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Specialist Advice — 6 minutes

Ouch! What’s chronic pain?

September 13, 2024

Michel Cameron, PhD
Michel Cameron, PhD
Associate Director, Pharmacogenomics, Medical Science Liaison
LinkedIn

All kids have had their knees scratched and elbows bruised, which is followed inevitably by tears and despair. In time, they learn that the pain eventually goes away, that the body heals itself, and that they can deal with it. When confronted with pain, the nervous system sends signals to the brain indicating that part of the body is injured. The type of pain someone feels when they scratch their knees is called acute pain. However, in some circumstances, pain signals persist, despite efforts to control it.

chronic-pain

Chronic pain, defined as pain that persists beyond three months, is a day-to-day reality for eight million Canadians that affects physical and mental health. It interferes with work, leisure, relationships, and overall quality of life. Chronic pain can arise from various conditions and factors, often making it complex and multifaceted.

Common causes of chronic pain include:
  • Arthritis: Conditions like osteoarthritis and rheumatoid arthritis can lead to joint pain and stiffness.
  • Back problems: Issues such as herniated discs, spinal stenosis, and sciatica can cause persistent back pain.
  • Fibromyalgia: This disorder is characterized by widespread muscle pain, fatigue, and tenderness in localized areas.
  • Neuropathy: Nerve damage or dysfunction, often due to conditions like diabetes or shingles, can lead to chronic pain.
  • Chronic migraines: Frequent and severe headaches can become a persistent issue.
  • Injuries: Past injuries that didn’t heal properly can cause ongoing pain.
  • Autoimmune diseases: Conditions like lupus or multiple sclerosis can contribute to chronic pain.
  • Chronic fatigue syndrome: This condition is characterized by extreme fatigue and often includes widespread pain.
  • Endometriosis: Pain from this condition is related to the presence of uterine-like tissue outside the uterus.
  • Complex regional pain syndrome (CRPS): A condition that usually affects an arm or leg, causing severe pain, swelling, and changes in skin colour and temperature.

Many strategies can be employed to deal with chronic pain. To be effective, a personalized approach is often preferred, which uses a combination of strategies, depending on the type and the severity of the pain as well as individual characteristics such as genetics. For example, a pharmacogenomic test could be useful when medications are not working as they should, either causing intolerable side effects or simply lacking in effectiveness.

Best tools and strategies for pain management and relief

Here are some tools and strategies used to manage pain.

1. Medications:

  • Over-the-counter (OTC) pain relievers: Such as ibuprofen (Advil, Motrin), acetaminophen (Tylenol), and aspirin.
  • Prescription medications: Including opioids (for severe pain), muscle relaxants, and certain antidepressants or anticonvulsants that can help with specific types of pain.
  • Topical analgesics: Creams, gels, or patches applied directly to the skin.

2. Physical therapies:

  • Exercise: Gentle exercise and stretching can improve strength and flexibility, reducing pain.
  • Physical therapy: Tailored exercises and techniques to address specific pain issues.
  • Massage therapy: Can help relieve muscle tension and improve circulation.

3. Alternative therapies:

  • Acupuncture: Involves inserting thin needles into specific points on the body to relieve pain.
  • Chiropractic care: Focuses on spinal alignment to alleviate pain, especially in the back and neck.
  • Osteopathy: Uses manual manipulation of the bones and muscles to treat pain.

4. Psychological and behavioural strategies:

  • Cognitive behavioural therapy (CBT): Helps people change negative thought patterns related to pain and develop coping strategies.
  • Mindfulness and meditation: Techniques that can help manage pain by improving mental resilience and reducing stress.

5. Lifestyle adjustments:

  • Healthy diet: Eating a balanced diet can reduce inflammation and overall pain.
  • Proper sleep: Good sleep hygiene helps in managing chronic pain conditions.
  • Stress management: Techniques such as relaxation exercises or hobbies can help reduce the perception of pain.

6. Interventional procedures:

  • Nerve blocks: Injections that block pain in specific nerves.
  • Epidural steroid injections: Can reduce inflammation and pain, particularly in the spine.
  • Surgical options: In some cases, surgery may be necessary to address the root cause of pain.

7. Supportive devices:

  • Braces, supports, and Assistive Devices: Can help stabilize and reduce strain on painful areas.

The healing potential of these strategies can be life changing. However, they do not always work and finding the right therapies can be a process of trial and error.

Living with chronic pain

For some, the biggest challenge when dealing with chronic pain is acceptance; acceptance that factors that contribute to pain cannot be controlled. As Michael J. Fox said: “Acceptance doesn’t mean resignation; it means understanding that something is what it is and that there’s got to be a way through it.”[1]

With so many Canadians living with this debilitating condition, Health Canada published “An Action Plan for Pain in Canada” in 2021. This report aimed to improve prevention and quality of life for people living with pain. The plan recommended a wide range of actions to ensure people with pain in Canada are recognized and supported and that pain is understood, prevented, and effectively treated.

Pain Canada

Stemming from this initiative, Pain Canada was created, which was the first multi-stakeholder national initiative where people with lived experience of pain are at the centre of decision making and priority setting. Pain Canada mobilizes resources to build capacity towards dramatically improved systems of care and support for people with pain.

Here are other resources if you want to learn more about chronic pain:

Quebec Pain Research Network

Contributes to the understanding of the neurophysiological mechanisms of pain, to prevent its chronicization, and to improve its management in order to contribute to the well-being of people living with pain and their families, through innovative, inclusive, partnership-based and intersectoral research activities and the mobilization of knowledge.

LivePlanBe

LivePlanBe is a free online self-management tool for people living with chronic pain. The name is a play on the concept of “Plan B” – the alternative we turn to when life doesn’t turn out as planned. It was created by Pain BC in partnership with people living with pain and healthcare providers. LivePlanBe is funded by the BC Ministry of Health.

For professional support, we’re here for you.

We provide services that can help your doctor identify how your DNA influences whether a drug may cause side effects, be ineffective, or provide relief.

Learn more about our innovative pain management approach.

Sources1
  1. Fox MJ. Lucky Man: A Memoir. Paperback – illustrated. April 9, 2003.