Persistent (Chronic) Pain
The latest evidence-based advice on persistent pain
Persistent (or chronic) pain usually refers to pain which lasts longer than 3 months. Sometimes, it started as a injury which has now healed, but often we don't know what has caused it. We have learnt a lot about pain in the last few years. Some of this knowledge is very new and is not yet widely known.
All pain, no matter where or how it is felt, is produced by the brain. Imagine you just stubbed your toe. Before your brain tells you, "Here is pain," it must first combine a lot of information, and then try and make sense of it all. Your nerves just say to your brain, "Danger"; they cannot tell you how serious the danger is. It's your brain that works this out, by weighing up things like what is going on at the moment, the experiences you have had in the past, and other life factors. Only after sorting through these will your brain tell you whether your toe hurts or not. It does this incredibly quickly - before you have even realised.
The problem is that the brain gets these signals through the nervous system. All of the nerves in our body, including the spinal cord and brain, change how sensitive they are in response to what we do, how we are feeling and how we see the world around us - a bit like turning the volume up or down on a radio. Sometimes, this can lead to big changes in pain levels without immediately obvious reasons. Persistent pain has more to do with these changes in the nervous system, than it does damage to your body. It's like the volume knob on your pain system has been left turned up, like a radio stuck on "loud". Persistent pain does not always indicate ongoing damage even though it may feel like it.
It's really important to understand that you can re-train your brain and nervous system to turn the volume down again, but this takes time, effort, and knowledge. The PPSS can work with you to give you tools and skills which can help you re-train your brain. This video can help you understand more about pain and what can help relieve it. There is also a very useful booklet available produced by the Tasmanian Health Organisation which explains this in more detail, which is listed to the right.
Even though you may not feel like it, the best way to relieve pain and to re-balance your life is to keep moving. This doesn't need to be a lot all at once. Small steps at a time, paced around what you are able to do, will help you start to gain your life back and prevent it being ruled by pain. Your mood, thoughts, stress levels, diet and sleep patterns can also all contribute to making your pain better or worse.
If you need to take pain relief to help keep you moving, you can take simple over-the-counter NSAID painkillers (such as Ibuprofen). If you have health issues that mean you can't take these types of medications (gastrointestinal, liver and cardio-renal toxicity), then speak to your GP or pharmacist first.
In the past, you may have been prescribed medications for your pain. These may be Opioids (such as Codeine, Fentanyl, Morphine, Methadone, or Zomorph) or Gabapentinoids (such as Gabapentin or Pregabalin). New research has shown that these aren't very effective at treating long-term pain. It has also shown they can be dangerous. It shows that:
If you have had these painkillers prescribed to you, the PPSS can support you to review your medications and work with you to see what is best for you in the longer term. Watch the video below to learn more about the body's natural pain killer processes.