Chronic Pain

Other ailments and conditions that can cause chronic pain

  • Broken bones

  • Virus infections such as shingles

  • Trauma

  • Joint problems such as arthritis

  • Back injury

  • Surgery in the spine

  • Joint injury and surgery

  • Surgery from cancer

  • Internal organ operations such as prostate or bowel

How Does Chronic Pain Occur?

Currently, one in five Australians including adolescents and children live with chronic pain. The prevalence rises to one in three people for those aged over 65. Injury is the leading trigger of chronic pain, with the most common injuries resulting from playing sport, car accidents and accidents at home or work.

Diabetes is also capable of causing chronic or persistent pain, as the high level of blood sugar irritates and damages the nerves, creating what is known as neuropathy – a form of nerve pain.

Any condition, even a small incident, that can cause a damaging change in the body can give rise to the continuing sensation of pain. If this pain lasts for longer than three months, we refer to this as chronic or persistent pain.

How does acute pain occur?

This type of pain occurs as the result of a particular illness, event or injury; and can be thought of as an alarm system alerting us to something that is not currently right in the body. Examples of acute pain are cuts, broken bones, childbirth and period pain. Acute pain normally does not persist past the time it takes the damage to heal (this may be a few days or weeks, though no longer than three months).

Treating acute pain

Acute pain will usually resolve through appropriate rest, and short-term use of pain relievers such as paracetamol and ibuprofen or (in the case of major events such as surgery or broken bones) stronger medications as prescribed by a doctor.

Diagnosis

Diagnosis and Treatment

Early Diagnosis

Early diagnosis is essential so that you understand what is happening to your body. It can be harmful if only the present symptoms are treated rather than the underlying cause. Once you have been diagnosed, it is important to quickly organise a treatment plan for your chronic pain, including a focus on the treatment of the underlying cause.

You should seek help for persistent pain when:

  • The pain has lingered for more than three months;

  • The pain is not responding to usual simple treatment and;

  • The pain is limiting your day-to-day function

Treating chronic pain

Like asthma or diabetes, chronic pain is treated as a long-term condition and is not seen as a symptom that can be easily fixed, but a condition that you can manage and control. Chronic pain management aims to reduce pain to improve your function and to help you undertake your daily activities and enjoy life despite pain. A chronic pain management plan may require input from several specialists, your General Practitioner (GP) and allied health professionals. As a starting point, reach out to your GP or MediADVICE Pharmacist for advice on managing your pain.

We know that pain management requires more than just medication and may include non-medical products such as TENS machines, heat and cold packs, braces and more active therapies like relaxation exercises, graded physical activity and mindfulness to name a few.

Medication

Do I need medication to manage my chronic pain?

Managing chronic pain is most often achieved through a combination of medicinal and non-medicinal therapies. Most pain relievers only decrease pain by 30% to 50% and therefore it is important to consider additional treatment methods other than medications alone.

In rare cases, long-term use of pain medications like opioids can cause the nervous system to become more “switched on”, causing you to become more sensitive to pain. If you experience the below symptoms when taking pain relief medication, it is important to see your GP or pharmacist.

  • Become more sensitive to pain

  • Pain continues even after doses of pain relievers are increased

  • Experience a change in pain sensations and previously non-painful sensation feel painful

As your pain experience changes, your pain relievers may need to change too. Depending on the medication, it can be best to gradually reduce the dose when changing to something else. With any change, doing this with the support of your GP and pharmacists is always recommended. Having your medications reviewed every three to six months by your pharmacist is important to maintain safety and effectiveness at all times.

What medications are used to treat chronic pain?

Non-prescription pain-relievers

Non-prescription pain-relievers can include paracetamol, anti-inflammatory pain relievers, combination products, complementary medicines, topical analgesic creams and specially compounded products.

Prescription pain relievers

If your pain is not controlled by a non-prescription pain reliever, your doctor can prescribe other pain relievers and medicines to suit your type of pain.

What pain medication is right for me?

Unsure if you should continue with your current pain relief medication? Speak with your GP or MediADVICE pharmacist who can advise on what pain medication is right for you. When you discuss this with a health professional, make sure to ask the following questions:

  • What are my options to treat chronic pain?

  • How likely are they to help?

  • When should I expect them to start working?

  • What level of pain relief should I expect?

  • If they don’t completely take the pain away, how do I know if they are helping?

  • What goals should I be achieving by taking this medication?

  • How long do I need to take them?

  • How much and how often do I take the medicine?

  • Do I need to take the medicine with anything or avoid things when I take the medicine?

  • What are the possible side effects? What should I do if I have them?

  • How do I safely start and stop chronic pain medicines?

  • Are there alternative forms of treatment, besides medicine, that can treat chronic pain?

  • What else could I be doing to help my pain?

Difference between chronic and acute pain

Acute pain is usually the result of an injury that causes tissue damage or swelling, or from a medical intervention such as a surgical operation.

  • In most circumstances, acute pain fades as the injury or damaged area heals and lasts for only a few days or weeks.

  • Acute pain is considered normal as it is a necessary form of pain that acts as an alarm system, stopping us from doing things that could cause further damage to our bodies.

Chronic pain, on the other hand, is usually a result of an injury from which the body has “recovered”, but the pain sensation still remains.

  • Chronic pain can be classified as pain that continues for three months or more and unlike acute pain, continues beyond the point of healing.

  • For this reason, chronic pain can be quite distressing and can lead to other changes in the central nervous system and body.

If the pain of this type is addressed early, these changes can be reduced and people can return to normal function. Identifying what contributes to a person’s chronic pain is important when deciding the best tools to help. Pain relievers should be reviewed every 3 to 6 months. Your Pharmacist or GP can also help to identify the type of pain you are experiencing and the best treatments to suit that pain.

If you’re experiencing pain, we are here to help. Our pharmacists are here to support you in managing your health. Simply speak with one of our pharmacists about your symptoms so we can identify the type of pain you are experiencing and recommend products and holistic treatments to suit that pain and help provide relief.

General advice only – this information should not replace the information provided to you by your health care professional. If symptoms are severe or persist, please speak to your health care professional. Information current as of date of publishing.

https://aci.health.nsw.gov.au/chronic-pain/painbytes/introduction-to-pain/what-is-acute-pain-and-chronic-pain

Chronic Pain

Pain that tends to last longer than 6 months can be termed chronic.

What to look for

The condition may include weakness, numbness, tingling, or other sensations, along with sleeping difficulties, a lack of energy, and depression. Some common forms of chronic pain are:

  • this type of pain can include headaches, muscle, back or joint pain that is enduring and debilitating or uncomfortable.

This type of pain can be sporadic, continuous, uncomfortable or Chronic pain can be mild or agonising.

The areas described above are the most common, however chronic pain can also include Achilles problems, sinus, other forms of degenerative joint disease, carpal tunnel syndrome, and localised pain.

The state of your mind has a lot to do with your perception of pain. And your state of mind is influenced by the surroundings you find yourself in and your attitudes as well. The psychological effect pain can have on us is substantial. Persistent severe pain can erode our natural threshold to pain and cause our personality to alter as a result. We can tend to perceive the pain as worse than it actually is or that it is becoming worse and worse. The immune system may also become affected adversely from persistent pain.

Causes

The causes of chronic pain are many and varied, some possible causes are as follows:-

  • aging (may affect bones and joints)

  • nerve damage and injuries that fail to heal properly.

  • Back pain

  • being overweight

  • curvature of the spine

  • to a traumatic injury

  • or to no obvious physical cause.

Disease can also be the underlying cause of chronic pain.

Sometimes it is a very difficult thing to pinpoint the exact cause of the pain as any possibility alludes healers and doctors. A process of elimination is then commenced to find the cause.

Traditional Treatment

People who suffer from chronic pain may need professional help.

The aim in many cases is not only to alleviate pain but also to teach the chronic sufferer how to come to terms with pain and function in spite of it. The first step in many cases is to wean the patient from a dependence on pain killing medications.

Other methods used by pain specialists include relaxation techniques to control brain-wave activity, behaviour-modification therapy to revise the way pain is perceived, acupuncture, hypnotherapy, meditation, and other forms of alternative therapy.

Over-the-counter pain killers can control milder cases of musculoskeletal pain and reduce inflammation.

Your doctor may prescribe stronger drugs if these others do not help.

Alternative Choices

A broad array of alternative options exists to address chronic pain.

Aromatherapy – Mix together the following essential oils with a carrier oil such as sweet almond, apricot kernel, or jojoba oil, and massage the blend into your skin at the site of the pain: lavender (Lavandula officinalis) to reduce inflammation and relax muscles; eucalyptus (Eucalyptus globulus) to bring down swelling and accelerate healing; ginger (Zingiber officinale) to relieve pain and stiffness associated with arthritis and other types of degenerative joint disease.   See Our Aromatherapy Section. Mix together the following essential oils with a carrier oil such as sweet almond, apricot kernel, or jojoba oil, and massage the blend into your skin at the site of the pain: lavender (Lavandula officinalis) to reduce inflammation and relax muscles; eucalyptus (Eucalyptus globulus) to bring down swelling and accelerate healing; ginger (Zingiber officinale) to relieve pain and stiffness associated with arthritis and other types of degenerative joint disease.   See Our Aromatherapy Section.

Massage – Massage therapy may provide temporary relief of muscle tension, stiffness, and spasms. Massage therapy may provide temporary relief of muscle tension, stiffness, and spasms.

Herbal Therapies – Capsicum, the active ingredient in cayenne (Capsicum frutescens), is believed to increase blood flow to joint tissues, thereby reducing inflammation. Capsicum, the active ingredient in cayenne (Capsicum frutescens), is believed to increase blood flow to joint tissues, thereby reducing inflammation.

An over-the-counter ointment made with cayenne may bring temporary relief of osteoarthritis and rheumatoid arthritis, although it is very hot and should be used for only short periods.

Infusions of black cohosh (Cimicifuga racemosa) or evening primrose oil (Oenothera biennis) may also lessen inflammation. Rubbing a dilution of peppermint (Mentha piperita) oil on the affected area may have a temporary numbing effect.

Topically applied dilutions of wintergreen (Gaultheria procumbens) oil, which contains a substance similar to what is found in aspirin, may have an analgesic effect. Geranium (Pelargonium odoratissimum) and white willow (Salix alba) bark are also natural painkillers. Chamomile (Matricaria recutita) may also be helpful.

You must take special precautions if you are pregnant.

Homoeopathy – Try Rhus toxicodendron for joint, back, and arthritic problems that feel worse when first rising in the morning and become better with warmth. Persistent pain may be relieved by Kali bichromicum. Calcarea fluorica.Sepia may be good for lower-back pain that is worsened by sitting. Try Rhus toxicodendron for joint, back, and arthritic problems that feel worse when first rising in the morning and become better with warmth. Persistent pain may be relieved by Kali bichromicum. Calcarea fluorica. Sepia may be good for lower-back pain that is worsened by sitting.

Topical homoeopathic creams that have Arnica as a main ingredient can help with muscle and joint pain.

Lifestyle

You should take some time out when you feel the pain, however too much rest in also not going to do your problem much good – it can actually make your muscles weaker and cause more pain eventually.

Research has shown that regular exercise can diminish pain in the long run by improving muscle tone, strength, and flexibility and also release the body’s natural pain killers to help you. Try low impact types of exercise.

Visualisation may be another worthwhile pain-controlling technique – seek out places in your area that teach this very worthwhile technique.

Hypnotherapy and self-hypnosis may help you block or transform pain through refocussing techniques.

Relaxation techniques such as meditation or yoga are also very helpful for chronic pain sufferers.

Dietary Considerations

Certain supplements have been known to help tremendously with chronic pain. These are:- DL-Phenylalanine (amino acid), Valerian, white willow bark.

See the entry for rheumatoid arthritis and allergies for dietary considerations and foods to eat and avoid.

At-Home Remedies


Remember “RICE”

– Rest – Rest

  – Apply ice to the affected area  – Apply ice to the affected area

C  – Compress the area  – Compress the area

E  – Elevate the area.  – Elevate the area.

  • Take herbal remedies suggested by a qualified herbalist

  • Do some low-impact exercise.

When to seek further professional advice

  • your pain continues for several weeks and doesn’t respond to over-the-counter products or rest

     

     

     

Scroll to Top

Upload Prescription

Log In