Chronic pain is defined as pain that lasts more than three months. Chronic pain sufferers may feel the pain all the time, or it may come and go. It can happen anywhere in the body and has many causes. Many people suffer chronic pain without having an associated past injury or evidence of illness.
According to a study by the Centers for Disease Prevention and Control (CDC), almost 21% of the U.S. population, 51.6 million adults, live with chronic pain. Of these, 17.1 million live with intense chronic pain that restricts their ability to work or participate in daily activities.
What Causes Chronic Pain?
There are many causes of chronic pain. Some of the more common types include:
- Arthritis or joint pain: Joint pain may be a symptom of many different health conditions, the most common cause being arthritis – and there are more than 100 types of arthritis. It can also occur after joint replacements, such as an artificial knee.
- Back pain, especially lower back pain: Back pain can be caused by arthritis, structural problems, and disc injuries. It may also result from a strain of a back muscle or tendon. Lower back pain is very common, with up to 80% of U.S. adults experiencing it at some point in their lifetime.
- Cancer pain: Cancer pain is a common symptom of cancer and a side effect of cancer treatment. It may be mild, moderate, or severe and take many forms.
- Fibromyalgia: Fibromyalgia causes pain in your muscles and joints throughout your body. Unfortunately, experts don’t know what causes fibromyalgia. There’s no cure for it, but there are treatments that can help manage symptoms.
- Headaches, including migraines: Headaches are a very common condition that most people will experience many times during their lives. There are several types of headaches, and tension headaches are the most common.
- Neck pain: Neck pain can last for days to years. It is commonly caused by physical strain, poor posture, mental stress, osteoarthritis, spinal stenosis, herniated disk, pinched nerves, tumors, and other health conditions.
- Neuropathic (nerve) pain: Neuropathic pain can range from mild to severe. Diseases like diabetes, shingles, and central nervous system disorders can cause it.
Who Should You See for Chronic Pain?
You should see a pain management specialist when pain becomes such a problem that it interferes with your life’s work and normal activities.
Pain medicine is a board-certified subspecialty practiced by several different types of doctors, including physiatrists (physical medicine and rehabilitation doctors), anesthesiologists, family medicine practitioners, psychiatrists, neurologists, emergency medicine doctors, and radiologists.
These doctors have specialized training in assessing, diagnosing, and treating pain. Their first step is to conduct a thorough evaluation, discuss how your pain affects your everyday activities and life goals, and then develop a customized treatment plan.
How Is Chronic Pain Treated?
There is no single optimal approach to pain management for everyone. A pain management specialist may recommend one approach or a combination of therapies.
This may involve treating the underlying cause of the chronic pain, and/or managing pain as a symptom. Usually, a pain management specialist will start with conservative, lower-risk therapies before recommending interventional options. Treatment programs may include both medical and non-medical techniques.
Approaches to chronic pain management may include:
- Lifestyle changes, like weight management and stress management.
- Exercise to reduce spasticity, joint contractures, joint inflammation, spinal alignment problems, or muscle weakening and shrinking to prevent further problems.
- Heat and cold treatments to reduce stiffness and pain, especially with joint problems such as arthritis.
- Emotional and psychological support.
- Complementary medicine therapies, like massage therapy, biofeedback, and meditation.
- Physical therapy and occupational therapy.
- Over-the-counter (OTC) medicines like anti-inflammatory drugs (NSAIDs), aspirin, or acetaminophen.
- Injection therapies, such as:
- Epidural Corticosteroid Injections: targeting the space around the spinal cord to alleviate back and leg pain caused by herniated discs or spinal stenosis. These can also help reduce inflammation in joints or the spine.
- Nerve blocks, with or without steroids: to interrupt pain signals from specific nerves, often used for sciatica, chronic migraines, or CRPS.
- Trigger point injections: injecting medication into tight, painful muscle knots to relieve spasms.
- Hyaluronic Acid/Viscosupplementation joint injections: used for knee arthritis, providing lubrication and pain reduction.
- Regenerative Medicine (Prolotherapy/PRP): using sugar-based irritants or platelet-rich plasma to stimulate the body’s natural healing of injured ligaments, tendons, and joints.
- Minimally invasive to Interventional procedures, such as radiofrequency ablation, to target the cause of the pain if it can be physically identified.
- Neurostimulation therapies that deliver mild electrical signals that disrupt nerve pain signals before they reach your brain.
- Prescription pain medicines for severe types of pain, but only in carefully controlled circumstances.
How Long Does It Take to Treat Chronic Pain?
Depending on the cause of a patient’s pain and its unique characteristics, it can take time to find the right approach that will work. This usually involves trying several different therapies while evaluating the benefits and possible risks of each. There is no cure for chronic pain when it isn’t associated with a specific, identifiable cause. However, a pain management specialist can work with a patient to develop a management plan to lessen the pain. This usually will involve a combination of medications, therapies, and lifestyle changes.