Chronic pain is pain that lasts longer than three months. It is often present all the time but can be intermittent and it can vary in severity. Sometimes the cause of the pain is apparent but often there is no evidence of tissue damage.
Persistent pain can significantly interfere with quality of life and can be made worse by the anxiety, stress and anger that often accompany the pain.
Pain medication is often unhelpful and can have unpleasant side effects. It has been shown that the best management of patients with chronic pain is provided by a multidisciplinary team of individuals who can address psychological as well as physical aspects of the condition to help patients manage their pain and improve their quality of life.
It is important to rule out an underlying problem that requires treatment but often there is not a clear underlying cause that can be treated.
What are the symptoms of Chronic Pain?
It can often be difficult to find the right word to describe pain as it may just be very unpleasant. Pain does not usually exist alone. Other problems associated with pain can include:
- Disturbed sleep
- Changes in mood such as irritability and depression
- Withdrawal from normal activities such as work and social events
If I have pain, there must be something wrong?
Pain is a sensation that allows us to be aware of an injury or illness which is why underlying problems need to be excluded. However pain mechanisms can go wrong just as other parts of your body can go wrong.
Sometimes an injury can cause the pain, sometimes it is not clear why the pain started.
Once the pain pathways are activated, changes can occur in the body that prevent these pathways from switching off even after an injury has healed. This then leads to long-term pain. This pain can be associated with other sensations – increased sensitivity, strange feelings in the affected area, changes in temperature sensation etc.
Is there a cure for chronic pain?
Unfortunately, persistent (chronic) pain is very common, and affects millions of people in Britain.
Most people will find the treatments aimed at relieving their pain will only help to some extent. For some people medication and other treatments (e.g. acupuncture) are used alongside other pain management strategies that may help you to live with your pain condition.
There are many ways that people can learn to manage their pain and to improve their quality of life. We specialise in helping people to explore different ways to move forward in life, even when the pain can't be cured.
If I just ignore it the pain, will go away?
Ignoring the pain is one way of trying to cope but, as you may have found, this can be hard to do. It rarely leads to the pain disappearing and for some people it can lead to more difficulties in the longer-term.
However, many people with chronic pain find that learning different pain management skills can help them to feel more able and confident to manage their pain.
How will talking about my pain help?
Patients referred to the Pain Management Programme (PMP) or to Backpack will have an individual assessment prior to joining the courses. This is an opportunity to talk to one of our specialists about the pain and the effects of the pain on your life. This assessment involves talking about the pain: where it is, how long it has been present, what makes the pain worse and easier, and the effects of the pain upon mobility, sleep and life in general. This appointment will help the healthcare professional understand more about your pain problems and help you to reach a decision about whether one of our programmes could be helpful to you.
We know that just talking about the pain wouldn't be helpful for many of the people that we see. During the programmes, our focus is upon finding helpful ways to move forward in life by making changes, such as developing pain management skills and strategies, and this involves more than just talking.
People who attend our courses often find it helpful to have the support and encouragement of other people who have similar problems.
You are of course free to choose how much you talk about your own situation with other people on the course.
Why is there a psychologist involved in some of the programmes?
Some people are concerned that there is a psychologist involved in some of the assessments and programmes (such as the Pain Management Programme, and Backpack) as they may worry that the psychologist may think that the pain is "all in the mind". This is not the reason that psychologists work in our service, as we know that your pain is real. However, persistent pain can have an effect on people's thoughts and feelings, and those thoughts and feelings can have an effect on the pain. Persistent pain can also affect relationships with people around the person with pain. Over time, many people work out their own ways of coping with these difficulties, but the specialist pain psychologist can often help to explore different ways of managing pain.
Will I need a physical examination during the assessment?
If you see a specialist pain doctor it is likely you will be examined.
A pain psychologist will carry out the initial assessment for a Pain Management Programme and a physical examination is not required.
Those joining a Pain Management Programme will have an assessment with a specialist physiotherapist at a later stage who will be looking to see what movement is manageable at the start of the course and to monitor progress as the weeks go by.
Most people who attend a Pain Management Programme will have better mobility at the end of the course, but we only know this by looking at somebody's mobility before they start.
The initial assessment for Backpack, following the information meeting, does involve a physical examination. The physiotherapist will want to see how the pain may have affected your posture, movement and strength. The examination will go at your own pace, and provides useful information for the patient and the physiotherapist during the course.