Living with chronic pain

Summary

  • If you have chronic pain you are not alone; up to one in three Australians are living with chronic pain. However your experience of pain is unique to you.
  • Your experience of pain can be influenced by lots of factors in your life and your experience of pain may vary over time.
  • It is important not to get caught in a negative cycle. It may seem natural to avoid doing activities that may make the pain worse, but inactivity can lead to muscle weakening and can affect sleep, mood and relationships. If no ongoing cause for the pain is found that is causing damage, you can slowly increase your activity despite the pain. This gradual approach to activity is called pacing.

If you have chronic pain you are not alone. One in five Australians, including children and adolescents, lives with chronic pain.1,2 This rises to one in three Australians over the age of 65 living with chronic pain.2

Pain is real even if it can't be explained3

Your pain experience is unique

An individual's experience of pain is unique to them and different from everyone else's experience.4

Pain intensity can vary over time

Each person's experience of pain is likely to be different over time. Although chronic pain is ongoing it is not usually at the same intensity all the time. For most people, pain will vary according to what they do, how they feel and what is happening in their lives. Most people experience 'pain flares', which are times when the pain is more severe. Sometimes you can identify the cause of a flare such as a poor night's sleep, but sometimes it is hard to identify a reason.5

Pain flares can last from a few hours to a few weeks – but they are often not a sign of a worsening underlying medical condition or injury.5

Click to expand Pain can vary over time

Pain can vary over time5
Adapted from: Siddall PJ, McCabe R and Murray R. The pain book: finding hope when it hurts. Sydney, Australia: Hammond Press, 2013.

The impact of chronic pain

Chronic pain can disrupt many aspects of your life. It can result in:6,7

  • reduced ability to work at home or in a job
  • interruption of daily routine
  • reduced social and recreational activities
  • economic hardship as a result of healthcare bills and potential loss or decrease in income.
  • reduced physical activities, fitness and wellbeing
  • disruption to family life and relationships
  • poor sleep
  • negative emotions and mood; living with chronic pain can be associated with anxiety, fear, depression, anger and frustration.

Many factors can influence how you feel pain

Variations in pain intensity are probably influenced by how the message travels from the nerves, along the spinal cord and into the brain.5 There are multiple influences including biological, environmental, lifestyle and psychosocial factors that can directly affect the nervous system and the transmission of the signal from the nerves into the brain.8 In turn the brain can provide feedback and influence the amount of pain we feel.5

Pain is not all in your mind

Although the brain and the mind are very closely connected, the brain is a physical organ made up of billions of neurones. The brain has billions of connections in very complex networks that control your whole body.9 Most of the processes are automatic and can't be controlled by direct thought. However, what you think and feel can have a big influence on all this complex activity without you even being aware of it.10

Click to expand Multiple factors affect perception of chronic pain

Factors affecting chronic pain5,11,12

Factors that affect chronic pain

The way we feel pain is influenced by lots of interrelated factors in our lives. These factors can be physical, psychological or social, and you might think some of them have nothing to do with your pain.5,11,12

Influencing factors include:

  • mood and emotions – for example associated with depression and anxiety
  • past experiences of pain
  • cultural/society attitudes to pain
  • coping style
  • understanding of pain
  • fear
  • activity levels
  • sleep
  • nutrition
  • family
  • levels of stress or distress
  • other illnesses or conditions.

The feedback cycle of pain

Over time, chronic pain can lead to muscle weakening or de-conditioning, which can affect how active you are and this in turn can affect sleep, mood and relationships. The negative thoughts that result can feedback and make the pain worse.13

When you have constant pain it seems natural to avoid doing things like walking, bending and moving around as these can make the pain worse.5 However our bodies are designed to move. When you stop being active, you lose muscle strength and become weaker – over time this means that even simple activities can become more difficult.5

It is important to remember that chronic pain is not necessarily associated with ongoing damage to your body, but is influenced by your nervous system becoming more sensitive over time.5 This means that 'hurt' doesn't necessarily equal 'harm'. If no ongoing cause for the pain is found you can slowly increase your activity despite the pain. This gradual approach to activity is called pacing.14

Find out more

References
  1. Australian and New Zealand College of Anaesthetists. National pain strategy: pain management for all Australians. Melbourne: ANZCA, Faculty of Pain Medicine, Australian Pain Society, Chronic Pain Australia, 2010. [Full text] (accessed 11 May 2015)
  2. Britt H, Miller GC, Henderson J, et al. General practice activity in Australia 2012–13. Sydney: Sydney University Press, 2013, 2013. [Online] (accessed 28 April 2015)
  3. University of South Australia. Chronic musculoskeletal pain (March 2014).  Adelaide: Department of Veteran's Affairs, 2014. [Online] (accessed 28 April 2015)
  4. University of South Australia. Chronic musculoskeletal pain: Helping to solve the pain puzzle (March 2014).  Adelaide: Department of Veteran's Affairs, 2014. [Online] (accessed 28 April 2015)
  5. Siddall PJ, McCabe R and Murray R. The pain book: finding hope when it hurts. Sydney, Australia: Hammond Press, 2013.
  6. West C, Usher K, Foster K, et al. Chronic pain and the family: the experience of the partners of people living with chronic pain. J Clin Nursing 2012;21:3352–60. [Pubmed]
  7. Pain Australia. Fact sheet 2: Prevalence and the human and social cost of pain. Waverly, NSW: Pain Australia. [Full text] (accessed 11 May 2015)
  8. Hayes C, Naylor R and Egger G. Understanding chronic pain in a lifestyle context. Am J Lifestyle Med 2012;6:421–8.
  9. Pandya SK. Understanding brain, mind and soul: contributions from neurology and neurosurgery. Mens Sana Monogr 2011;9:129–49.
  10. Butler D and Moseley L. Explain pain. 2nd ed. Adelaide, Australia: NoiGroup Publications, 2013.
  11. Turk DC, Wilson HD and Cahana A. Treatmnent of chronic non-cancer pain. Lancet 2011;377:2226–35. [Pubmed]
  12. Leung L. From ladder to platform: a new concept for pain management. J Prim Health Care 2012;4:254-8.
  13. Moore P and Cole F. The pain toolkit.  [Fulltext] (accessed 24 April, 2015)
  14. Therapeutic Guidelines. Key points for patients about chronic pain. Melbourne, Victoria: Therapeutic Guidelines Limited, 2011.