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Chronic Pain: At a Glance

By The Manual's Editorial Staff,

Usually, pain is considered chronic if it

  • Lasts more than 1 month longer than expected based on the illness or injury
  • Recurs off and on for months or years
  • Is associated with a chronic disorder (such as cancer or arthritis) or an injury that does not heal

Pain is the most common reason people visit their doctor.

What Can Cause Chronic Pain?

Chronic Pain Does More Than Just Hurt

Chronic pain can have many, sometimes serious consequences:

  • Loss of sleep

  • Fatigue and loss of energy

  • Lack of participation in activities, resulting in social isolation

  • Avoidance of physical activity, resulting in loss of muscle strength and flexibility

  • For older people, difficulty doing their daily activities and increased dependence on other people

Did You Know...

  • Chronic pain can physically change the nervous system in ways that make the pain worse and last longer.

For a full discussion, see pain.

Why Does Pain Become Chronic?

Chronic pain repeatedly stimulates the nerve fibers and cells that detect, send, and receive pain signals. Repeated stimulation can physically change nerve fibers and cells or make them more active and can thus increase pain transmission to the spinal cord and brain. As a result, things that might not ordinarily be painful become painful, and things that are painful may seem even more painful.

How Bad Is the Pain?

No examination nor test can prove that a person is in pain or determine how severe the pain is. So doctors often people to rate how severe their pain is using a standardized pain scale.

Pain Scales: How Bad Is the Pain?

Can Anything Relieve the Pain?

Treatment includes

  • Pain relievers such as acetaminophen, aspirin, and other nonsteroidal anti-inflammatory drugs (NSAIDs)

  • Other drugs such as certain antidepressants and anticonvulsants

  • Other treatments such as biofeedback, relaxation training, distraction techniques, and hypnosis

Doctors may prescribe opioid pain relievers when other treatments do not work.

Pain may also be treated as part of rehabilitation therapy. Such treatment makes movement easier and enables people to participate more fully in rehabilitation. Techniques used include heat therapy, cold therapy, electrical stimulation, traction, massage, and acupuncture.

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