Common Chronic Pain Questions

When does pain become "chronic"?
The term chronic pain is generally used to describe pain that has lasted for more than six months. It's also used to describe pain that persists even after the original injury has healed.

What causes chronic pain?
It isn't always clear what causes chronic pain. There are several possibilities:

• injury: Even after the injury has healed, the nerves can continue to send pain signals to the brain. The medical community isn't sure why this happens.
• disease: Some conditions cause chronic pain. Fibromyalgia and osteoarthritis are two examples.
• nerve problems: You can injure part of your nervous system—the nerves themselves. This type of chronic pain, called neuropathic pain, doesn't respond well to treatment.
• unknown: Pain can develop, even with no obvious injury, disease, or nerve problem.

Are there different types of chronic pain?
Yes, there are different types of chronic pain. It can be:

• neuropathic pain: Pain caused by damage to the nerves themselves.
• nociceptive pain: Nociceptors are the receptors in the nervous system that get activated when there's an injury. If there isn't an injury from outside the nervous system, the nociceptors aren't active. Nociceptive pain, then, is pain caused by an injury to something other than the nerves. In chronic pain, though, the nociceptors may still be sending pain messages long after the original injury has healed.

Why is my doctor sending me to a psychologist if it's my body that's in pain?
Chronic pain does have an emotional component. If your doctor refers you to a psychologist, it means that he or she is well-aware of the emotional effects chronic pain can have. The psychologist can help you deal with any depression, anxiety, or other mood disorders often associated with chronic pain. The psychologist can also teach you to use various psychological "tools," such as relaxation techniques, to help you perceive your pain as less intense. The main goal is to help you live your life fully, despite the pain.

Am I going to end up on a lot of drugs and medications for my chronic pain?
Drugs and medications are one treatment option available to treat chronic pain. Your doctor will work with you to figure out the right medication—or combination of medications—to control your pain. You should communicate clearly with your doctor what works and what doesn't.

If you're scared that you're going to end up on a lot of medications (or that you'll become addicted to medications), talk to your doctor about that concern. It's an important point to bring up, and your doctor can walk you through possible side effects, how long you'll be on a medication, your dosage level, etc.

What else can I try besides drugs and medications to control or relieve my pain?
To control or relieve chronic pain, you can also try:

• acupuncture
• Alexander technique
• exercise
• herbal remedies
• injections
• massage
• mind-body therapies (biofeedback, meditation, etc.)
• physical therapy
• radiofrequency rhizotomy
• spinal cord stimulation
• spinal pump