Understanding chronic pain

When you’re in chronic pain, you feel as if there must be something physically wrong, but despite X-rays, scans and tests, your doctor may not be able to explain it.

One in 5 Australians over 45 lives with chronic pain.¹ If you’re one of them, you’ll know it can impact every aspect of your life, including your work, relationships, sleep, physical activity and mental health.

Chronic pain is a complex beast but understanding how it works is an important part of managing the condition and improving your quality of life.

Chronic pain is defined as pain that persists beyond the expected healing time.

If pain continues for more than 3 months, even after you've physically healed from an injury, surgery or another condition,¹ and it has a physical and psychological impact, it can be categorised as chronic pain.

Chronic pain can range from mild to severe, and can be difficult or even impossible to cure.

The latest figures show that 3.6 million Australians live with chronic pain.² Almost half are in their prime earning years, between 25 to 64 years old, with women more likely to report experiencing it than men.³ By 2050, it is estimated that the annual cost of chronic pain in Australia will rise to $215.6 billion.⁴

Pain is there to keep you safe. It’s a warning sign that tells you something is wrong and that you need to do something about it.

So, when you stub your toe, pull a muscle or fall from a bike, you’ll feel pain. You hurt for a while, and then it gets better. Except sometimes, it doesn’t. Chronic or persistent pain is different from acute pain. Although it often begins with an injury or underlying illness such as arthritis, it’s sometimes difficult to identify the original cause.

Pain experts believe that many cases of chronic pain are due to changes in the central nervous system (your spinal cord and brain), rather than damage to the body. It’s a process called central sensitisation or pain system sensitisation.⁵

After being in pain for a long time, your brain can become too protective, and your pain system can become too good at making pain. You can get warning signs (pain) that are unnecessary or out of proportion to the stimulus.

Note: This doesn’t mean the pain is ‘all in your head’. Pain is always real, and it’s always produced by your brain.

Chronic pain is complex and can vary from person to person. There may not be an obvious root cause for ongoing pain, but some include:

• musculoskeletal conditions, such as arthritis and osteoporosis
• nerve damage or injury
• joint, muscle or bone conditions
• cancer
• migraine
• persistent pain after surgery or injury

Anything that causes your central nervous system to become more sensitive, such as fear, frustration, stress or anxiety, can make all forms of pain worse, while anything that calms it down (mindfulness, meditation, self-compassion) can help lower your pain. Understanding this can be key to managing and reducing your pain. In fact, pain science education is considered an essential part of chronic pain treatment.⁶

Living with daily pain is stressful, not just physically but emotionally, too, and can play havoc with your everyday life.

Chronic pain can affect your ability to function socially, at home and at work. It’s also common for people with chronic pain to feel overwhelming fatigue, have trouble concentrating, and have difficulty sleeping.

These frustrations can sometimes result in depression and anxiety. It’s important to consult your doctor to see what can be done in terms of pain relief and mental health support.

Chronic Pain Australia hosts an online forum to connect people living with chronic pain. There are also resources and information for people, their carers and families.

Musculoskeletal Australia offers support and information for those living with conditions such as chronic back pain and arthritis.

Pain Australia has up-to-date information on medication, legislation and healthcare reforms on treating pain in Australia.

Pain Management Network enables you to develop skills and knowledge in the self-management of your pain in partnership with your healthcare providers. It also includes a dedicated youth channel.

More Good Days provides evidence-based and low-risk digital programs to help people with persistent pain.

Tame the Beast provides education on retraining your pain system to reduce persistent pain.