What is Chronic Pain?

Chronic pain is a type of pain that lasts longer than three months and feels like it’s not getting any better. There are many conditions that can cause chronic pain, and sometimes the cause is unknown. The management of your chronic pain can depend on your specific condition and other needs.

In this guide we go through all of your options for managing chronic pain.

Chronic pain definition

What does chronic pain mean?

Chronic pain is any pain the lasts longer than 3 months. Pain can be an unpleasant physical or emotional experience caused by actual or possible damage to our bodies.

An example of chronic pain is knee pain that doesn’t go away after three months. You might need to take medicines or practise daily exercises to manage the knee pain. Acute pain only lasts a short time, such as pain after twisting your ankle.

For some people there is an obvious ongoing cause of the pain. For others the cause of the pain has gone, or there was no obvious cause to start with. Every person’s pain is as unique as they are and should be managed individually.

Chronic primary pain

Chronic primary pain is a type of long-term pain where there is no obvious cause for the pain. The pain is a condition in its own right, and not due to an illness or injury.

Chronic primary pain can be difficult to explain to others because it’s not related to any visible injury or condition they can see. It can affect your overall mental and physical health. This should be taken into account when your healthcare team is helping you manage your pain.

Chronic secondary pain

Chronic secondary pain is a type of long-term pain that’s caused by an underlying health condition.

There are many conditions that may lead to you getting chronic secondary pain. These include arthritis, joint damage, back injuries and cancer.

In chronic secondary pain, your pain becomes a problem in itself. It does not feel like a symptom of another illness. Chronic secondary pain may continue even after the health problem has been treated.

Chronic secondary pain is treated and managed in a similar way to chronic primary pain, because they are both types of long-term pain.

Acute vs chronic pain

Acute pain is a short-term reaction to a disease or injury to your body. While acute pain can feel severe at the time it happens, the pain itself will stop once the injury or disease has gotten better.

Chronic pain lasts for more than three months. It can occur due to a condition or even when there is no injury or disease. It can also continue after a pain-causing illness has gone away.

Chronic pain is associated with other physical and mental health problems such as anxiety and depression. If you have chronic pain, it can be managed by your doctor, at a pain clinic or in hospital if needed.

Causes of chronic pain

Common causes of chronic pain

There are many common causes of chronic pain. These can include problems with the muscles, bones and joints, such as arthritis and back pain. Other causes include injury to nerves, cancer, or surgery.

Chronic primary pain is pain in its own right, without any other obvious cause. Chronic secondary pain is due to an underlying illness or injury. Your illness or injury may have healed or got better, but the pain continues.

Whether there is an underlying cause for your chronic pain or not, there are many options to improve what you can do and how you feel.

Chronic pain symptoms

Common symptoms of chronic pain

Common symptoms of chronic pain include:

  • Dull throbbing in the area of pain
  • A sudden sharp pain once every so often
  • Tingling or numbness in the area
  • Finding it difficult to move around due to the pain
  • Feeling unable to sleep well because of the pain
  • The pain getting worse when you make certain movements
  • Lingering pain that you need medication for to carry on with your day

Your experience of chronic pain is unique to you. Pain can be constant, or it comes and goes. You might find there are specific triggers that can increase how much pain you feel. This sudden increase in pain is known as a flare-up.

Some people with chronic pain have what we call neuropathic symptoms. These are unusual feelings that may be due to nerve damage. They are often described as a burning, tingling or numb feeling in the area where they get pain.

Chronic pain conditions

Common conditions that cause chronic pain

Your chronic pain might be from another source or have no obvious condition causing it.

It’s worth seeing a medical expert, such as a doctor that specialises in chronic pain, to understand your needs and help you manage your chronic pain. They can also try to determine what the cause of the chronic pain could be and offer effective ways to treat it.

Common conditions that cause chronic pain include bone, muscle and joint issues, such as:

Arthritis
Repetitive stress injuries
Broken bones
Back pain

Problems with the brain or nerves can cause chronic pain, including:

Headaches
Nerve damage

Pain from internal organs that can cause chronic pain include:

Irritable Bowel Syndrome (IBS)
Endometriosis
Cancer
Surgery

Chronic pain treatment

NICE chronic pain guidelines

The NICE chronic pain guidelines help doctors and other healthcare professionals in the UK decide how to treat chronic pain.

In the NICE chronic pain guidelines, they state that the team that treats you should:

  • Focus on treating you as a whole, rather than just your condition
  • Think about other possible causes of your pain
  • Ask how your pain affects you
  • Ask about activities that affect your pain
  • Provide you with advice and information
  • Develop a care and support plan, including how to manage flare-ups of pain

There are specific NICE chronic pain guidelines for conditions like:

For chronic primary pain, NICE recommends these chronic pain treatments:

  • Exercise and general daily physical activity
  • Psychological therapy, such as acceptance and commitment therapy (ACT), or cognitive behavioural therapy (CBT)
  • Acupuncture
  • Medication, starting with antidepressants

Ways to relieve chronic pain

Here are some helpful ways to relieve chronic pain without medication:

  • Staying active – find what you can manage to do each day, and work your way up to 30 minutes per day
  • Reducing stress – this can include mindfulness meditation, thinking of ways to relax or considering seeing a professional therapist
  • Social activities – these can include meeting with other people who can share how they manage their chronic pain
  • Seeing a physiotherapist if the chronic pain is due to bone, muscle or joint problems
  • Speaking to a doctor that specialises in chronic pain treatment

You may need to try more than one way to relieve chronic pain, and some ways will work better for you than others.

Medications used for chronic pain

Medications that are used for chronic pain include those you can buy yourself without a prescription. These are called over the counter (OTC) medications which you get from a pharmacy, and include:

  • Paracetamol
  • Non-steroidal anti-inflammatory medicines (NSAIDs), such as aspirin, ibuprofen or naproxen
  • Co-codamol, which contains codeine and paracetamol
  • Codeine with ibuprofen

Some medications need to be prescribed by a doctor and include:

  • Different NSAIDs, such as diclofenac
  • Amitriptyline
  • Pregabalin
  • Gabapentin
  • Opioid medicines, such as codeine, dihydrocodeine, tramadol, morphine, buprenorphine, fentanyl or oxycodone
  • Lidocaine patches
  • Capsaicin
  • Medical cannabis, from a doctor that is a specialist prescriber

In pain clinics or hospitals, doctors might suggest an injection to areas that are causing chronic pain. These injections may contain corticosteroid medicines to reduce swelling and numb pain. They can relieve chronic pain for a long time. In some cases, pain can be relieved for a few months or years.

Arrange an Appointment

If you are a patient or carer seeking an appointment to discuss treatment with medical cannabis, you can complete this form and we can assist you with this.

Eligible patients can provide us with their healthcare records or we can obtain these through your GP. This is to confirm that a patient’s condition has been fully assessed and all other treatment options have been attempted. We will ensure that the primary care provider receives all treatment communication to maintain the highest level of clinical governance.

We also accept referrals from healthcare professionals.

To refer a patient to us, please click here to fill and securely submit a referral form.

Chronic pain clinics

Most chronic pain clinics are run by the NHS. You can be referred to one of these clinics by your GP. Some private chronic pain clinics are available and you may be able to refer yourself to these. For example, Sapphire Medical Clinic is a pain clinic that your doctor can refer you to, or you can refer yourself.

Chronic pain clinics usually consist of more than one type of healthcare professional. You may see more than one person when you visit a clinic. Pain clinic staff include:

  • Specialist pain doctors
  • Specialist pain nurses
  • Pharmacists
  • Physiotherapists
  • Occupational therapists
  • Psychologists or counsellors

After you have an appointment at a pain clinic, you should have a plan that will help you to manage your pain better.

Chronic pain FAQs

What is the role of physiotherapy in chronic pain?

The role of physiotherapy in chronic pain is that it can be used as an effective treatment of chronic pain. Officially, the NICE chronic pain guidelines recommend physiotherapy and physical activity as chronic pain treatments.

Many pain clinics have physiotherapists as team members. They can help you manage your chronic pain in several ways, such as:

  • Using a supervised exercise program, where they find exercises that allow you to remain active and relieve chronic pain
  • Manual therapy, where they move parts of your body where you feel pain to relieve it
  • Therapies like acupuncture, where very fine needles are placed in the skin to relax muscles and stimulate nerves to relive chronic pain

The NICE chronic pain guidelines advise that exercise programs and physical activity are a core part of managing chronic pain. Physiotherapists are experts in helping suggest which activities and exercises can help you with your specific chronic pain needs.

Is cognitive therapy for chronic pain effective?

Cognitive therapy is a type of cognitive behavioural therapy (CBT). It’s also known as psychotherapy or a talking therapy. The NICE chronic pain guidelines recommend both CBT, and acceptance and commitment therapy (ACT) as effective chronic pain treatments.

Pain clinics are likely to have a psychologist, therapist, or trained counsellor as part of their team to provide cognitive therapy for chronic pain.

With psychological therapies, you need to try them for a while to see if they’ll work for you. You might find some of the techniques you learn through ACT or CBT are helpful and an effective way to treat chronic pain long term.

Is acupuncture for chronic pain effective?

Acupuncture is a chronic pain treatment that is recommended in the NICE chronic pain guidelines. With acupuncture, very fine thin needles are placed in specific places in the skin to relax muscles and stimulate nerves to relieve chronic pain.

Acupuncture can give you short or long-term pain relief depending on the type of chronic pain you are treating. You may need to get acupuncture more than once for it to be an effective chronic pain treatment. Normally, you’ll have one or two sessions of acupuncture per week for a few months.

It’s important to make sure you get acupuncture treatment for chronic pain from a qualified healthcare professional, so we recommend that you get acupuncture at a pain clinic or with a certified physiotherapist.

Can I buy painkillers for chronic pain?

Some painkillers are available without a prescription, and these are called over the counter (OTC) painkillers you can get from a pharmacy.

Over the counter painkillers for chronic pain include:

  • Paracetamol
  • Non-steroidal anti-inflammatory medicines (NSAIDs), such as aspirin, ibuprofen or naproxen
  • Co-codamol, which contains codeine and paracetamol
  • Codeine with ibuprofen

A pharmacist will be able to advise you on which over the counter painkiller is right for your chronic pain. If you need to use OTC painkillers regularly or find that they’re no longer helpful, you should see your doctor for advice and to get different medicines.

You can see a doctor that specialises in treating chronic pain or try going to a pain clinic for chronic pain treatment.

Is chronic pain hereditary?

There’s some evidence that chronic pain can be hereditary. This means it’s caused by genes that you get through your parents and there’s a higher chance that you’ll have chronic pain at some point in your life.

One condition which might cause hereditary chronic pain is fibromyalgia. Fibromyalgia is often experienced as widespread body pain with other symptoms, such as tiredness and concentration problems. Having a close relative with fibromyalgia makes it more likely that you’ll have it and get chronic pain as a result.

There is less evidence for other chronic pain conditions being hereditary at the moment, but more research is being done by scientists to find out more.

How can I sleep with chronic pain?

To help you sleep when you have chronic pain, you can try:

  • Setting an alarm an hour before bed to get ready to sleep
  • Having a bedtime routine, such as having a shower, brushing your teeth and then reading a few pages of a book
  • Going to sleep and waking up at a regular time every day
  • Meditating before bed to help you relax, even if it’s just for a couple of minutes
  • Writing down any thoughts on your mind into your journal or a notepad
  • Time your chronic pain medication around your sleep time, so it lasts all night
  • Listen to calming music or podcast
  • Gentle stretching to relieve tension in the area you’re experiencing chronic pain

If you find it difficult to sleep throughout the night and wake up every few hours, you may want to consider seeing a specialist doctor. A pain clinic can offer you advice and chronic pain treatment options.

How can I manage chronic pain naturally?

You can manage your chronic pain naturally, which means without taking medications or having medical interventions. As with all chronic pain treatments and management techniques, what may work for you may not work for someone else.

Here are some suggestions on how you can manage chronic pain naturally:

  • Physiotherapy, including exercises and manipulation of painful areas
  • Psychological therapies, such as cognitive behavioural therapy (CBT) or acceptance and commitment therapy (ACT)
  • Exercise, which is gentle enough that it does not make your pain worse
  • Acupuncture, may be available in pain clinics

You can also try keeping a chronic pain journal to keep track of:

  • What’s working for you
  • What you’d like to improve
  • Anything you’d like to speak to a healthcare professional about

When does pain become chronic?

Chronic pain becomes chronic when you have pain that lasts longer than three months.

This does not mean that you should wait to see a doctor if you are in pain. If your pain has not gone away after an injury or is getting worse then you should get medical attention.

How can I support someone with chronic pain?

The best way to find out how to support someone with chronic pain is simply to ask them what they need help with. Each person with chronic pain is an individual, with needs as unique as they are.

Here are some ways that you can support someone with chronic pain:

  • Communication – talking with them, and not just about pain, is one of the most helpful things you can do
  • Socialising – spend time together over the phone, or visit them regularly and help them visit others too if you can, as chronic pain can be very isolating
  • Purpose – help them set and achieve goals, and celebrate special occasions together
  • Independence – help them live their life on their own terms
  • Seek help – get advice from chronic pain communities, or a chronic pain charity such as Pain UK

Can you cure chronic pain?

Chronic pain can be cured in some people, depending on the cause and the treatments available for their condition.

In cases where chronic pain cannot be cured, it can be managed. There are many ways to relieve chronic pain, so you can live life the way you want to.

There are a lot of healthcare professionals and scientists around the world that research chronic pain to find new and effective chronic pain treatments.

At Sapphire Medical Clinic, we have created the UK Medical Cannabis Registry to support research into chronic pain treatment.

Pricing

Sapphire Access Scheme

Initial
Consultation

£ 50

Follow-up
Consultation

£ 50

Quarterly
Check-up

£ 50

Average Cost of Treatment

To help patients understand the likely cost of treatment, we have outlined the average cost to a patient with chronic pain. Cost of medication varies on an individual patient bases.

£135/month*

Inclusive Of Appointments And Medicine

£4.43/day*

Inclusive Of Appointments And Medicine
No repeat prescription fee

Average cost to a patient with chronic pain using dried cannabis flower

£127/month*

Inclusive Of Appointments And Medicine

£4.18/day*

Inclusive Of Appointments And Medicine
No repeat prescription fee
For more details including some exceptions, see full price list: