Have you ever woken up one morning with pain you can’t explain? Or a midday headache that won’t go away?
Most people treat their pain with rest, heat or ice, and over-the-counter pain medications. In a few hours or days, they’re back on their feet. For people with chronic pain, though, these home remedies just don’t cut it. If you lived day in and day out with that pain, how would it change your life?
Chronic pain is a very real and widely misunderstood condition. While everyone experiences chronic pain differently, someone who lives with pain every day may need a wide mix of treatments, medications, therapies, and coping skills to manage not only their daily discomfort, but the mental health impacts that come along with it.
But what causes chronic pain? And what can we do to help our loved ones with chronic pain? In this article, we answer the most frequently asked questions about chronic pain, including:
What is chronic pain?
Are there different types of chronic pain?
What is the difference between chronic pain and chronic discomfort?
What are the symptoms of chronic pain?
What causes chronic pain?
How is chronic pain diagnosed?
Who is at risk of developing chronic pain?
How is chronic pain treated?
Why is it sometimes difficult for people with chronic pain to find treatment?
Is chronic pain a disability?
Where can I get more information about chronic pain?
What is chronic pain?
Simply put, chronic pain is any recurring pain that lasts for more than three months. This pain may be constant, or it might come and go. Sometimes, this pain comes from an underlying condition that can be treated, but chronic pain often has no obvious cause.
According to a 2021 study from the US Centers for Disease Control and Prevention (CDC), about 20.9% of American adults, a whopping 51.6 million people, experience chronic pain. Organizations like the Institute of Medicine and the American Society of Anesthesiologists put this number even higher, at over 100 million US adults.
Pain is the body’s way of telling us that something is wrong. Think of it like an alarm bell going off in your brain. If that alarm went off, day after day, for months or for years, how would that affect your life?
The effects of this condition are more than physical: someone living with chronic pain may also find their mental health, emotional health, job prospects, and social circles affected.
Are there different types of chronic pain?
Yes. Chronic pain can affect one part of the body or many.
Types of chronic pain include:
Joint pain, like pain associated with arthritis
Pain that feels like it’s in your bones (“achy bones”)
Headaches or migraines
Neck pain
Nerve pain (also called neuropathic pain)
Back pain or lower back pain
Pain associated with cancer treatments
What is the difference between chronic pain and chronic discomfort?
Chronic pain is a type of chronic discomfort, a collection of unpleasant symptoms or side effects that create unpleasant, recurring feelings in someone’s daily life. While pain can be a type of chronic discomfort, it is not the only example.
Chronic discomfort might appear as:
Vertigo, a common symptom of many chronic conditions that can cause problems with balance, vision, lightheadedness, and nausea
Dizziness or lightheadedness
Fatigue or exhaustion
Nausea and other gastrointestinal issues
Muscle spasms or cramps
Circulation problems, which can cause difficulties with temperature regulation
Difficulties with homeostasis, or your body’s natural internal rhythms and processes
Conditions that can cause chronic discomfort include:
Chronic fatigue syndrome (CFS), extreme, long-lasting exhaustion beyond regular tiredness
Ménière’s disease, an inner ear condition that affects balance and hearing
Hyperhidrosis, a condition that causes excessive sweating
Autonomic dysfunction (AD), also called dysautonomia, or problems with your body’s autonomic nervous system (responsible for maintaining your body’s automatic functions like breathing, sleep, blood pressure, balance, and temperature regulation)
Postural orthostatic tachycardia syndrome (POTS), a condition that affects your heart rate and blood flow, often leading to fainting, balance and movement difficulties, and fatigue
Tinnitus, a condition that causes constant ringing or buzzing in your ears
What are the symptoms of chronic pain?
Pain may occur in any part of the body. It can be constant, or it might go away for a few hours or days before coming back. The pain might:
Sting
Ache
Throb
Burn
Feel like it’s shooting from one spot to another
In addition to the pain itself, a variety of symptoms accompany chronic pain. These include:
Fatigue, insomnia, or other sleep and energy problems
Stiffness
Swelling or inflammation
Movement difficulties
When left untreated, the pain and its side effects can lead to:
Mental health problems like depression or anxiety
Irritability or mood swings
Social difficulties, relationship changes, or social isolation
Guilt or shame, especially if the pain affects someone’s social life
Pain medication dependence, which can lead to substance abuse issues
Job loss or inability to work
Suicidal ideation
When these additional symptoms appear, doctors may refer to the condition as chronic pain syndrome.
What causes chronic pain?
Part of what makes chronic pain so difficult to diagnose and treat is that it can be caused by any number of underlying injuries or conditions.
Just a few conditions linked to chronic pain include:
Arthritis, especially rheumatoid arthritis and juvenile arthritis
Muscle strain or sprain
Repeated stress injuries, or movements that put pressure on the same parts of the body over and over (common in people who play sports or work on their feet)
Injuries like broken bones or injuries that never heal correctly
Surgery recovery
Fibromyalgia, a condition that affects muscles all over the body
Lyme disease
Nerve damage
Brain damage, especially traumatic brain injuries
Cancer
Gastrointestinal issues like Crohn’s disease, inflammatory bowel disease (IBD), or irritable bowel syndrome (IBS)
Ulcers or acid reflex
Endometriosis or polycystic ovary syndrome (PCOS)
Phantom limb pain, or feeling pain in a limb that has been amputated
How is chronic pain diagnosed?
Because there are so many conditions that can cause chronic pain, chronic pain syndrome is often hard to diagnose. Doctors don’t know exactly what causes it, and some types of pain are resistant to standard treatments like physical therapy or pain medication.
A typical chronic pain diagnosis is based on:
A complete physical examination to rule out conditions and try to find the source of the pain.
An interview in which the doctor asks questions about your pain, including how long it’s been happening, where it hurts, and what treatments you’ve already tried.
Imaging tests like computed tomography (CT) scans, magnetic resonance imaging (MRI), or x-rays.
Muscle and nerve reaction tests, like electromyography (EMG) tests or nerve conduction studies.
Blood, urine, and spinal fluid tests, in addition to others that help to diagnose and rule out other conditions.
Balance and reflex tests, which help identify problem areas that might be affecting the pain.
A review of your previous medical history, like past x-rays or medical records.
Your family’s medical history, especially if someone in your family also deals with chronic pain.
Questionnaires or other studies to rate your pain and keep track of it.
Once you have a chronic pain or chronic pain syndrome diagnosis, your doctor may refer you to a specialist like an anesthesiologist or pain medicine practitioner.
Who is at risk of developing chronic pain?
Chronic pain can affect anyone regardless of age, gender, race/ethnicity, or medical history. Some factors, however, can increase your risk of developing chronic pain.
These include:
Age, as “wear and tear” on your muscles and bones increases.
Genetics, if chronic pain or conditions that cause it run in your family.
High stress, including frequent stress, recurring stress, or post-traumatic stress disorder (PTSD).
Smoking, which makes people three times more likely to develop lower back pain.
Obesity, which can put extra weight and pressure on painful parts of the body.
Working in a manual labor or high-intensity job, like warehouse work, stocking, waiting tables, or construction.
Previous injuries, especially those that required surgery or were left untreated.
How is chronic pain treated?
If the pain can be linked to an underlying condition, treatment focuses on that condition as well as pain management. If doctors don’t know where the pain is coming from, treatment focuses more on managing the symptoms and finding day-to-day coping strategies to lessen the pain’s impact on your life.
Typical treatments for chronic pain include:
Over-the-counter medications or non-steroidal anti-inflammatory drugs (NSAIDs) like ibuprofen, aspirin, and acetaminophen.
Heavier-duty pain medications like opiates and other controlled narcotics.
Medications to treat other conditions, like antidepressants, steroids, or some anti-seizure medications that have shown a positive impact on pain levels.
Physical therapy, occupational therapy, and other therapies that focus on building strength, improving range of movement, and relieving pain.
Surgery, if that will help the underlying cause.
Traditional forms of talk therapy, like cognitive behavioral therapy (CBT) or family therapy. The goal of these sessions is to learn day-to-day coping skills for pain management.
Alternative therapies, like medical cannabis, acupuncture, massage therapy, or relaxation and meditation techniques.
Experimental therapies, like essential oils, visualization, and some Eastern medicine techniques. Check with your doctor before starting any alternative therapy, as many experimental therapies lack in-depth studies or have not been approved by the Food and Drug Administration (FDA).
Lifestyle changes, like weight loss, dietary changes, quitting smoking, and low-intensity exercise programs.
In addition, some people keep track of their pain levels, mental health, medications, and other information through specialized apps. Information stored in these apps can be helpful for doctors as well, to track how well a treatment or medication is working.
Why is it sometimes difficult for people with chronic pain to find treatment?
Chronic pain is a complicated condition, which makes diagnosing and treating it difficult. Pain in general is an under-studied science, and the complicated social opinions toward things like the over-prescription of opioids and the subsequent opioid crisis, unconventional pain treatments, and medical cannabis usage have created an unfortunate social stigma against people living with chronic pain.
In addition, some people with chronic pain struggle to get their symptoms taken seriously. Because it is an “invisible illness,” often without visible symptoms, some people have their symptoms dismissed entirely by the medical community. Others have lived with chronic pain for so long that their pain tolerance has increased or they’ve become better at masking their symptoms, which can make doctors and loved ones stop believing that their pain is actually so severe.
Until the medical industry knows more about the science of pain, and until the general public accepts that chronic pain syndrome is a real and difficult condition, many people will have trouble accessing the care they need.
Additionally, people with chronic pain may not be able to access care because of:
Poor transportation options, if they don’t have a car, can’t afford to take public transit, or have movement disabilities associated with the pain.
Cost of care and medication, especially if they have lost their job or cannot work because of their chronic pain.
Medication tolerance, when the body gets used to a medication and needs higher and higher doses to get the right effect.
Psychological and emotional factors, if they fear their pain, worry about what their friends and family will think, or are overwhelmed by poor mental health related to their pain.
Is chronic pain a disability?
It depends. Some people with chronic pain can manage their pain with simple treatments like physical therapy and over-the-counter medications. Others have more severe pain that impacts their daily life, making it hard to complete their daily routines, work, sleep, or communicate with others. This type of pain is called high-impact chronic pain.
The Americans with Disabilities Act (ADA) protects people’s right to equal employment opportunities and accommodations or modifications at work. The ADA does not cover a specific list of conditions; instead, it offers protections to anyone with a disability that “substantially limits” their day-to-day life.
High-impact chronic pain may be considered a disability in some cases, but it’s often hard to prove, especially when trying to access things like legal assistance or Social Security payments. Contact an employment lawyer or Social Security representative in your state to learn more about your rights.
Where can I get more information about chronic pain?
To learn more about conditions that cause chronic pain, check out our full Portal of educational resources. We recommend starting with:
In addition, Ability Central offers a collection of resources to help people with disabilities understand their rights and manage their care, including:
To find community organizations near you that help people with chronic pain and associated conditions, check out the Ability Central Service Locator tool. This nationwide database offers contact information for thousands of nonprofits, community organizations, and more offering support for people with conditions like CPS.
Additional Information
The content provided in this article is for informational purposes only and is not intended as a substitute for legal, medical, or other professional advice. While we strive to provide accurate and up-to-date resources, some information may become outdated or incomplete. Always consult with your provider about personal medical concerns.
