What is chronic pain?

Chronic or persistent pain is pain that lasts for more than 3 months, or in many cases, beyond normal healing time. It is different from acute pain, such as pain from an injury, which develops quickly and doesn't usually last for long.

Chronic pain is a complex condition, and everyone experiences it differently. The pain can range from mild to severe and is experienced on most days.

What causes chronic pain?

There are different types of chronic pain, including nerve pain, pain caused by a bone, muscle or joint condition, as well as pain due to cancer.

Chronic pain can also be caused by illnesses such as migraine, osteoporosis, arthritis and other musculoskeletal conditions, or after an injury or surgery. Sometimes there is no apparent cause of chronic pain.

Normally, if you have an injury, nerves carry signals from the injured part of your body to the brain, telling the brain that there’s a problem. The brain reads these signals as pain.

But when someone has chronic pain, the nerves that carry pain signals to the brain, or the brain itself, are behaving in an unusual way. The nerves might be more sensitive than usual, or the brain might be misreading other signals as pain.

Acute pain can develop into a chronic pain condition if left untreated or if the acute pain is poorly treated. The longer pain remains untreated, the greater the risk of pain becoming chronic.

If you are concerned about your pain, talk to your doctor.

Living with chronic pain

Chronic pain can make it hard to work, take care of yourself and do the things you enjoy. It can also affect your sleep and mood. More than half of Australian adults with chronic pain become anxious or depressed because of their pain. It's important to treat this if it happens to you.

Just as pain can affect your mood, improving your emotional health and wellbeing can also help you manage your pain.

Watch this video from NPS MedicineWise: Australians talk about their pain experience and the impact that pain has had on their lives.

Managing chronic pain

Medicines alone are not the solution to managing chronic pain. If you have chronic pain, you will also need other treatments such as self-management, physical activity and psychological approaches.

People with chronic pain who actively manage their pain on a daily basis do better than those who rely on passive therapies such as medication or surgery. Most people benefit from a range of different treatments and self-management, including:

• seeing a psychologist or using online self-help sites
• seeing a physiotherapist or exercise physiologist
• activity pacing
• relaxation techniques, such as meditation
• exercise such as walking, swimming, cycling or tai chi
• improving your sleep

Talk to your doctor about developing a plan for managing your chronic pain. You will probably see several health professionals as part of the plan.

Medicines can play a role in managing chronic pain and include:

• paracetamol — this very effective pain-relief medicine is usually taken along with other medicines. Speak to your doctor if paracetamol is not controlling your pain.
• non-steroidal anti-inflammatory drugs (NSAIDs) — medications such as ibuprofen and diclofenac may help, but take them in the lowest possible dosage for the shortest possible time since they can have serious side effects
• antidepressants — medications normally used to treat depression, such as amitriptyline, can also reduce pain
• anticonvulsants, or antiepileptic medicines — medicines normally used to treat epilepsy can also control nerve pain. They include pregabalin and gabapentin.
• opioids — strong opioid pain-relief medicines, such as morphine, fentanyl, oxycodone or codeine, might be prescribed for short periods but are not very effective in chronic pain that is not caused by cancer

Opioids are not usually recommended for chronic pain, unless it is caused by cancer.

Long-term use of opioids is potentially harmful, including accidental fatal overdose, life-threatening breathing problems, dependence, tolerance and addiction. Their long-term use of opioids can also make a person more sensitive to pain — known as ‘opioid-induced hyperalgesia’.

Sometimes, medicines won’t relieve all your pain symptoms. But the aim of managing chronic pain is to stop pain from disrupting your life so that you can resume doing the things you enjoy, such as socialising, working and being active.

You might also consider being referred to a pain management program at a pain clinic, available in most major public hospitals and also privately. Your doctor can help you arrange this.

Resources and support

These organisations provide specialist information and support services for people who are looking for effective and safe ways to manage long-term pain:

• Go to Painaustralia to find pain services and programs in your area.
• Go to Chronic Pain Australia for more information on chronic pain.
• Discover how other people have managed chronic pain on the Pain Management Network, including people from Aboriginal communities.
• The Australian Pain Management Association provides advocacy, information and practical support for people living with chronic pain.
• Discuss your pain on the Pain Link helpline (1300 340 357) which is staffed by volunteers with personal experience of chronic pain.