If you are one of the millions of people in the UK living with chronic pain, it is important to know that you are not alone.
There is support for you that can help you to manage your pain and reduce the impact it has on your life.
This short guide is intended to help you:
- understand what chronic pain is
- get the support you need
- learn about what therapies are available
You can download this short guide as a PDF leaflet using the button below.
You are not alone
Living with chronic pain is not easy and it can sometimes feel very lonely and isolating. It is OK to experience these feelings, but we want you to know that you’re not alone.
It is estimated that between 1 in 3 and 1 in 2 people are affected by chronic pain in the UK.
Some people call chronic pain an ‘invisible illness,’ as you cannot tell if someone is affected just by looking at them.
Speaking to other people who are living with chronic pain can give you the chance to listen to their stories and share your own. You can find details of support groups and other organisations at the bottom of this page.
You may also want to share this short guide with your family and friends to help them understand more about what you are experiencing.
What is chronic pain?
Chronic pain, also called persistent or long-term pain, is:
- pain that lasts for 12 weeks (three months) or more,
- pain that continues after you have recovered from an injury or illness
Our current understanding of chronic pain is that there are changes to how our bodies send and respond to pain signals, and this affects our experience of pain. This can include sending signals when there is no injury or illness.
This is different to other types of pain where there is usually a clear injury or illness that causes the pain signals and can explain the level of pain we are experiencing.
Whilst this guide focuses on chronic pain, other types of pain exist. Pain can be divided in to different types based on:
- Length of time
- Acute pain – pain that only lasts for a short time and then goes away after you have
healed or recovered
- Chronic pain – pain that lasts for 12 weeks or more, or past the point of recovery
- Intermittent pain – pain that starts and stops with pain-free periods between each episode
- Acute pain – pain that only lasts for a short time and then goes away after you have
- Cause of your pain
- Nociceptive pain – pain that is caused by an injury or illness affecting your body
- Neuropathic pain – pain that is caused by damage to your brain, spinal cord, or nerves
- Cancer-related pain – pain that is caused by the effects of cancer or the treatments for cancer on your body
Your GP will help you to diagnose your pain correctly and make sure you are receiving the right support to manage it.
What causes chronic pain?
Chronic pain has many possible causes. It affects people of all ages and can occur anywhere in the body.
Chronic pain can be a symptom of another condition or long-term health problem such as endometriosis, ulcerative colitis, or arthritis.
Chronic pain can develop following an injury, illness, or surgery.
Sometimes, chronic pain may be experienced without any known cause.
Depending on whether your pain is related to or caused by another condition, it may be defined as either:
- chronic primary pain, or
- chronic secondary pain
Chronic primary pain is chronic pain that is not related to a separate underlying condition.
Chronic primary pain includes chronic pain conditions such as fibromyalgia or chronic low back pain, where the condition itself is defined by having chronic pain.
Chronic pain that is related to or caused by a separate underlying condition is called chronic secondary pain.
It is possible to have both chronic primary pain and chronic secondary pain at the same time.
The following are just some of the many different chronic pain conditions that can affect people:
- Fibromyalgia – a chronic pain condition that causes widespread pain all over the body, and can also cause fatigue, headaches, muscle stiffness, and difficulties with sleeping and concentrating.
- Chronic migraine – a type of headache that lasts at least 15 days a month, for more than 12 weeks, and where for least 8 of those days you also experience migraine features, such as throbbing pain, dizziness, and sensitivity to light and sound.
- Chronic low back pain – pain in the lower area of the back (below the ribcage) and waist that carries on for more than 12 weeks or continues after you have recovered from an injury or illness. You may also be stiff and have difficulty moving and standing straight.
- Complex Regional Pain Syndrome (CRPS) – a chronic pain condition in which you might experience severe ongoing pain in a specific part of your body, such as one of your arms or legs. This often follows an injury to that part of your body.
- Persistent Spinal Pain Syndrome Type 2 (PSPS-T2) – a chronic pain condition in which you experience new or ongoing pain after having spinal surgery for back or leg pain. This can include pain that may have been reduced by the surgery but is still present.
How might chronic pain be affecting you?
Everyone’s experience of chronic pain is different, but it should not be underestimated how much chronic pain can impact a person’s life.
In people living with chronic pain:
- one person in every three finds it very hard to do everyday tasks
- one person in every two had to stop working or take time off
Chronic pain can affect your ability to take part in social and physical activities. This can impact your relationships with family and friends, as well as your general health and wellbeing.
Chronic pain can also lead to depression, anxiety, and trouble sleeping. Each of these can make your experience of pain worse, and this can eventually lead to a cycle or loop that is difficult to break without support.
It is important that you, and your healthcare team, take time to understand how your pain affects you.
Effective pain management will treat you as a whole person, rather than only focussing on your level of pain.
How to get support with chronic pain
If you have been experiencing pain for 12 weeks or more, you should contact your GP and ask to discuss this with them.
Your GP may:
- carry out a physical examination
- ask you about your pain and how it is affecting you
- check for any signs of other illnesses
To support you, your GP may advise you on techniques to help manage your pain levels day-to-day and prescribe you medication that is effective for long-term pain.
Your GP may advise you to try using common painkillers (e.g., paracetamol) for short-term relief or when your pain flares up, but these medications are often not effective for long-term management of chronic pain.
You may be referred by your GP to try different types of physical and psychological therapy. They will also help you consider how to stay active and maintain your general health and wellbeing.
If you continue to face difficulty managing your pain, ask your GP for a referral to a pain management service or specialist pain clinic. These are led by teams of healthcare professionals and offer a wider range of therapies to help you develop strategies for managing your pain.
Ways to manage chronic pain
Chronic pain does not often respond to the same pain medication and pain relief therapies that are used to relieve acute pain – and when it does, the relief often lasts for only a short amount of time.
Chronic pain management often combines medical therapies with self-care to maintain and improve your general health and wellbeing – including exercise and physical activity, relaxation, and engaging with others.
Everyone is affected by pain differently. It is important that you find the right support for you. Your support needs may also change over time as you continue living your life.
It is not always possible to become completely pain-free, and instead the focus may need to be on learning to manage your pain and maintain the best possible quality of life you can.
There are many lifestyle changes, medications, and therapies to consider as you find the right approach to help you reduce your pain and improve your quality of life.
Self-care describes the things you can do each day to take care of yourself and to maintain and improve your own general health and wellbeing. Self-care may involve eating a healthy diet, exercising regularly, sleeping well, and taking some ‘me’ time. It can reduce stress, improve your energy levels, and boost your self-esteem.
Self-management is more about the things you can do to help manage your pain, and the impact it has on you, when you are at home or going about your daily life.
Self-care is often an important part of self-management, but self-management might also include:
- pacing yourself and your daily activities
- including time for rest as part of making plans
- asking family and friends for support when you need it
- practicing learned skills, such as mindfulness, to help you manage your pain, as well as any challenging thoughts and feelings
Visit www.paintoolkit.org for more ideas.
Chronic pain may be managed using a combination of painkillers and other medications for long-term pain.
Some of these medications are better known for treating other conditions and you might see them referred to as anti-depressants or anti-epileptics, for example.
Physical therapy from a trained professional may involve exercises, stretching, and techniques like manipulation, acupuncture, or massage to help relieve your pain.
You may be referred to see a clinical psychologist to help understand how your pain affects you and how your thoughts, feelings and behaviours have an impact on your pain.
These programmes can support you to live with chronic pain by helping you learn more about pain and discover new ways of dealing with the effects caused by it. These programmes are often delivered through group sessions and run over a number of weeks.
Medication can be injected close to a nerve or group of nerves to reduce your pain. One or more medications may be used to help reduce inflammation of the nerves and to block pain signals.
Radiofrequency ablation (RFA) uses heat on targeted nerves to stop them from sending pain signals to your spinal cord and brain.
Spinal cord stimulation (SCS) involves sending small electrical impulses directly to your spinal cord to relieve your pain. These electrical impulses are sent by a medical device that is implanted under your skin.
This procedure may be used to help people with chronic mechanical back pain. It is similar to SCS (see above) but in this situation the device sends the impulses to a group of muscles that support your back (multifidus muscles).
A medical device is implanted under your skin and is used to deliver very small quantities of medications directly in to fluid around your spinal cord.
If your pain is being caused by another condition, then treating or managing that condition may be an important part of managing your chronic pain.
This can take place alongside therapies that focus specifically on your pain.
Where to find more information
The following websites and organisations may also provide further information and support that can help you manage your pain and connect with others:
A big thank you
Thank you to everyone who contributed to and supported the development of this short guide, including Poppy Smith, Nicky Saul, Eike Davis, and the members of Specialist Neuromodulation Nurses and Associated Partners (SNNAP).
This short guide was produced as part of a collaboration with Boston Scientific, who provide the NHS with spinal cord stimulation devices. For more information on their range of products, please visit www.controlyourpain.co.uk
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We welcome any feedback, comments, or suggestions you may have have about this page. Please send an email with your thoughts to [email protected]