Chronic Pain: Symptoms, Diagnosis, & Treatment

Symptoms

• Chronic pain is often defined as any pain lasting more than 12 weeks. Whereas acute pain is a normal sensation that alerts us to possible injury, chronic pain is very different. Chronic pain persists—often for months or even longer.
• Chronic pain may arise from an initial injury, such as a back sprain, or there may be an ongoing cause, such as illness. However, there may also be no clear cause. Other health problems, such as fatigue, sleep disturbance, decreased appetite, and mood changes, often accompany chronic pain. Chronic pain may limit a person’s movements, which can reduce flexibility, strength, and stamina. This difficulty in carrying out important and enjoyable activities can lead to disability and despair.

Diagnosis

• Pain is a very personal and subjective experience. There is no test that can measure and locate pain with precision.  So, health professionals rely on the patient’s own description of the type, timing, and location of pain. Defining pain as sharp or dull, constant or on-and-off, or burning or aching may give the best clues to the cause of the pain. These descriptions are part of what is called the pain history, taken during the start of the evaluation of a patient with pain.
• Since chronic pain may occur in a variety of locations in the body and for many different reasons, patients and their health professionals need to work together to identify the causes and symptoms of that pain and how it can be relieved.
• Although technology can help health professionals form a diagnosis, the best treatment plans are tailored to the person, with input from healthcare team members, who each have different training backgrounds and understand chronic pain. The person with pain and his or her loved ones also must be actively involved in the treatment.

Treatment

With chronic pain, the goal of treatment is to reduce pain and improve function, so the person can resume day-to-day activities. Patients and their healthcare providers have a number of options for the treatment of pain. Some are more effective than others. Whatever the treatment plan, it is important to remember that chronic pain usually cannot be cured, but it can be managed. The following treatments are among the most common ways to manage pain.

Medications, acupuncture, electrical stimulation, nerve blocks, or surgery are some treatments used for chronic pain. Less invasive psychotherapy, relaxation therapies, biofeedback, and behavior modification may also be used to treat chronic pain. These methods can be powerful and effective in some people. When it comes to chronic pain treatment, many people find adding complementary or alternative medicine (CAM) approaches can provide additional relief. These may include tai chi, acupuncture, meditation, massage therapies, and similar treatments.

Self-management of chronic pain holds great promise as a treatment approach. In self-management programs, the individual patient becomes an active participant in his or her pain treatment—engaging in problem-solving, pacing, decision-making, and taking actions to manage their pain. Although self-management programs can differ, they have some common features. Their approach is that the person living with pain needs help learning to think, feel, and do better, despite the persistence of pain. Improving communication with the healthcare provider is part of that empowerment.
Through NIH-supported research, starting successful self-management programs has reduced many barriers to effective pain management, regardless of the underlying conditions. Individuals who participate in these programs have significantly increased their ability to cope with pain. They improve their ability to be active, healthy, and involved members of their communities. In fact, new research suggests that the best self-management programs teach people different ways of thinking about and responding to pain, making their actions to relieve it more effective.

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