What is chronic pain?

Chronic pain is pain that lasts longer than 3 months. Chronic pain is different from acute (short-term) pain, which develops and heals quickly.

There are many different causes of chronic pain. Often, the shift from short-term pain to long-term pain involves nerve damage, long-term inflammation or changes in how the brain and spinal cord process pain.

Chronic pain is complex. Pain can range from mild to severe. Every person experiences it differently. Living with chronic pain can affect many aspects of your life, including your emotional, physical and social wellbeing.

Your doctor can help you develop a tailored plan for managing your pain.

What are my options for managing chronic pain?

There are many options to manage chronic pain, including:

• medicines
• psychological therapies
• relaxation techniques
• physical activity
• physiotherapy

People who actively manage their pain in these ways see more improvements in their mood, health and ability to function, compared with people who only use medicines to manage their pain.

Chronic pain is best managed using a mix of different approaches. Medicines alone are not the most effective way to treat chronic pain.

Every person with chronic pain should have their own management plan.

Physical activity and therapy

Depending on the cause of your chronic pain, physical activity may be one of the first interventions your doctor suggests. It is usually recommended together with other methods to manage your pain.

If you have chronic pain, it might seem logical to avoid too much standing, bending or moving around. The opposite is usually true — exercise and stretching can often reduce your pain and improve your ability to function.

If you are less active over time, you may start to lose muscle mass, flexibility and strength. This makes it more difficult to carry out regular daily activities, especially as you become weaker as time goes on.

Physiotherapists and exercise physiologists can help teach you how to move your body safely. Some professionals have specialised training to manage chronic pain.

It can also help to pace yourself throughout the day by doing tasks in smaller steps, rather than all at once.

Psychological therapy

Your mood and mindset can influence the way you experience pain. Psychological techniques, such as cognitive behavioural therapy (CBT) and mindfulness, can help reduce unhelpful thoughts. This may change the way you experience and respond to pain.

Some people find it helpful to include mood and social goals in their pain management plan. For example, you might aim to spend 30 minutes a day socialising with friends or family.

Mind-body therapies

Mind-body therapies include yoga, relaxation and meditation. These therapies can help reduce your stress levels and pain. Yoga and tai chi can also be a part of your physical therapy program.

Other therapies

As well as the options already described, these complementary therapies may also help:

• Learn strategies to improve your sleep, which can help improve your ability to function well during the day and feel less pain.
• Join a support group, where you can share your experiences and hear how others in similar situations manage their pain.
• Seek advice from an expert in pain management.

What is the role of medicines in managing chronic pain?

In some cases, medicines can be helpful in managing chronic pain. These may include over-the-counter (OTC) medicines, such as paracetamol and ibuprofen, or medicines prescribed by your doctor.

Before you take any pain medicine, including OTC medicines, talk to your doctor or pharmacist. They can tell you if the medicine is suitable and appropriate for you.

Depending on your situation, your doctor may prescribe other medicines. Here are some examples:

• antidepressants — some medicines used to treat depression, such as amitriptyline, are also sometimes prescribed by doctors to reduce pain.
• anticonvulsants or antiepileptic medicines — medicines commonly used to treat epilepsy can also help manage nerve pain. They include pregabalin and gabapentin.

In Australia, these medicines are only available with a doctor's prescription.

What medicines are not recommended to treat chronic (non-cancer) pain?

Opioid medicines (such as oxycodone, morphine and codeine) can be used to treat:

• acute (short-term) pain, such as pain after surgery or an injury
• chronic pain for people with cancer

Opioids are not recommended to help people with chronic, non-cancer pain.

Using prescription opioids for a long time can be dangerous and even addictive.

Research shows that the longer you take an opioid, the less pain relief you will feel. This is because your body gets used to the dose of opioid that's being taken, known as ‘tolerance'. When you develop tolerance to opioid medicines, you will need a higher dose to get the same effect. Higher doses also increase the chance of serious side effects.

What is interventional pain management?

Interventional pain management techniques are procedures to help manage your pain. If other options have not helped you, a doctor specialising in pain management may recommend these options.

Interventional pain management techniques include:

• Transcutaneous electrical nerve stimulation (TENS) uses a battery-operated stimulator to send electrical pulses through the skin near the area of pain. TENS can help in a range of chronic pain conditions.
• Spinal-cord stimulation involves placement of an electrical device under the skin near your spine. The device delivers a current to your spinal cord, which interrupts the pain signals being sent to your brain. A hand-held control allows you to adjust the intensity of the charge.
• Radiofrequency ablation is a procedure performed by a doctor that targets joint- and nerve-based chronic pain. Needles are placed onto the nerves responsible for the pain, and the tip of the needle is heated, which interrupts pain signals to the brain.
• A nerve block involves injection of a local anaesthetic around a nerve to stop it from sending pain signals.
• Epidural injections of corticosteroids or local anaesthetic can be injected in the space around your spinal cord to reduce pain.
• Some types of chronic pain may respond to surgical treatment.

Your doctor or pain specialist can discuss the risks and benefits of these treatments and if they're suitable for you.

During the period of relief, you might find it easier to adjust your lifestyle and develop healthy habits. This can make it easier to cope with chronic pain if it returns.

When should I see my doctor?

You should see your doctor if:

• you have chronic pain and you want to explore your treatment options
• your current treatment isn't helping

Resources and support

• Visit Chronic Pain Australia to learn more about chronic pain and support services.
• Call 1300 MEDICINE (1300 633 424) to talk about the medicines you are taking for your pain.
• Go to Painaustralia to find pain services and programs in your area.
• Call healthdirect on 1800 022 222 at any time to speak to a registered nurse (known as NURSE-ON-CALL in Victoria) for more information and advice.

Other languages

The Pain Management Network has translated resources about pain in many community languages.

The Alcohol and Drug Foundation has translated their guide to using medicines safely into many community languages.

Information for Aboriginal and/or Torres Strait Islander peoples

The Pain Management Network has a collection of resources for Aboriginal and/or Torres Strait Islander people.

Pain Australia has information about services for managing chronic pain for Aboriginal and/or Torres Strait Islander people.