What is chronic pain?

Pain is cited as the most frequent reason for consulting a doctor or GP, as well the major reason people take sick leave from work. There are significant healthcare costs associated with treating pain and societal costs associated with absenteeism or occupational disability that stem from injuries.

What is Chronic Pain?

After an injury, the unpleasant experience of pain is normally experienced. However, in cases where this pain persists for more than three months this is known as chronic pain. This occurs when the nervous system continues to signal pain to the area despite healing, making the pain unrelated to the original diagnosis or injury.

According to Painaustralia, 3.24 million Australians were living with chronic pain in 2018, and 68.3% were of working age.

There are a variety of underlying causes that contribute to chronic pain, although it's not always possible to determine the precise cause of the pain.

Chronic pain may happen as a result of persistent stimulation of nociceptors in areas of ongoing tissue damage, for example due to osteoarthritis. 

Frequently, on the other hand, chronic pain is often related to maladaptive changes in the central nervous system, environmental changes, and psychological factors  that may persist for a long duration after the tissue damage that initially triggered the onset of pain has been resolved.

Painful Problems

According to Painaustralia, chronic pain may have an adverse effect on an person's physical functioning, mood and social relationships. 

There are other issues associated with pain following an injury such as:

  • Persistent sleep problems – this can also lead to fatigue, sleep disturbance and issues with concentration and memory
  • Discontinuing physically demanding activities - although activity reduction might give some short-term pain relief, it can lead to a worsening the pain condition in the long-term, slowing the pace of recovery.
  • Contribution to mental health problems - approximately one third of individuals with chronic pain conditions will experience symptoms of depression, others might develop symptoms of anxiety
  • Increased intensity of pain in cases where there is limited social support

How Much Longer?

The time course of pain will vary depending on the injury or illness, given different symptoms and individual differences. Therefore, it is difficult to predict with complete accuracy how long pain will last.

Once pain becomes chronic, it can persist for years after the injury has been sustained. Some usual time frames include one to two months after back pain or fracture while different symptoms of pain associated with spinal cord injuries can emerge months or year after following an accident.

Chronic pain is non-specific and occurs in the absence of the original injury – so despite the injury or illness being healed, there is a continuing sensation of pain and therefore harder to treat given no physical source. Keeping up with usual activities in spite of the presence of pain is important, as medications have a limited role in treating chronic pain.

 It is important to understand that chronic non specific pain (that is pain more than three months after injury) occurs in the absence of a continuing specific injury. The injured diseases have healed but there is continuing sensitisation of the spinal cord or brain that maintains the pain.

It is important to understand that the principles of management of chronic pain are completely different to acute pain. In chronic pain it is important to maintain usual activities in spite of the presence of pain. Medications have a very limited role in treatment of chronic pain. Other treatments include psychological interventions and physical rehabilitation.

Returning to Work

Chronic pain will limit your recovery to work, depending on the intensity and the demands of your occupation. However, chronic pain can be managed and eventually your workload might be able to increase.

There is support for those experiencing chronic pain including Pain Link support on 1300 340 357.

Each state has pain management clinics and services, based in communities or hospitals. Although loved ones and GP’s can offer great support, interacting with peers can assist in managing pain and improving lifestyle.

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