Almost everyone has experienced some form of pain before - whether it's a niggling headache after a long day at work or the pain of a broken bone. For the majority of us, this pain is only temporary and disappears once the cause has been eliminated. For some people however, pain is something they have to live with every day.
Chronic pain relates to any type of pain that lasts for longer than three to six months. Another definition states that chronic pain is simply pain that extends beyond the expected period of healing.
There are many different causes of chronic pain, ranging from conditions such as fibromyalgia to chronic headaches. Whatever the reason is, suffering from chronic pain can be devastating - both physically and emotionally.
What is chronic pain?
The term chronic refers to something that is ongoing or recurring. In regards to pain, this means the pain experienced by the sufferer is something they experience continuously or on a recurrent basis. In medical terms, a pain is considered chronic if it is ongoing for more than three to six months.
The pain itself can be mild or excruciating; it can be continuous or episodic. The pain may be a mild inconvenience to the sufferer, or totally incapacitating. All of this depends on the cause of the pain - whether that be a musculoskeletal cause or a neurological cause.
Those suffering from chronic pain may experience other symptoms as well as the pain, including:
- weakened immune system
- difficulty sleeping
- mood changes.
It is thought that roughly 10 million people in Britain suffer from pain daily, resulting in time off work and an impact to quality of life. There are several different conditions that can result in chronic pain, each with its own symptoms.
Some medical conditions mean the sufferer will experience pain as part of their symptoms. If you suffer from a painful condition, your doctor should factor this into your treatment programme. If you think you suffer from any of the following conditions, be sure to seek medical advice.
Complex regional pain syndrome
The most prominent symptom of complex regional pain syndrome is a severe burning pain in part or all of a limb. This pain is usually triggered by an injury, but the pain tends to be worse than is expected - for example you may just have an ankle sprain, but the pain felt could resemble a severe burn. The skin of the affected limb can become incredibly sensitive, so much so that the slightest touch can be excruciating.
Fibromyalgia is a long-term condition that causes the sufferer to feel pain all over the body. The exact causes of fibromyalgia are unknown, but those with the condition have been seen to experience similar changes to their bodily functions, including:
- irritable bowel syndrome
- sleeping difficulties
- muscle stiffness.
There is no cure for fibromyalgia, but treatment can help to ease symptoms and aims to improve quality of life.
Headaches and migraines
For most people, headaches are an occasional nuisance that can be cured relatively easily with painkillers. For those who suffer from chronic headaches and migraines however, they can be a source of immense distress.
Migraines are far more than just a bad headache. Affecting over 15% of people in the UK, migraines cause the sufferer to experience extreme pain along with nausea and visual disturbances. At their worst they can prevent the sufferer from their normal daily activities for days at a time. Some people find they grow out of migraine attacks, but others will suffer from them for their entire lives. While there is no cure, migraine sufferers can take preventative measures and specially developed pain medication.
Chronic headaches, such as cluster headaches and tension headaches can be caused by poor posture, muscle contraction or even by taking too many painkillers. Again, there is no cure for these types of headaches, but by recognising triggers and taking preventative measures symptoms can be reduced.
Arthritis is a relatively common condition that causes pain, stiffness and inflammation within a joint and can affect people of all ages. There are several different types of arthritis, and the amount of pain experienced will depend on the nature of the arthritis. In some cases arthritis may cause muscles to weaken and can cause the sufferer to have difficulty keeping mobile.
Another common ailment in the UK is back pain. Most people suffer from some form of back pain during their lives, but certain conditions can cause chronic pain. You may have suffered an injury that weakened your back and you are now prone to soreness. Other conditions such as sciatica and frozen shoulder can cause recurrent pain for the sufferer.
When it comes to pain management, your first port of call should be your doctor. If you suffer from a painful condition, you should be given advice and (if necessary) medication. For some conditions a whole team of staff are needed to help you improve your quality of life and lessen painful symptoms.
As well as taking medication, there are many other things you can do that may help with the pain management of your condition, including the following:
(note: you are advised to check with your doctor before trying any new treatment)
- Gentle exercise - Certain exercises like walking or swimming can help to keep you mobile and stretch out muscles to relieve pain. Swimming is ideal for those with limited mobility as there will be less pressure on any sore joints.
- Relaxation techniques - When we are tense and anxious, we tend to feel pain more. Techniques such as meditation can help relax muscles and potentially take the edge off the pain.
- Breathing exercises - If you are in pain, you may find you are taking shorter, shallower breaths. This can lead you to feel panicked and anxious. Taking deeper breaths and learning certain breathing techniques can help you to regain focus, calm down and feel more in control of the situation.
- Physiotherapy - If your doctor agrees, physiotherapy and/or massage can be useful for certain musculoskeletal conditions. This therapy can help maintain mobility, which is important for those with conditions such as arthritis.
- Alternative therapies - There are some alternative and complementary therapies available that people with painful conditions may like to try. Such therapies may include aromatherapy, acupuncture or yoga therapy.
- Distraction - Sometimes simply distracting your mind from the pain can help to take the edge off. Try taking up a hobby such as knitting that will require some degree of concentration. Alternatively, reading a book or listening to a piece of music could help to take your mind off the pain.
- Avoiding alcohol and junk food - Keeping your body as healthy as possible can really make a difference with painful conditions. Alcohol and junk food can cause inflammation in the body that may make pain worse.
Living with chronic pain
Dealing with pain on a regular basis can be both physically and emotionally draining. The pain may make you feel more stressed, leading to the development of depression and anxiety. For conditions that have no cure, it can be easy to feel as if there is no hope, and again this can lead to depression in some patients.
Some people who suffer from chronic pain complain of cognitive impairment such as forgetfulness and difficulty completing daily tasks. While there is little research into the effect pain has on cognition, there have been several published conclusions that note a link between the two.
Combine all of this with the feeling of isolation often experienced by those with chronic pain, and it's easy to see why depression and anxiety can develop. For many people, the fear and anxiety of pain can stop them leading an active life - which can make pain worse and isolate them even further.
If you are experiencing symptoms of depression or anxiety, you are advised to speak to your doctor. They may recommend you seek counselling or join a support group to help you deal with the emotional impact of chronic pain.
- Join a support group with other people dealing with chronic pain. Sharing your experience with others who understand what you're going through can often help you feel less isolated.
- Socialise with friends and family regularly. It can be easy to think shutting them out is for their own benefit, but chances are they want to spend time with you. If you are unable to go out to visit them, invite them round for a coffee and a catch up.
- Learn more about your condition. Ask your doctor for some reading material to help you understand your condition and what could help.
- Practice relaxation techniques to help you lower stress levels and manage pain.
How can counselling help?
Looking after your psychological well-being can be especially important when you are experiencing physical problems. Maintaining a positive mindset and lowering stress levels can improve your quality of life and can even help to reduce your pain.
Talking therapies such as counselling are especially helpful to those suffering from depression and/or anxiety. There are several psychological treatments that may help you, these include:
CBT is becoming an increasingly popular technique to help with a range of issues, including chronic pain. The therapy is based on the principle that the way you feel about things depends partly on the way you think about them. CBT aims to break down overwhelming problems into smaller, more manageable segments. It also looks at negative behaviour patterns (i.e. how you react when symptoms of pain first appear) and looks to change them over time.
Another therapy that is gaining popularity is mindfulness. Often used as a meditation technique, mindfulness helps you to focus on the present, rather than worrying about the past or future. For those with chronic pain, mindfulness can help you to judge your pain levels more accurately and may help to reduce anxiety about future attacks/episodes.
In many cases, those with chronic pain benefit simply by talking to someone about their experience. An individuals counsellor will be able to explore your feelings (whether these are related to your pain or not) and help you to figure out new ways of coping or reacting to the pain. Some people who suffer from chronic pain are also counsellors - so you may even be able to find someone who understands what you're going through in more detail.
What should I be looking for in a counsellor or psychotherapist?
There are currently no laws in place stipulating what training and qualifications a counsellor must have in order to treat those with chronic pain. However, the National Institute for Health and Care Excellence (NICE) have developed a set of guidelines that provide advice about the recommended treatments for those with a chronic illness suffering from depression, including the following:
- Treatments for depression include psychological treatments and antidepressants. The decision about what type of treatment to have will depend on your preference and a number of other factors.
- If your physical health problem means that you are unable to have psychological treatment face to face, you may be offered an antidepressant or psychological treatment by phone.
- If you have a learning disability or other problem that may affect your understanding, you should be offered the same treatments as other people with depression and a physical health problem. The treatment may be adapted to suit your needs.
- If you have both depression and anxiety, you will be treated first for the one that causes you the most problems. Because treatments for anxiety and depression are similar, treatment for one condition can often help the other.
Read the full NICE guidelines: