Chronic Pain
Chronic pain is when pain lasts longer than 3 months in the same part of your body. Our pain medicine consultants are experienced in identifying the cause and delivering effective, personalised treatment.
What is chronic pain?
Chronic pain, sometimes called persistent or long-term pain, is pain that lasts for 3 months or longer in the same part or parts of the body. Unlike short-term pain after something like a minor injury or tension headache that eases quickly, chronic pain keeps going. It can be caused by a range of health conditions and injuries.
Pain is like an alarm going off that tells you something’s wrong that needs to be addressed. If that alarm goes off continuously, it can become the focus of your life and feel all-consuming.
Over a third of adults in the UK have chronic pain, and it can be diagnosed as a condition in its own right.
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Chronic pain can affect your ability to function well physically and mentally.
Physically, chronic pain can limit mobility, making even simple tasks like walking, standing, or sitting unbearable. This often leads to a reduction in physical activity, which can contribute to muscle weakness, joint stiffness, and further exacerbate the pain cycle.
Sleep problems are also common, as discomfort can interfere with falling and staying asleep, leading to fatigue and cognitive impairments. Sleep deprivation can also make pain feel worse.
The psychological toll of chronic pain is also significant, and can cause not just everyday low mood, frustration and stress, but eventually depression and/or anxiety. Constant pain can erode your sense of self-worth and identity if it stops you from doing your usual job, daily routine and social activities. This can lead to social withdrawal and isolation. In a sensitised nervous system, low mood and stress can also affect your perception of pain, making it feel worse.
The emotional burden can be felt not just by the person in chronic pain, but also by their loved ones. Relationships may suffer as individuals struggle to communicate their experience, and loved ones may find it challenging to understand the condition. Families may need to adapt around a person who is no longer able to do the same things they used to do.
If you have chronic pain, you might experience symptoms such as:
ongoing pain – it might feel like burning, aching, shooting, throbbing, or stinging
poor sleep
low mood
fear of certain activities
stress and worries about the future
reduced physical activity
fatigue
poor concentration and poor short-term memory
a sense of feeling overwhelmed
hypersensitivity to light, sound and touch
Overall, chronic pain isn’t just a physical ailment but a complex condition that affects every aspect of your life. It’s important that your chronic pain is fully assessed and treated with comprehensive management strategies that address the physical and emotional sides.
At Welbeck, our consultants diagnose and treat patients with chronic pain in our state-of-the-art Pain Medicine centre.
Sometimes a pain or injury gets worse because it isn’t treated early, or it’s caused by a health condition that’s getting worse, such as untreated migraine. It might be due to a long-term health condition such as arthritis, fibromyalgia, cancer or diabetes (nerve pain called diabetic neuropathy). It may also be caused by something like repetitive strain in your job or a regular sport you play.
Sometimes, it’s caused by your nervous system signalling that you’re experiencing pain even if there is no physical cause.
This is how chronic pain occurs in the body:
nerves carry messages to and from your brain – some of those messages are about feeling pain
the brain interprets messages from the nerves and creates feelings of pain – sometimes wrongly
chronic pain can change your brain and nervous system – they become oversensitive and create pain signals when there is no obvious physical cause, sometimes creating higher levels of pain
Risk factors can be very specific if the cause of the pain is a known health condition. There are also some general factors to bear in mind:
Smokers are more likely to experience pain: smoking can also increase sensitivity to pain.
Previous injury: if your injury doesn’t heal or over-sensitises your nervous system, it can increase the risk of chronic pain. If you’ve had a traumatic injury, you’re more likely to develop chronic pain.
Family history: some conditions that cause chronic pain can be genetic, such as migraine, arthritis, or diabetes.
Age: as you age, the “wear and tear” on the body increases, making it more likely you will get chronic musculoskeletal pain.
Having a physically demanding job: if you have a job that places demands on your body or involves repeated movements, it can increase the chances of injury and wear and tear.
Frequent or severe stress: research has linked chronic pain to long-term and high levels of stress.
Sleep problems: research has linked poor sleep to the onset of chronic pain and its worsening.
Obesity: carrying extra weight can put stress on your body and joints, making pain worse.
Diagnosing not just chronic pain but its type and cause can take some time and detective work. At an initial consultation in our pain medicine clinic, a consultant will usually:
1. Take a history to get a full understanding of your pain and how it affects you – for example how severe it is, what makes it worse or better, how it affects daily life.
2. Talk about your current lifestyle and goals for managing your pain.
3. Do a physical examination of the painful area.
4. Review any relevant scans and other previous investigations.
5. Talk through their initial findings and what will happen next.
They may also:
ask you to fill out pain questionnaires
perform further imaging tests such as MRI, ultrasound or X-ray
perform nerve conduction tests to identify or rule out nerve damage
The purpose is to understand what’s causing your pain and come up with a management plan to reduce it and make it manageable long-term. Our consultants have access to multidisciplinary teams who can be brought in to support your personalised pain management plan.
Reducing your risk of chronic pain involves tackling any risk factors that can be changed - such as:
smoking cessation
managing sleep, weight, and stress
getting treatment and control for conditions that cause pain, such as arthritis, diabetes or inflammatory bowel disease
However, there are factors that you can’t change, such as your family history or a previous injury, therefore prevention is not always possible.
As there are so many causes of chronic pain, the complications it can cause vary widely. In general, if it goes untreated it can cause psychological issues such as low mood, depression, anxiety, and even withdrawal from friends, family or work.
If you’re offered treatments for your pain that may cause complications – such as a surgery – your consultant will talk you through all of these at the time, based on your personal medical history.
A combination of approaches can be used to treat chronic pain. Often these address not only the physical effects of the pain but also the psychological and social effects. A mix of a number of different treatments often leads to a better result – the overall aim of treatment is to improve your pain levels, ability to function in your daily routine, and improve your quality of life. Treatment options will be tailored to you but may include:
pain-killer medications ranging from simple drugs like paracetamol through to stronger agents like anti-nerve pain medicines that need specialist knowledge to prescribe safely
physiotherapy
injections to block nerves
advanced procedures such as neuromodulation
complementary therapies like acupuncture
surgical options
psychological skills such as mindfulness and cognitive behavioural therapy (CBT)
At Welbeck, our pain medicine specialists are experts in their field and are dedicated to providing world-class care to every patient.
With access to colleagues across other specialties, our consultants are also able to refer within the Welbeck ecosystem if required to ensure you receive the treatment you need as quickly as possible, all under one roof.
All appointments, testing, treatment, and follow-up appointments take place within our state-of-the-art facilities, enabling us to deliver accurate diagnostics and advanced treatments.
Your health is important to us, so we strive to offer same-day appointments whenever possible.
Our consultants are recognised by the major health insurance companies. If you have private health insurance, your treatment at Welbeck can begin once you have obtained authorisation. We also provide care to self-paying patients. Learn more about the different payment options at Welbeck.
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Frequently asked questions
It does depend on the reason why you are experiencing chronic pain – but usually, chronic pain can be reduced – sometimes dramatically – but most often it isn’t cured completely. A personalised pain management plan should help make you more comfortable and help you find your way to a more fulfilling daily life.
Pain relief is aimed at reducing or blocking pain and is often a short-term measure using medicines. Pain management is a more holistic look at how to manage a long term pain issue so you can manage to live your life as fully as possible. It may not always make the pain disappear completely, but it can reduce it and help you think differently about it so it becomes manageable. It will often combine lifestyle and exercise approaches along with medicines or treatments, such as injections or surgery.
Long term pain management involves coming to terms with whatever level of pain becomes normal for you – hopefully much lower than the pain you are experiencing when you start your pain management journey. Your chronic pain may mean you need to adjust some things in life such as the type of exercise you do, or the amount of socialising you do. This can have an emotional effect that psychological support can help with.
There are also some proven ways to help you cope better with pain, and distract yourself from it – with therapies and techniques such as CBT or mindfulness.
Psychological support, including support groups of other people coping with similar situations, can help lift your mood and help you feel more confident coping with pain.
Acute pain is a shorter-term pain that can usually be explained by an injury or illness. It’s often relieved by medicines and usually goes away within 12 weeks. Chronic pain is a longer lasting pain that can’t always be clearly explained and may not be helped as effectively by medicines alone. If it isn’t managed it might cause you to change your daily activities and routines and feel low or depressed as a result.