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Frequently asked questions about chronic pain

Pain can either be acute or chronic.

Acute pain is pain that comes on suddenly (for example, when stubbing your toe) and is likely to end soon. The term acute doesn't have anything to do with to how bad the pain is or how serious the problem is.

Chronic pain (also called persistent pain) is pain that carries on after you were expected to recover from an injury or illness.

The difference between these two types of pain is important, as different approaches are needed for treating and managing them.

Why am I still feeling pain?

A person can continue to experience chronic pain long after the initial injury has healed or when the initial problem has been removed or repaired.

It is not a simple problem. There is no dividing line between skin, muscles, nerves, the spinal cord, the brain and thoughts, beliefs and emotions – it's the nervous system as a whole that produces your pain experience. The fact that environmental and emotional factors can influence pain doesn't make it any less real.

Is pain not a signal of damage to the body?

Not necessarily. Chronic pain often reflects a problem with your pain system itself rather than damage in a particular part of your body. It's a bit like a fire alarm that sounds without a fire.

Can you not just cut the nerve or remove the problem area?

Unfortunately, the solution is seldom this simple. It is not always possible to pinpoint what causes the pain or where it starts. What is happening with the nerve may only be a small part of the whole pain picture.

Also, there is no guarantee with this sort of procedure that the pain wouldn't return (possibly even worse than before) and there is a risk of serious complications such as loss of function. A good example of this is phantom pain after a limb is removed – there is no limb, but the pain problem persists.

Why have not I been given a diagnosis?

Chronic pain is a diagnosis by itself. Even if your doctor cannot find a particular condition causing your pain, the fact you have chronic pain is the important diagnosis.

Why do doctors not give me stronger medication?

Stronger medication is not necessarily more effective and can result in unpleasant side effects. You might even become dependent on the medication.

People can develop a tolerance to medication they use regularly, meaning they need stronger and larger doses to get the same pain relief.

Also, the drugs that are often used for acute pain aren't usually effective for chronic pain.

Something has to be done!

Something can be done! Health professionals sometimes say that nothing further can be done to deal with the pain problem, but this is not entirely accurate. Usually, this comment refers to the idea that there are no further medications or interventions that could cure or fix the problem.

However, it is not all hopeless. Depending on what contributes to your pain experience, there are many recognised pain management techniques you can use to help manage your pain, so it doesn't have as big an impact on your life.

If something is sore, does it not make sense to not move it?

Pain doesn't necessarily mean you have to give up all your activities. There are ways you can manage how you approach activity when you have pain.

If you avoid activities, you're likely become less physically capable, which will harm your confidence and probably increase your pain over time.

Overdoing activities can also lead to problems. Learning to change your approach to activities can be difficult, but if you're patient and persevere, it's possible. Ask for help if you aren't sure how to do this.

Is it my fault that I have this pain?

No. No one asks for a chronic pain problem to develop and no one deserves the suffering that can come with it. In New Zealand it's estimated that one in five people experience chronic pain, making it a significant problem.

Is this problem all in my head?

It's common for people with chronic pain to feel that others doubt their pain is real. Chronic pain may not be visible on a scan or to others around you, but it's a recognised condition that is based in the central nervous system (brain and spinal cord).

When should I accept the pain and give up trying to find a cure?

When the specialists are satisfied that you've been appropriately investigated and they have diagnosed a chronic pain condition, it may be time to look at the ways you can manage this condition.

It's important however, to know that giving up trying to find a cure doesn't mean giving up on the problem entirely – it simply means that you may have to take a different approach. This will likely mean enhancing your ability to self-manage your pain.

I have been told I have to learn to live with it – what does this mean?

A pain management approach shows you how to stop the pain interfering in your life so much and how to increase your confidence in coping despite pain. As many factors contribute to your chronic pain problem, your management plan needs to consider all these things.

Why should I bother when nothing else has worked?

Only you can answer this question. By using pain management strategies, you can learn to be more in control of your pain rather than it controlling you. Structured pain management input can be useful. But what is essential is your willingness to try and your belief that change is possible.

Does this mean that I will have to stop taking medication?

Medication can be useful in managing chronic pain and you should talk to your GP about this. Remember that medication is only one part of a larger pain management plan.

I already know how to manage my pain – I have been doing it for years!

You may have developed useful ways of dealing with your pain problems. If what you're doing is working for you then well done! If you think there may be room for improvement, it may be worth taking another look at your pain management plan with a healthcare professional.

I do not want to accept that my pain will be there forever!

You do not have to resign yourself to indefinite pain to take part in a pain management programme. But for the time being, it's important to recognise that the pain is there. This doesn't mean having to like the pain or giving in to it, but rather finding a healthy way to live with it.

I am scared that the pain will get worse

This is an understandable and very common concern. It's usually related to the idea that you wouldn't be able to cope with more pain. But as people become better at using their pain management skills and more confident in managing fluctuations in pain, their worries and fears usually lessen. Setting down a plan for dealing with problems can help you feel more in control of the situation.

My family does not understand

It is very frustrating for people to see someone they care about in pain, especially if it seems that there is little they can do to help. Most people do want to help. It's important to let people know what you need to strike a balance between doing things for yourself and having good support from others.

I have read about this new breakthrough with chronic pain – does it work?

Often you read or see in the media some new technique for managing chronic pain. The possibilities are mind-numbing and explanations so confusing and conflicting that you may feel like giving up before you start.

Try to learn as much as possible about each technique so you know what you're getting into. Do not be afraid to ask questions. Also be aware that the techniques will not work for everyone. What works for your best friend may not be the key to your recovery.

Explore your options and choose the strategies that fit your life and your situation. Be aware that it is not necessary to try everything. Always remember to weigh up the pros and cons of any technique.

On the next page: Self-care for chronic pain

Written by the Burwood Pain Management Centre. Adapted by HealthInfo clinical advisers. Last reviewed August 2021.

Page reference: 79022

Review key: HICHP-79018