10 chronic pain facts
We will describe 10 facts about chronic pain.
Key Points
-
Chronic pain is a complex condition requiring multidisciplinary management
-
Affects physical and mental health, impacting quality of life
- It is poorly understood
-
But accurate diagnosis and tailored treatment is essential.
1. Definition
-
Chronic pain: persists beyond expected healing time (typically >3 months)
-
Contrasts with acute pain, which resolves with healing.
Chronic pain can be called ‘primary’. This means there is no clear underlying cause, or the pain is out of proportion to the underlying injury or disease – or the underlying cause has ‘gone’ but the pain persists.
It can be ‘secondary’ to (caused by) an underlying condition (for example, osteoarthritis or rheumatoid arthritis, disc disease, ulcerative colitis or endometriosis). Again, the original cause may have passed.
2. Epidemiology
-
It is very (very) common – affecting approximately 30 million adults in the UK (>45% of population)
-
Prevalence increases with age; 15% of people 16-25 years, 50% over 70 years
-
More common in females than males.
3. Risk Factors
-
Age
-
Female sex
-
Previous trauma or injury
-
Mental health conditions (depression, anxiety)
-
Social determinants (low socioeconomic status).
4. Causes
Chronic pain, and its causes, are poorly understood.
-
Musculoskeletal conditions (e.g. osteoarthritis)
-
Neuropathic conditions (e.g. diabetes, other causes of nerve damage)
-
Inflammatory conditions (e.g. rheumatoid arthritis)
-
Cancer and its treatment.
-
Unknown/idiopathic.
5. Symptoms
-
Persistent pain (>3 months). Commonest sites:
- Back pain
- Joint pain
- Headache
-
Pain interfering with daily activities
-
Fatigue, sleep disturbances
-
Mood changes (depression, anxiety)
-
Cognitive impairment.
6. Diagnosis
-
Comprehensive clinical assessment
-
Pain history and character
-
Physical examination.
Investigation
-
Blood tests (e.g. inflammatory markers, infection screening)
-
Imaging studies (e.g. x-rays, MRI)
-
Nerve conduction studies
-
Questionnaires (e.g. pain severity, quality of life).
Differential Diagnosis
-
Other chronic conditions (e.g., irritable bowel syndrome)
-
Mental health conditions
-
Substance misuse
-
Factitious disorder.
7. Treatment
-
Multidisciplinary approach
-
Pharmacological (e.g. analgesics, pain prophylaxis agents (gabapentin, pregabalin), antidepressants (duloxetine is very good)
-
Non-pharmacological (e.g. physiotherapy, cognitive-behavioral therapy)
-
Interventional procedures (e.g. injections, nerve blocks).
- Surgery.
When to see a doctor
If pain persists, interferes with daily life, or is severe, or associated with red flag symptoms.
8. Complications
- Mental health issues, substance misuse, decreased mobility.
9. Prognosis
- Variable; some patients achieve significant improvement, while others experience ongoing disability.
10. Prevention
- Early intervention, lifestyle modifications (e.g. exercise, stress management), and addressing risk factors.
Summary
We have described 10 facts about chronic pain. We hope it has been helpful.
Other resource
What can I do about my chronic pain?
Note. These facts are a summary and not exhaustive. You should consult the National Institute for Health and Care Excellence (NICE) guidelines, the British Pain Clinic, and other relevant resources for comprehensive information.
