Pain is an unpleasant sensory and emotional experience associated with potential damage to your body.1 The purpose of pain is to alert us that something may be wrong. For sufferers of chronic pain, the condition can be debilitating and affect many aspects of life.
Read on to find out more about the condition, including symptoms and treatment options.
The International Association for the Study of Pain describes chronic pain as ‘pain that persists past normal healing time’.2 Pain is defined as chronic if it lasts for more than three to six months.2 It can involve complex psychological and social factors.
Chronic pain is a long-term condition, with examples including arthritis, fibromyalgia, migraine, and back pain3:
At least 10% of the global population suffers with chronic pain, while estimates of prevalence in some countries and regions are around 20–25%. A further one in 10 people develop chronic pain every year worldwide.4 In Europe, 19% of the adult population report having moderate or severe chronic pain.5
There are no specific stages of chronic pain but In some cases – for example, back pain – the pain may start off as short-term following an accident or strain and become chronic even after the injury has healed. Pain can also develop over time as we age.7
Chronic pain itself is not hereditary, but there is evidence to suggest that some conditions which can lead to chronic pain may be.
A team of UK researchers carried out a study involving 4,282 sets of twins looking at four conditions that can manifest as chronic pain: irritable bowel syndrome, musculoskeletal pain, pelvic pain, and dry eye disease. The study showed that if one identical twin suffered from one of these ailments, then it was likely the other twin did as well. As identical twins share virtually the same genetic code, this suggests a heritable element to these conditions.10
In a 2019 study the association between risk factors and the development, persistence, or severity of chronic pain was assesssed. They found that the most important clinical risk factor (or ‘tell-tale sign’) for chronic pain to develop is the presence of another site of acute pain within the body. In other words, people who experience short-term severe pain (for example, as a result of an injury) are more likely than people without any pain to develop chronic pain. The study also found that patients with depression or cardiovascular disease were more likely to suffer with chronic pain than those without.
Chronic pain does not reduce life expectancy, and most patients can find ways to manage their pain in order to live a full life. Chronic pain can have a profound effect on quality of life and mental health.12
If someone thinks they are suffering with chronic pain, it is important to visit a doctor so that they can make a diagnosis.
As pain measurement is subjective and very personal to each individual, the healthcare provider will need to carry out a comprehensive assessment to better understand the pain experienced.
A detailed pain assessment will allow the healthcare professional to determine whether the pain being experienced matches a pain syndrome, or whether there is a disease that may help explain the pain.
There are tools that healthcare providers can use to help determine the severity of pain and the impact it has on daily life. A pain assessment chart may be used to help gather a clear history of the pain while assessing its nature and severity. The three types of assessment chart that are usually used rate pain on a numerical scale, a verbal scale, or a visual scale.14
There are other methods healthcare professionals can use to diagnose chronic pain, these depend on the type of pain being experienced. For example, in the case of nerve damage a nerve function test called electromyography (EMG) could be used. This involves an electrode being inserted into a muscle to record electrical activity and assess the severity of the damage .15 The healthcare professional may perform a nerve conduction study to record the nerves’ responses to an electric current by attaching a flat electrode to the skin that emits a low electric current.
Treatment plans are tailored to the individual and usually consist of a combination of medication, exercise, and physical therapy. No single technique is guaranteed to provide complete pain relief, but most patients are able to find a combination of treatment options that helps them manage their condition.
As chronic pain is so personal to each patient, any medication plan will be tailored to the individual and should be overseen by a healthcare professional. Below are some options that may be offered as part of a treatment plan.
It’s likely a doctor will refer someone with chronic pain to services that can provide self-help techniques to manage the pain. Physical therapy is a common treatment for chronic pain and can involve manipulation, stretching, and pain relief exercises. Physiotherapists may provide exercises that can be done at home to help relieve the symptoms.18
Although there is no solid scientific evidence that a particular diet can treat chronic pain, eating a variety of foods, including fruits and vegetables, is recommended for a healthy lifestyle.
Research has suggested that magnesium, vitamin B12 and zinc may be beneficial for those with chronic pain.20
Although resting for short periods of time can alleviate pain, too much rest could increase the risk of injury when the person attempts to move again. Exercise is recommended as part of a daily routine for those with chronic pain as can improve strength, flexibility and balance. For many people, doing exercise each day can reduce the number of bad pain days, or at least lead to the pain becoming more manageable. Helpful gentle exercises to try include walking, swimming, using an exercise bike, and yoga.21
Chronic pain is a serious condition that often has a huge impact on the sufferer’s life and puts a burden on health services. Unfortunately, there is no proven preventative measure for the condition, but protective factors, such as level of exercise, healthy diet, sleep, coping skills, and social support, can help to reduce risk of developing chronic pain.22
As chronic pain is a condition affecting so many patients worldwide, it is unsurprising that there are a wealth of scientific studies on the topic, ranging from the efficacy of treatment options to how widespread the condition is.
The European Commission is currently funding an international collaborative research project called QSPainRelief, which uses computer modelling to implement new personalised treatments for chronic pain patients. Researchers are hoping to find combinations of existing medications that may provide relief for these patients.23