The Facts



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The following conditions may be associated with chronic pain:

  • cancer
  • fibromyalgia
  • spinal injury
  • headaches
  • arthritis
  • stomach ulcers
  • nerve inflammation or damage
  • mood and/or anxiety disorders







  • previous bad experiences with pain
  • insomnia
  • anxiety
  • depression


Symptoms and Complications



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Making the Diagnosis

Pain that lasts longer than 6 months and doesn't respond to treatment is diagnosed as long-term chronic pain.

Although it can be hard to describe pain exactly, your doctor needs to know how it feels and where it's coming from, what aggravates the pain, how it impacts your daily life, and what makes it better. Doctors often use pain scales to help to rate the intensity.

In some cases, people suffering from chronic pain who have symptoms at multiple sites, become debilitated due to chronic pain, or who are not responding to pain medication or require more may be referred to a pain specialist.

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Treatment and Prevention

Treatment for chronic pain blocks the pain signal anywhere in the pathway from the skin to the spinal cord nerves and from the spinal cord to the thalamus and cortex. Treatment ranges from traditional medications to alternative therapies.

Painkillers, also called analgesic medications, are often used to lessen chronic pain. Nonsteroidal anti-inflammatory drugs (NSAIDs) such as acetylsalicylic acid* (ASA), ibuprofen, and naproxen can provide some relief. Acetaminophen is also commonly used. These medications are usually tried first. If they are ineffective, stronger medications such as opiates might be added.

Opiates (also referred to as narcotics) such as morphine and codeine, relieve pain. Opiates have caused concerns because they have been linked to dependence and addiction. They are the strongest analgesics available and have significant potential to become habit-forming and to cause drowsiness, nausea, constipation, and itching.

Although many people are afraid of becoming addicted to opiates, addiction is extremely rare when the medication is being used to treat pain. Addiction involves a psychological need to abuse drugs that is different from tolerance (needing higher doses of medication to keep the same level of pain control) and dependence (experiencing withdrawal symptoms if the medication is stopped suddenly).

Anesthetics such as lidocaine and mexiletene (given as ointments, patches, or oral medications) can relieve severe chronic pain if they're taken slowly and steadily in very small amounts.

Corticosteroids reduce the pain of bone cancer and anticonvulsant medications such as carbamazepine relieve the pain of damaged nerves. Some types of antidepressants are also helpful for nerve-related pain.

Transcutaneous electrical nerve stimulation (TENS) directs electrical energy to the painful sites on the body and blocks the transmission of pain signals. The energy starts a natural reaction in the spinal cord that relieves the pain. Not all people respond to TENS, but it takes away the pain completely for some individuals.

If someone suffers from chronic pain that's carried by one or more specific nerves, they can have a nerve block, which temporarily or permanently stops the pain signal from traveling along that particular nerve. An injected anesthetic blocks the nerve from carrying the pain signals. 50% of people are cured of the pain, and the remaining 50% have the pain return within a year. People can also have the nerves destroyed by surgery or by hot or cold treatments. The pain can return, however, and some people may lose feeling or movement in the part of the body controlled by the destroyed nerve.

In extreme cases, implantable nerve stimulators can be placed in the spinal cord and be used to change the sensation from pain to parasthesia (tingling).

Acupuncture is used to treat many painful conditions, including migraine and back pain. In acupuncture, the acupuncturist will insert thin needles just under the skin at specific points on the body. Acupuncture probably stimulates natural anti-pain chemicals in the spinal cord. Relaxation and meditation techniques can help relax muscles, relieve anxiety, and stop the cycle of pain.

Biofeedback relieves chronic pain very well. In biofeedback, an instrument measures breathing, heart rate, and other specific bodily responses and feeds them back in the form of light or sound. People can then learn to control these bodily responses through relaxation and cognitive techniques.

Various forms of psychological treatments have been used to help relieve chronic pain. Cognitive therapy can help people substitute positive thoughts for negative ones. Behaviour therapy tries to change the activity level of people with chronic pain.
