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FAQs:

What is Chronic Pain?

Chronic pain is long-standing pain that persists beyond the usual recovery period or occurs along with a chronic health condition, such as arthritis. Chronic pain may be "on" and "off" or continuous. It may affect people to the point that they can't work, eat properly, take part in physical activity, or enjoy life. Chronic pain is a major medical condition that can and should be treated.

What is the Most Common Form of Chronic Pain?

Back pain is by far the most common type of chronic pain that drives people to seek help. Nearly one-third of people experiencing chronic pain are feeling it in their back. The next most common types of chronic pain are headaches or migraines, neck pain, and joint pain. Women are more likely to experience chronic pain than men. These issues are the most common, but many people experience pain in other areas such as their face, abdomen, or chest. The bottom line: if you have pain that doesn't stop and is beginning to interfere with your daily life, it's time to see a doctor.

How Chronic Pain Affects Work Productivity?

1. Reduced Concentration:

Constant pain acts as a persistent distraction, making it challenging for individuals to concentrate on their work tasks. The brain’s cognitive resources become diverted toward processing pain signals, leaving fewer mental capacities available for focus and problem-solving. As a result, tasks that require sustained attention and critical thinking may take longer to complete, and errors may become more frequent. Furthermore, chronic pain can impede short-term memory and the ability to retain new information. This can be particularly problematic in roles that demand learning and adaptation, hindering the employee’s ability to stay updated with industry trends or organizational changes.

2. Fatigue and Low Energy:

Chronic pain often disrupts sleep patterns, leading to poor sleep quality and inadequate rest. As a consequence, individuals with chronic pain often wake up feeling fatigued and drained, even before starting their workday. Persistent fatigue can diminish their energy levels, making it difficult to stay alert and productive during working hours. Fatigue can also contribute to slower reaction times and increased susceptibility to making mistakes, which can be particularly hazardous in jobs that involve operating machinery or handling complex tasks.

3. Absenteeism and Presenteeism:

Chronic pain often results in increased absenteeism from work. Individuals may need to take time off for medical appointments, treatments, or simply to manage pain flare-ups that make it impossible for them to perform their duties. Frequent absenteeism can disrupt workflow, burden coworkers, and lead to a reduction in overall team productivity. On the other hand, some employees with chronic pain may still come to work despite experiencing significant discomfort. This phenomenon, known as presenteeism, is driven by the fear of job insecurity, financial strain, or the desire to demonstrate commitment. However, when presenteeism occurs, productivity is likely to suffer significantly, as the employee’s focus and effectiveness are compromised.

4. Emotional Impact:

Dealing with chronic pain can take a toll on an individual’s emotional well-being. The persistent pain, coupled with the challenges it poses in their work and personal lives, can lead to emotional distress, anxiety, and depression. In the workplace, employees experiencing chronic pain may feel isolated or misunderstood, leading to a sense of detachment from their colleagues and work environment. The emotional struggles can further affect their motivation, enthusiasm, and overall job satisfaction.

What is the Difference Between Acute and Chronic Pain?

Acute pain usually comes on suddenly and is caused by something specific. It is sharp in quality. Acute pain usually doesn’t last longer than six months. It goes away when there is no longer an underlying cause for the pain.

Chronic pain is pain that is ongoing and usually lasts longer than six months. This type of pain can continue even after the injury or illness that caused it has healed or gone away. Pain signals remain active in the nervous system for weeks, months, or years. Some people suffer chronic pain even when there is no past injury or apparent body damage.

Is Chronic Pain a Disability?

Unfortunately, pain is subjective and hard to measure or prove and the Social Security Administration does not consider chronic pain to be a disability, nor is it listed as an impairment in the Blue Book. To qualify for Social Security Disability Income, you must show you have a medically determinable mental or physical impairment (MDI) that is established by objective symptoms and laboratory tests. Alternatively, you could provide evidence of a mental impairment, such as somatoform pain disorder (a form of mental illness that causes one or more bodily symptoms, including pain), to meet the MDI requirement.

Can Chronic Pain Cause Fatigue?

The NIH tells us that 126 million American adults live with chronic pain. When you live with chronic pain, you are exhausted before you even start your day. In addition, pain makes it hard to sleep and you wake up with increased pain. Poor sleep causes an increase in inflammation that makes your pain worse and then fatigue follows. Without quality sleep your threshold for pain tolerance is reduced, and it can even intensify whatever pain you have. Restorative sleep is necessary for the body to heal and repair itself. Unfortunately, once you reach the part where you are tired all the time, your pain becomes worse. It is a cycle hard to escape from and you need an intervention to break it.

How Does Chronic Pain Affect the Brain?

Chronic pain reduces the volume of gray matter in our brains. Grey matter is the area of the brain that controls learning, attention, memory, thought processes, motor control, and coordination. This means that chronic pain patients can have problems with memory processing, learning new things, keeping their attention focused on one task, thinking through problems, and finding solutions.

Motor control can also be impacted as this study explains. This means that chronic pain patients can struggle to control their motor functions (including day-to-day activities and movements and more precise movements and coordination).

This study found that chronic pain patients had up to 11% less grey matter than those without chronic pain. This is the same amount of grey matter that would be lost in 10 to 20 years of aging! The study discovered that the longer a person is in chronic pain, the more grey matter they lose, explaining that, “The decreased volume was related to pain duration, indicating a 1.3 cm3 loss of gray matter for every year of chronic pain.”

This can sound scary but don’t worry. This doesn’t mean your brain is permanently damaged. This study from the Journal of Neuroscience went into depth to discover whether this impact chronic pain has on the brain’s structures is reversible, and concluded that “we suggest that the gray matter abnormalities found in chronic pain do not reflect brain damage but rather are a reversible consequence of chronic nociceptive transmission, which normalizes when the pain is adequately treated.”

This means that when you get effective treatment for your chronic pain, you can reverse the effects and regain the brain’s normal functioning. However, the key here is that the longer you are in untreated chronic pain, the more gray matter is lost. Therefore the longer without treatment, the longer it will take to recover. 

This study concluded that “Neuroplastic brain changes that may have developed over several years (as a consequence of constant nociceptive input) need probably more time to reverse completely.” So the sooner you seek treatment, the quicker you can get back to a normal level of functioning both physically and cognitively.

Can Chronic Pain Ever Go Away?

Severe cases of chronic pain could require more invasive treatment. This could include electrical stimulation, nerve blocks, or surgery. There is usually no cure for chronic pain. Talk to your doctor to learn how to best control your pain.

What Happens If You Don't Treat Chronic Pain?

In many individuals, there can be neuropsychiatric problems from untreated chronic pain. Issues such as memory loss, attention deficit, anxiety, and depression are common in long-term pain sufferers, and some increase the risk of suicide. Brain disorders and sexual dysfunction can also result from enduring pain.

Who Suffers from Chronic Pain the Most?

Adults reporting poor general health and adults with a disability experienced an exceptionally high prevalence of chronic pain (67.6% and 52.4%, respectively) and high-impact chronic pain (48.7% and 32.0%, respectively). Among all chronic medical conditions reported, the age-adjusted prevalence of chronic pain and high-impact chronic pain was highest among adults with a history of myalgic encephalomyelitis/chronic fatigue syndrome (70.0% and 43.8%, respectively) and dementia (54.9% and 34.2%, respectively).

Why is Chronic Pain so Difficult to Treat?

Every pain experience, acute or chronic, is registered in the brain. The brain processes the sensation, identifies it as pain, and, ultimately, associates it with the events that led up to or caused the feelings of pain. The brain is rewired and the pain now becomes a memory – and like most memories, it can be recalled over and over again.

Because of the complex relationship between the brain, the nervous system, and the body’s hormones, chronic pain requires a multidisciplinary treatment approach. It's not like having an infection, where you take antibiotics and it’s gone. Chronic pain is complex and there isn’t one treatment or one pill that will cure it.

Can Chronic Pain Be Secondary to PTSD?

Some people's chronic pain stems from a traumatic event, such as a physical or sexual assault, a motor vehicle accident, or some type of disaster. Under these circumstances, the person may experience both chronic pain and PTSD. The person in pain may not even realize the connection between their pain and a traumatic event. Approximately 15% to 35% of patients with chronic pain also have PTSD. Only 2% of people who do not have chronic pain have PTSD. One study found that 51% of patients with chronic low back pain had PTSD symptoms. For people with chronic pain, the pain may serve as a reminder of the traumatic event, which will tend to make the PTSD even worse. Survivors of physical, psychological, or sexual abuse tend to be more at risk for developing certain types of chronic pain later in their lives.

5 A's of Chronic Pain

The 5 A's of Chronic Pain is a framework designed to help healthcare professionals address and manage pain effectively. The 5 A's stand for Analgesia, Activity, Adverse effects, Aberrant behaviors, and Affect. Each A represents a crucial aspect of chronic pain management. The monitoring tool helps assess pain when on analgesic therapy.

1. Analgesia refers to the relief of pain. In the context of chronic pain management, it involves finding the most appropriate and effective ways to alleviate pain. This could include medications, physical therapy, alternative treatments, or a combination of approaches tailored to the individual's needs. Analgesics are a class of medications specifically designed to relieve pain.

2. Activities of daily living (ADLs) encompass routine tasks such as bathing, dressing, eating, and mobility. In chronic pain management, it's essential to assess how pain affects a person's ability to perform these activities. Adapting and optimizing ADLs can improve the overall quality of life for individuals with chronic pain.

3. Adverse effects when managing pain. Healthcare providers must carefully weigh the benefits of pain relief against the potential adverse effects and side effects of medications or treatments. It involves constant monitoring and adjustment to minimize negative consequences while ensuring effective pain management.

4. Aberrant drug-related behaviors refer to any unexpected or problematic behaviors related to the use of pain medications. This could include misuse, non-compliance, or signs of addiction. Identifying and addressing these behaviors is crucial to ensure the safe and responsible use of pain medications.

5. Affect refers to the emotional and psychological aspects of pain. It involves assessing the impact of pain on a person's mental well-being, including mood, stress, anxiety, and depression. Addressing these emotional aspects is integral to a holistic approach to chronic pain management.

Conditions that Cause Chronic Pain

Sometimes chronic pain can begin without any obvious cause. But for many people, it starts after an injury or because of a health condition. Some of the leading causes include:

1. Past injuries or surgeries

2. Back problems

3. Migraines and other headaches

4. Arthritis

5. Nerve damage

6. Infections

7. Fibromyalgia is a condition in which people feel muscle pain throughout their bodies

Symptoms of Chronic Pain

Chronic pain can range from mild to severe. It can continue day after day or come and go. The pain can feel like:

- A dull ache

- Throbbing

- Burning

- Shooting

- Squeezing

- Stinging

- Soreness

- Stiffness

Sometimes pain is just one of many symptoms, which can also include:

- Feeling very tired or wiped out

- Not feeling hungry

- Trouble sleeping

- Mood changes

- Weakness

- A lack of energy

Risk Factors for Chronic Pain

Since many conditions or injuries can cause chronic pain, there are several risk factors for experiencing it. Some risk factors include:

1. Your genetics: Some chronic pain causes, like migraines, run in the family (are genetic).

2. Having obesity: Having obesity can worsen certain health conditions that cause pain, such as arthritis since there’s extra pressure on your joints.

3. Your age: Older people are more likely to experience chronic pain from arthritis and neuropathy.

4. Having a previous injury: If you’ve had a traumatic injury, you’re more likely to develop chronic pain in the future.

5. Having a labor-intensive job: If you have a physically strenuous job, you’re at greater risk for developing chronic pain.

6. Experiencing stress: Studies have shown that chronic pain is connected to both frequent stress and post-traumatic stress disorder.

7. Smoking: If you smoke, you’re at greater risk for developing medical conditions that lead to a need for chronic pain treatment.

Complications of Chronic Pain

Complications of chronic pain can include:

- Decreased quality of life.

- Depression.

- Anxiety.

- Substance abuse disorders.

- Worsening of existing chronic disease.

- An increased risk of suicidal ideation and/or suicide.

The complications of chronic pain are serious. Because of this, it’s essential to seek medical care if you’re experiencing chronic pain. There are many options for pain treatment and management. While it may take a while to find the right combination of therapies that work for you, it’s worth undertaking.

How to Treat Chronic Pain

The main goal of treatment is to reduce pain and boost mobility. This helps you return to your daily activities without discomfort.

The severity and frequency of chronic pain can differ among individuals. So doctors create pain management plans that are specific to each person. Your pain management plan will depend on your symptoms and any underlying health conditions. Medical treatments, lifestyle remedies, or a combination of these methods may be used to treat your chronic pain.

Medications for Chronic Pain

Several types of medications are available that can help treat chronic pain. Here are a few examples:

1. over-the-counter pain relievers, including acetaminophen (Tylenol) or nonsteroidal anti-inflammatory drugs (NSAIDs) such as aspirin (Bufferin) or ibuprofen (Advil).

2. opioid pain relievers, including morphine (MS Contin), codeine, and hydrocodone (Tussigon)

3. adjuvant analgesics, such as antidepressants and anticonvulsants

Medical Procedures for Chronic Pain

Certain medical procedures can also provide relief from chronic pain. An example of a few are:

1. electrical stimulation, which reduces pain by sending mild electric shocks into your muscles.

2. nerve block, which is an injection that prevents nerves from sending pain signals to your brain.

3. acupuncture, which involves lightly pricking your skin with needles to alleviate pain.

4. surgery, which corrects injuries that may have healed improperly and that may be contributing to the pain.

Lifestyle Remedies for Chronic Pain

Additionally, various lifestyle remedies are available to help ease chronic pain. Examples include:

1. Physical therapy

2. Tai chi

3. Yoga

4. Art and music therapy

5. Pet therapy

6. Psychotherapy

7. Massage

8. Meditation

What Not to Say to Someone with Chronic Pain

Sometimes we have the best intentions and want to help others as much as we can. But in the process of helping, we fumble over the words or say the wrong thing, unable to verbalize what our mind wants us to articulate. There are things you shouldn’t say to someone with chronic pain, such as:

1. “You’re in pain? Funny, you don’t look hurt (or injured) at all.”

2. “I noticed you’ve been hobbling around at work. Dude, you’re too young to be in pain.”

3. “Listen, everyone gets tired, and sometimes that makes pain seem worse than it is, so sleep it off.”

4. “Eh, you’re just having a bad day.”

5. “Pain? It’s all in your mind.”

6. “Suck it up.”

7. “Wow, now you’ve got an excuse for not going to work (or school) today. I’m so envious.”

8. “You know what? My arms hurt for months because of repetitive stress movements, but my therapist told me to exercise, and guess what? No more pain. You should try that.”

9. “Sure, I know you’re in pain, but there’s always someone who’s got it worse and you’re mostly healthy, right?”

10. “Does this mean we’re not going to the concert Friday night?”

11. “I don’t know what’s going on, but I hope you feel better soon! I’m picking up your slack at work.”

12. “Ok, how about if you try this? I saw it on a podcast.”

13. “Listen, I’ve heard some old people say they will away their pain. You know, mind over matter and all that.”

14. “I don’t know. When I was in pain a lot, my dietician told me to lose 7% body weight and now I feel like a million bucks.”

15. “Maybe you need to sleep more.”

16. “How about getting a new pillow or mattress?”

17. “I know what you’re going through.”

To communicate with someone with chronic pain, you need to be engaged, compassionate, and listen to what they’re telling you. You might suggest different kinds of treatment or see a different doctor, but the conversation is always about the other person.

How to Manage Chronic Pain

Besides taking medications, getting therapy, and making lifestyle changes, take good care of yourself. The following actions can help you cope with your chronic pain and improve your overall health:

- 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.

- Manage your stress.

- 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.

- Try to think positively.

How to Help Someone with Chronic Pain

Loved ones must understand the effect of chronic pain on a person's daily life. Not being able to engage with family and friends can lead to mood symptoms like anxiety, helplessness, and hopelessness. It's beneficial to encourage people with chronic pain to maintain a sense of normalcy, remain involved in social activities, and stick to a routine sleep schedule. However, caregivers should balance encouraging activity and enabling passivity, as helping can exacerbate physical and psychological limitations and dependency. When supporting someone with chronic pain, here are some ways a loved one can help:

1. Understand the nature of chronic pain.

Recognize that chronic pain differs from acute pain and can last beyond the expected recovery period. Be aware of the different types of chronic pain and their effect on your loved one's life.

2. Encourage movement and physical activity.

Motivate the person to do gentle exercises, stretching, or physical therapy, even if it initially causes some discomfort. Gradually increasing activity levels can help improve pain and overall functioning.

3. Support a balanced routine.

Help establish a regular sleep schedule and ensure the person is exposed to daylight during the day. Encourage healthy habits such as maintaining a nutritious diet and avoiding substances like drugs or smoking. Understand that someone with chronic pain may have fluctuating levels of pain. Encourage them to participate in social events and integrate into family meals or outings when they feel up to it.

4. Provide emotional support.

Chronic pain can take a toll on a person's mental health. Listen when needed, offer emotional support, and encourage open communication about their feelings and experiences. Help them seek professional help if needed. Understand that chronic pain can be unpredictable, and the person may have good and bad days. Practice patience, flexibility, and adaptability to accommodate their needs and limitations.

5. Avoid enabling behaviors.

While being empathetic is important, avoid reinforcing a sedentary or inactive lifestyle. Encourage independence and motivate the person to participate in their daily activities as much as possible.

6. Stay informed and advocate for proper medical care.

Educate yourself about the specific condition causing chronic pain, available treatments, and strategies for managing pain. This knowledge will help you better understand and support the person's journey. Help the person find healthcare providers who specialize in chronic pain management. Advocate for their needs and ensure they receive appropriate medical attention, including seeking second opinions if necessary.

7. Encourage self-care.

Remind the person to prioritize self-care, including practicing relaxation techniques, pursuing hobbies, and engaging in activities that bring joy and reduce stress.

How to Prevent Chronic Pain

Maintaining a healthful lifestyle is a strong intervention to prevent chronic pain.

- Maintain a healthful diet and weight.

- Exercise regularly.

- Eliminate unhealthy practices such as excessive alcohol use and smoking.

- Work and rest in a variety of healthy postures.

- Manage stress with deep breaths using the diaphragm muscles, participating in enjoyable activities, and reducing sources of unnecessary stress whenever possible.

- Seek counsel or psychological/behavioral therapy whenever needed.

Medical Specialists Associated With Pain Management

Chronic pain affects all parts of your life. The most effective treatment includes symptom relief and support. A multidisciplinary approach to pain management is often required to provide the needed interventions to help manage the pain. Pain management programs are usually done on an outpatient basis. Many skilled professionals are part of the pain management rehabilitation team, including:

- Neurologists and neurosurgeons

- Orthopedists and orthopedic surgeons

- Anesthesiologists

- Oncologists

- Physiatrists

- Nurses

- Physical therapists

- Occupational therapists

- Psychologists/psychiatrists

- Social workers

- Case managers

- Vocational counselors

Steps to Find a Good Chronic Pain Doctor Near Me

Finding the right chronic pain doctor requires a systematic approach to ensure you receive the most suitable care for your specific needs. To help you navigate this process effectively, follow these essential steps to locate a reputable specialist:

1. Research Potential Doctors: Initiate your quest by conducting thorough research to identify potential chronic pain doctors in your area. Utilize trustworthy online resources, medical directories, and healthcare platforms to compile a list of potential candidates. Take note of their areas of expertise, specialties, and affiliations with reputable medical institutions.

2. Check Credentials: Once you have a list of potential chronic pain doctors, delve deeper into their credentials and qualifications. Verify their medical licenses, certifications, and any additional accreditations related to pain medicine or interventional pain management. Confirming their credentials will give you confidence in the doctor’s expertise and adherence to professional standards.

3. Consider Experience: Assess the experience of the chronic pain doctors on your shortlist. Look for experts who have a track record of successfully treating patients with conditions similar to yours. Experienced doctors are better equipped to accurately diagnose complex pain issues and offer effective treatment plans tailored to your specific needs.

4. Evaluate Communication Style: During the initial consultations with potential chronic pain doctors, pay close attention to their communication style. A good one will actively listen to your concerns, exhibit empathy, and take the time to explain treatment options clearly and understandably. Effective communication fosters trust and ensures you are actively involved in your pain management journey.

5. Read Patient Reviews: Before making a final decision, read patient reviews and testimonials about the chronic pain specialist you are considering. Genuine patient feedback can provide valuable insights into the doctor’s approach to care, treatment outcomes, and overall patient satisfaction. Use this information to gauge the doctor’s reputation and the quality of care they offer.

Sources:

Hopkins Medicine

Cleveland Clinic

WebMD

Healthline

IDCC Health

LinkedIn

BRR Law

Patients Like Me

Albany Ketamine

Mayo Clinic Health System

IASP

Madison Medical Associates

Pathways

Family Doctor

Carolinas Pain Center

Logansport Memorial

CDC

UH Hospitals

PTSD VA