetic agents are injected to block the nerve supply of the affected areas in order to control the pain. These are administered by a specialist only.
Transcutaneous electrical nerve stimulation (TENS)
It is a treatment modality whereby brain cells are stimulated with the help of electrical pulses in order to modulate the pain signals for pain relief.
Surgical options are helpful in cases where pain is caused by pressure on the nerves as in the case of disc herniation.
Psychotherapy helps patients develop a better understanding of the reason for their chronic pain so that they can better cope with it. Psychotherapy deals with the emotional aspect of chronic pain which takes a toll on patients’ mental health2. One of the most commonly employed therapies is the “cognitive behavioral therapy” (CBT).
Alternative therapies like acupuncture have been shown to have a beneficial role in controlling chronic pain.
Don’t forget!
You don’t have to live with chronic pain. If chronic pain is compromising your lifestyle, book an appointment with a neurologist or a pain specialist for appropriate management in order to live a pain-free and fulfilling life.

1. Gatchel RJ, McGeary DD, McGeary CA, Lippe B. Interdisciplinary chronic pain management: past, present, and future. American Psychologist. 2014 Feb;69(2):119.
2. Ballantyne JC, Sullivan MD. Intensity of chronic pain—the wrong metric. N Engl J Med. 2015 Nov 26;373(22):2098-9.

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