Chronic pain

Chronic pain is pain that lasts longer than 3 months. It is also called persistent pain or long-term pain. It is often described as pain that does not go away as expected after an illness or injury.

Key points

  • About 1 in 6 New Zealanders live with chronic pain and no two people are affected in the same way.
  • Examples of chronic pain include fibromyalgia, lower back pain and arthritis pain.
  • Chronic pain can range from mild to severe and can continue day after day or come and go.
  • Chronic pain can be distressing and can impact on your emotional and physical wellbeing. Although it can never be completely cured, it can be managed in ways that improve your quality of life and wellbeing.
  • Medicines alone are not an effective way to manage chronic pain because of the harmful side effects of using them on an ongoing basis. Rather, non-medication treatments and strategies for helping you cope with your pain and come to terms with it are more effective.

How is chronic pain diagnosed?

Effective management of chronic pain requires a comprehensive assessment of your pain and its impact on your life. This may include assessments by a psychologist, pain medicine specialist, physiotherapist, social worker or occupational therapist.

There is no one specific test or scan that can diagnose persistent pain, so it can often take some time to determine what is going on.

To help with the diagnosis, your doctor will want to know about such things as when your pain started, where you feel the pain, what your pain feels like, when it is worse and what, if anything, makes it feel a bit better. See describing your pain for more information.

What are the symptoms of chronic pain?

Everyone feels pain differently and your experience of chronic pain may be different. It is usually described as pain that does not go away as expected after an illness or injury. The pain can be shooting, burning, aching or electrical in nature and can lead to discomfort, soreness, tightness or stiffness. Having ongoing pain can be distressing and often leads to other symptoms, such as:

  • fatigue, which can cause impatience and a lack of motivation
  • trouble sleeping, often because the pain keeps you awake during the night
  • not being active and an increased need to rest
  • a weakened immune system, leading to frequent infections or illness
  • low mood and feelings such as hopelessness, fear, anxiety and stress
  • disability, which may include not being able to go to work or school or perform other daily activities.

Chronic pain cycle

Chronic pain is often described as a cycle where your pain causes feelings of anxiety, low mood, fatigue and sleeplessness, which results in increased pain. The increased pain then causes you to have more low mood, tiredness and stress, so you can get caught in an endless cycle. The good news is that means there are a number of ways you can approach managing chronic pain to get improved wellbeing.

How is chronic pain treated?

Chronic pain is complicated and not easily cured. The goals of treatment are therefore to reduce your pain and increase your ability to function. Fortunately, there are a number of strategies to help you live well with pain.

Accept the pain

Accept that the pain is unlikely to disappear, but recognise that you can do things to reduce its severity and minimise its impact on your life. This first step can in itself help you to feel less hopeless and to regain a sense of control over your situation.

Change the way you think about pain

When you realise that pain in itself is not harmful, you can “retrain your brain” to respond differently to your pain. Instead of reacting to it in a negative way, you can learn to respond with reassuring thoughts about it not causing you harm, and with positive thoughts about what you can do to manage the pain at that moment.

Start moving gently

Incorporate enough activity every day to keep your body moving regularly. Keep moving at an even level throughout the day, rather than having long periods of inactivity followed by short bursts of doing a lot. This helps to keep your body conditioned, as well as keeping your pain to a minimum and reducing the risk of flare-ups sparked by over-activity.

Identify strategies to help you manage stress

Emotional stress and physical pain are closely related, and persistent pain can lead to increased levels of stress. Learning how to deal with your stress in healthy ways can help you to cope more effectively with your chronic pain. Eating well, getting plenty of sleep and engaging in approved physical activity are all positive ways for you to handle your stress and pain.

Become active and engaged

Distracting yourself from your pain by engaging in activities you enjoy will help you highlight the positive aspects of your life. Isolating yourself from others fosters a negative attitude and may increase your perception of your pain. Consider finding a hobby or a pastime that makes you feel good and helps you connect with family, friends or other people via your local community groups or the Internet.

Learn about mindfulness

Mindfulness reduces stress, tension and anxiety. It can help you to avoid focusing too much on your pain as well as directing your thoughts in a way that is helpful for managing your pain. Read more about mindfulness.

Consider non-medication treatments

Chronic pain is best managed with a multidisciplinary pain management approach that takes into account the physical, psychological and environmental factors that influence your experience of pain. This usually involves the use of non-medication treatment options.

There are a variety of non-medication-based treatment options to manage pain such as massage, acupuncture, TENS and CBT. Many of these don't have scientific evidence as to whether they benefit or harm people and not all of these will be suitable for everyone. Read more about non-medication treatments for chronic pain.

If your pain persists and is affecting what you can do, ask your doctor or nurse about referral to your local pain service, a pain specialist or pain programme.

Support

Pain can affect you in many ways and can stop you doing the things that you want to do. It is normal to feel frustrated about having chronic pain and the impact this has on you.

Depending on the cause of the pain and the impact that it has on your life, one or more of the following support options might be helpful in addition to the appointments that you have with your GP or specialist.

Family and friends – support, reassurance and assistance from family and friends with daily activities can be very helpful while you recover.

Counselling – this can be especially helpful if your pain arose from a trauma e.g. a car accident. Speak with your GP about counselling services available through your GP practice. You could also phone:

Learn More

Preventing and managing discomfort at work Habit at Work, ACC
Safety at home ACC
Occupational Therapy Board   
Physiotherapy New Zealand