There’s a very strict definition of “chronic pain” that you can find in scientific papers and the works of international associations. There you’ll find terms like “pain that persists past normal healing time” and “lacks the acute warning function of physiological nociception.” But if you’re suffering from chronic pain, you know that you don’t need these definitions. You know that something is getting wrong, and it isn’t getting any better.
What is Chronic Pain?
Chronic pain, whether it is in your knees, back, shoulder, neck, or elsewhere, can be a persistent problem in your life. It inhibits movements, decreases motion, and generally just makes life more difficult. When you are suffering from chronic pain, all you want is for it to get better. To do so it is important to understand the causes of chronic pain, chronic pain symptoms, and what you can do about it. Starting physical therapy as soon as possible can be a crucial step toward living the life you want to live. You don’t have to know how to define chronic pain. You just have to know it doesn’t have to define you.
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Common Causes of Chronic Pain
The clearest way to split apart chronic pain vs. acute pain is to look at causes and duration. Acute pain generally has a sudden or explicable onset. Some of these causes can include:
- Accident
- Injury
- Illness
- Surgery
- Childbirth
- Broken bones
- Cuts
- Burns
Acute pain can be terrible, but it does subside and eventually go away. This sort of pain rarely lasts longer than six months. That’s where we start to get into the first key differentiator: Classically, chronic pain is pain that lasts longer than six months, but some of these timeframes are getting shorter. That is a pretty clear statement, but what is less clear is how chronic pain comes on. It can be a result of any of these, and also other overlapping conditions.
Chronic Pain Symptoms & Causes
The illness is treated. The injury is healed. By all external accounts, life should be back to normal. But it isn’t. Pain continues to impact everything you do throughout the day and trouble your sleep at night. Months have gone by, and it isn’t getting better. This is chronic pain. Chronic pain has many causes and can be split into many different categories. In 2017, the WHO approved a basic classification of the types of chronic pain.
CHronic Cancer Pain
Pain caused by both the cancer itself (such as the tumor) and the treatment. This is usually persistent background pain or recurring, intermittent pain.
Chronic Neuropathic Pain
This is caused by a disease or lesion of the somatosensory nervous system, often associated with a stroke, nerve trauma, or other unpredictable conditions
Chronic Headache Pain
These often relate to neurology, but could be impacted by musculoskeletal issues such as chronic neck pain
Chronic Visceral Pain
This deal with pain from the organs, which could be but is not always cross-referenced with cancer pain
Musculoskeletal Pain
This is pain that arises as part of a disease process — not from injury or accident.
Post-Surgical and Post-Traumatic Pain
Surgery and trauma (such as injuries) usually are accompanied by pain, but this is pain from that (with other causes, such as infection) that can be ruled out.
Chronic Primary Pain
Pain that lasts longer than three months and carries significant functional disability or emotional distress and that “cannot be explained by another chronic pain condition”. The last one, primary pain, might seem to fit for many people. There is no one cause, no one thing that you can point to that is a cause of pain. A lot of times, major sources of chronic pain are an accretion of time and activity, repetition, wear and tear, such as with rheumatoid arthritis. Other times, it is sudden and dramatic. Sometimes it is everything. That’s why it is so important to look at some of the major causes of chronic pain in vital areas that can respond well to treatment.
Common Types of Chronic Pain
There are many types of chronic pain that come from disease, injury, accident, or persistent conditions. This is far from an exhaustive list, but can help show the many different ways that chronic pain can become a part of your life.
Chronic Knee Pain
Frequent knee pain affects nearly 25% of American adults. But it is hard to take comfort in numbers when walking, running, and even standing become difficult of nearly impossible. Chronic knee pain can make nearly every aspect of life harder. It’s harder to walk, harder to exercise, harder to do simple activities, and just really make the day to day aspects of your life that much harder.
Some of the common causes of chronic knee pain include:
- Injury (sprained or strained ligaments of muscle)
- Torn cartilage
- Accident
- Arthritis and osteoarthritis
- Gout
- Infections
- Tendonitis
These aren’t the only reasons. You can suffer knee pain from an issues with your gait, from weight gain or loss, and from other lifestyle issues. The cause is important. The effect impacts every day.
Chronic Back Pain
This is the literal backbone of your life. So much of your life is impacted by back pain…pretty much everything you do standing, sitting, or lying down. Back pain often starts out slow, and then spreads, which is why it is important to pay attention to the signs and understand the causes.
- Injury (see doctor first)
- Accident
- Obesity
- Muscle Strain
- Scoliosis
- Herniated Disc
- Osteoporosis
- Wear and tear
Of course, sometimes there is no one reason. It can be repetitive use, stress, or just the normal result of aging. But just because back pain comes from living your life doesn’t mean you have to live with it.
Chronic Shoulder Pain
Lifting. Exercising. Picking things up. Even just putting on a shirt can be an exercise in discomfort when suffering shoulder pain. We don’t think very much about our shoulders, but they are crucial joints, and their health can be impacted in a lot of common ways.
- Swimmer’s Shoulder (tendon rubbing on shoulder blade)
- Rotator cuff tear
- Adhesive camsultities
- Arthritis
- Shoulder instability
- Pinched nerve
- Stiffness (frozen shoulder)
- Injury or accident
- Repetitive stress injuries
These aren’t the only reasons. You can suffer shoulder pain from an issues with your reach, your job, from playing sports, or even just picking up the kids or grandkids.
Chronic Neck Pain
It’s impossible to overstate the compounding effects of neck pain. Everything from turning your head to sleeping is impacted, and it can damage your spine, your nerves, and more, leading to even more pain. Some of the common causes of sudden or chronic neck pain include:
- Injury (see doctor first)
- Muscle strain
- Degenerative disc disease
- Herniated disc
- Spinal stenosis
- Age-related wear and tear (spondylosis)
- Accident
These aren’t the only reasons. You can suffer neck pain from poor posture, constant stress, disease, and work-related issues. Neck pain is a very serious issue. It can cause pain throughout your entire body and deeply impact the comfort with which you live your life.
All these types of pain make every day harder. And they can impact your body far outside of the physical realm.
The Effects of Chronic Pain
There’s a strange thing about chronic pain: it tends to be invisible. You aren’t walking around on crutches; you aren’t laid up in a hospital bed. And because of that, it can be hard to explain. It can be hard to understand, even for you. People who suffer from chronic pain often feel like their own bodies have betrayed them. This is made worse by the narrowing of possibilities in life. Many people are unable to see friends and family, go on picnics, exercise, go to their favorite places, travel, and in many cases even work. This has serious social and economic consequences, and these can create even more emotional issues.
Some of these can include:
- Anger
- Depression
- Demoralization
- Anxiety
- Fear of reinjury (leading to further isolation)
- Feeling misunderstood
Physical Therapy for Chronic Pain
If chronic pain could be treated by taking over the counter medications or prescription drugs, it wouldn’t be chronic. Instead, what is often the best course of action for chronic pain is comprehensive physical therapy. Most people suffering from chronic pain don’t understand that they can start physical therapy first…before they see a doctor. And that makes sense. We often think that we have to check with a physician before doing, well, anything.
But that’s not always the case with therapy. Many therapy centers start with an assessment. They figure out what is causing this chronic pain, how bad it is, and what can be done. They may refer you to a physician, or may start with a regime of personalized physical therapy right away. You can also come in following a visit to a therapist who may prescribe PT as a way to overcome your pain. If this is the case, it’s important not to hesitate to start. The sooner you get started, the quicker it is to see results.
What to Expect During Chronic Pain Physical Therapy
Your therapist will set up a personalized treatment plan, designed to help treat your specific pain, provide longer-term pain relief, and reach your unique goals. You may want to put on a shirt again without pain, or you may want to hike the Appalachian Trail. Discovering what you want to accomplish, and the possibilities of therapy, will create the regimen for how therapy will go. From there, you work. And it can be hard work, up to three days a week for 4-6 weeks. But while it may be hard, the point is to get rid of chronic pain. It’s to set yourself up to live your best life for years to come. It’s to alleviate what has been keeping you from being the person you want to be.
Chronic pain is different for everyone. Treatment is different for everyone. But the one universal is that no one suffering from chronic pain needs to be alone. No one needs to feel abandoned. Help is here, and the sooner you get started, the sooner you can define your own possibilities.