If you are experiencing long-term or persistent pain that won’t go away, for example, back pain, it is likely to be affecting your day to day life and leaving you feeling low.
Most of the time pain will subside on its own, but rarely it can become long term and persistent, or what we call chronic pain.
The one thing that we want you to take away from this article is that there are steps you can take to manage your pain and to reduce the impact that it has on your life.
Why is this happening to me?
There are many different causes for chronic pain or persistent pain.
Pain can be easier to understand and accept if there is an obvious reason for it, for example, a cut or a bruise.
Other pain cannot be seen or explained in the same way such as back pain, but anyone who has had appendicitis will tell you that the pain is real.
Why is pain described in different ways?
Healthcare professionals use different terms for different types of pain:
Acute pain – used to describe short-term pain, such as a sprained ankle. Most acute pain settles or shows signs of getting better within eight weeks.
Recurrent pain – used to describe pain that comes and goes, such as a headache.
Chronic or persistent pain – used to describe long term pain that doesn’t go away, such as back pain.
It is not unusual to have more than one sort of pain, or to have pain in several places.
Acute pain clearly serves a purpose – it tells you that something is wrong and encourages you to take action by resting or treating the area.
Persistent pain appears to serve no useful purpose but can have a huge impact on your life.
What is pain?
Pain signals normally travel from the painful part of your body along thousands of specialised nerves, through the spinal cord and to the brain.
Pain signals are initially processed in the spinal cord and some pain relieving chemicals are released by your body to help manage the pain.
These pain signals continue to the brain where connections are made with other areas such as memory, anxiety, sleep, appetite and emotions.
This triggers the many experiences we all have when we are in pain, such as loss of appetite, difficulty sleeping and a short temper, which is all stored in our memory.
Why doesn’t my pain go away?
Pain signals can be ‘wound-up’ as well as ‘wound down’ by these other centres in the brain, which send messages down the spinal cord to increase or decrease pain.
If the ‘winding up’ keeps happening pain can feel like it’s getting worse over time even if the original injury has healed.
The system becomes over-sensitive to pain and this is why the pain doesn’t always go away.
Can my pain be fixed or cured?
Persistent pain is complicated and is not easily ‘fixed’.
Often it is necessary to try lots of different treatments and approaches to see if they help.
This is not because your physiotherapist or doctor doesn’t know what they are doing, but because pain is complicated and every pain and every person is different.
Unfortunately, you may still suffer from some level of pain because there may not be a complete cure.
This does not necessarily mean that it will get worse and it does not mean that continuing damage is being done.
Who can help me?
Speaking to your GP or a physiotherapist is the best place to start.
Understanding the pain is an important part of helping you to manage your pain and your physiotherapist will be able to talk to you about this.
They may refer you onto other professionals as sometimes a team approach may be helpful involving your GP, pain specialists, psychologists, physiotherapists, nurses and pharmacists.
What can I do to help myself?
Find ways to relax
Your mental health can have a big impact on your physical health and vice versa.
Living with persistent or chronic pain can easily lead to additional stress and anxiety, which we know can increase your feeling of pain and turn into a vicious cycle.
Don’t be afraid to get active
Being active is an essential part of your overall wellbeing and managing persistent pain.
Whilst your pain may not change when you are being active or moving, this does not mean that you should avoid activity all together or that it is doing you harm.
Many patients that we see with persistent pain fear ‘exercise’ because it may have caused them problems in the past.
Your physiotherapist will be able to help you find ways of moving and being active, not necessarily exercising.
Over time the pain may reduce as you get fitter, stronger and become less bothered by or aware of the pain.
Try to find an activity that you enjoy, as it will help you to stick to your routine and feel happier overall.
Set realistic targets each day and each month.
This could be something like attending a swimming class once a week, or smaller steps such as walking around the garden two times a day and getting dressed before 10am.
They need to be things that are important to you and that matter.
Carrying on physical activity to the point of unbearable pain or exhaustion isn’t helpful.
Don’t push through extreme pain and stay within your own limitations.
Break the activity you want to do into manageable chunks, with regular rests and you will succeed. It might take a little longer, but it will be worth it in the long run.
Many people refer to a sudden increase in pain as a flare-up.
Having a flare-up is unfortunately part and parcel of having a persistent pain condition and you may not be able to prevent them.
Having strategies to cope with and manage these phases are important and can help you to feel in control.
For example, practicing your relaxation techniques (see point 1) and taking pain medication with the advice of your doctor or pharmacist.
Sleep is an essential part of managing persistent pain.
We know that when you sleep well you can cope better with any discomfort or pain psychologically.
You may be thinking ‘easier said than done’ if pain is keeping you awake at night, but there are a number of practical steps that you can take to greatly improve your chances of getting the rest that you need.
Eating a balanced diet and maintaining a healthy weight will help you manage persistent pain.
This is because your body and mind needs the right nutrients to function properly and feel good.
Even if you are within your healthy BMI range, it’s still important that you get the nutrients you need and eat well.
Make time for enjoyment
Living with persistent pain can leave you feeling lonely and low at times, so try to do something that you can enjoy within your limitations each day.
This could be as simple as having a friend visit you or taking a bath with some scented candles, whatever works for you.
If you are struggling with your mobility then there are still plenty of activities that you can complete sitting down, such as painting or playing a musical instrument.
Socialise and connect
It’s important to recognise that the emotional impact of persistent pain may lead you to withdraw from socialising and can affect your relationships.
Try to maintain positive relationships with those around you, by managing your stress and talking to them about how you feel.
Don’t shy away from social events or opportunities for you to connect with others.
There are a number of local, national and virtual support groups and organisations for those living with chronic pain.
Some are for specific conditions and others are for all types of persistent pain.
Action-on-pain – Volunteer led charity offering a telephone helpline and a national network of support groups.
Pain Toolkit – Simple information about managing pain, handy tips and support.