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Chronic Pain

Everyday tasks can be a struggle,  but treatment options can help you manage your chronic pain and regain your quality of life.

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Abandoned hobbies. Strained relationships. Impacted careers. Chronic pain can steal much of what makes you YOU.

Chronic pain affects between one-third and one-half of the population of the UK, corresponding to just under 28 million adults, with women being more frequently affected than men.¹

Chronic pain  can make daily tasks like cooking, walking and sleeping difficult.

~38% of Europeans with chronic pain report that their pain is not adequately managed with medication.²

Chronic pain and acute pain — what‘s the difference?

To determine the best treatment, pain is categorised as either chronic or acute, both of which can manifest as mild, moderate or severe:

Acute pain occurs immediately after injuries such as burns, fractures or invasive procedures and lasts no longer than six months.

Chronic pain lasting six months or more is challenging to treat as similar pain types may need different treatments.

Understanding chronic pain syndrome

Chronic pain syndrome (CPS) is a condition that causes pain lasting longer than three to six months and is often associated with actual or potential tissue damage. It may be accompanied by other symptoms that interfere with daily life, such as sleep disorders, concentration problems, exhaustion, increased irritability and depressive moods.

Chronic pain syndrome can start with some form of physical injury anywhere in the body and persist beyond the usual recovery period, or it can occur along with a chronic health condition.

What is neuropathic pain?

Neuropathic pain is a chronic pain condition caused by damage or disease affecting the somatosensory nervous system.

Neuropathic pain is caused by nerve damage from either an injury or a medical problem. This pain is different from a cut or bruise and is more associated with burning or tingling sensations.

Although the brain processes pain signals, it does not actually "feel" pain because it lacks pain receptors. Neuropathic pain occurs because the brain misinterprets or overreacts to abnormal signals coming from the damaged nerves.

Neuropathic pain can affect different parts of the nervous system:

Peripheral nerves: These nerves are spread throughout your body, in places like your arms, legs, hands, and feet. When these nerves are damaged, they can send faulty signals to the brain, leading to pain.

Spinal cord: This is the main pathway for signals traveling between your brain and the rest of your body. If there is damage to the spinal cord, it can disrupt normal pain signaling, resulting in neuropathic pain.

How does neuropathic pain feel?

Spontaneous Pain

This type of pain occurs without any obvious trigger or injury and can feel like any of the sensations below:

Burning: Many people describe a persistent burning feeling, almost like the affected area is on fire.

Stabbing Pain: Sudden, sharp jabs of pain that come and go unpredictably.

Electric Shock: Some individuals experience sudden jolts of pain that feel like an electric shock, often described as sharp and intense.

Allodynia

Allodynia is when something that usually wouldn't cause pain — like a light touch, something brushing against your skin or even a breeze — becomes painful. For example, wearing clothes might suddenly feel unbearable on the skin.

Hyperalgesia

This is when something that usually causes mild pain, like a small pinch or a tiny prick, becomes extremely painful. Your body overreacts to pain signals, making the pain feel much worse than it normally would.

Hypoalgesia

In contrast, hypoalgesia is when your sensitivity to pain decreases, causing you not feel pain as strongly as you normally would, even if something should cause significant discomfort.

Dysesthesia

Dysesthesia is a term used to describe abnormal and unpleasant sensations like tingling, prickling, or a creepy-crawly feeling. Dysesthesia can be persistent and bothersome, affecting your daily comfort.

What are types of chronic pain?

Chronic Back, Leg & Pelvic Pain and Lumbar Sciatica

This type of pain originates in the lower back, legs or pelvic region. Common causes are injuries, muscle strain or conditions like lumbar sciatica.

Learn more about chronic back, leg and pelvic pain

Sacroiliac Joint Dysfunction

This type of pain mostly stems from a dysfunction in the sacroiliac joints, which connect the lower spine to the pelvis. If these joints are irritated or inflamed, this often causes discomfort or pain in the lower back, hips or even legs.

Learn more about sacroiliac joint dysfunction

Peripheral neuropathy and diabetic peripheral neuropathy

Peripheral neuropathy occurs when peripheral nerves are damaged. This leads to pain, tingling or numbness, particularly in the hands and feet. Diabetic neuropathy is a specific type of nerve damage linked to diabetes.

Learn more about peripheral neuropathy and diabetic peripheral neuropathy

Peripheral Artery disease

This condition involves reduced blood flow to the limbs, causing pain or cramping, usually in the legs.

Learn more about peripheral artery disease

Complex Regional Pain Syndrome

CRPS is a severe, often debilitating pain that typically affects an arm or a leg after an injury. It's characterized by intense pain, swelling, and changes in the skin.

More about complex regional pain syndrome (CRPS)

What are the treatment options for chronic pain?

The treatment option that will work best for you depends on its source and impact on your body's functions.

Your doctor can help determine suitable options. Pain management specialists focus on treating patients with severe pain. If you do not currently have a pain management specialist, use the Pain Centre’s Locator to locate one near you.

Depending on your pain type and severity, your doctor will tailor your treatments to your individual needs.

These treatments do not include injections, implants, or other surgical procedures.
  • Rest and diet changes
  • Exercise and physical therapy
  • Acupuncture, massage, and spinal adjustment
  • Anti-inflammatory drugs
  • Cognitive and behavioral modification
  • Transcutaneous electrical nerve stimulation (TENS)

Other non-interventional treatments are used when there are no improvements from basic treatments.

These include:

  • prescription opioid and non-opioid medications
  • prescription painkillers, muscle relaxants, antiseizure drugs, and some antidepressants.

These minimally invasive, targeted procedures are potential treatment options when non-interventional methods do not provide adequate pain relief. They are less invasive and have a quicker recovery time than most surgical procedures and are often used when non-interventional treatments fail.

Epidural steroid injections (ESI) or nerve blocks
Injection of an anaesthetic, steroid, and/or anti-inflammatory into the pained area.

Radiofrequency Ablation (RFA)
RFA is a minimally invasive outpatient procedure that uses thermal energy to interrupt pain signals at their source. RFA can be used to treat pain in the back, hips, knees, shoulders, feet, and neck, and can provide months – or even years – of relief.

Learn more about RFA

Spinal Cord Stimulation (SCS)
SCS therapy can help manage chronic neuropathic pain of the lower back and limbs by using mild electrical impulses to interrupt pain signals. Boston Scientific's SCS Systems offer more therapy options in a single device than any other system, providing a greater chance of finding effective, long-term relief for each person's individual pain.
A minimally invasive treatment, SCS may also be used to help manage pain that is unresolved or even caused by more invasive surgical procedures.

Learn more about SCS

These are more invasive procedures that may be necessary to correct structural damage or to relieve pain that does not respond to other treatments.

Surgery
Surgical treatments such as laminectomy and spinal fusion may be needed when structural problems occur within the spinal column. These treatments often require prolonged postoperative hospitalisation and rehabilitation.

Implantable drug pumps
Pumps deliver pain medication directly to the space surrounding the spinal cord. The pumps delivering the medication need frequent specialised care.

Other surgical procedures
Often used as a last resort when other therapies fail, some surgical techniques permanently destroy nerves and tissue that conduct pain. These procedures are most often used to relieve pain due to cancer or other incurable diseases.

Get the answers you need

Whether you are considering SCS or RFA or are in the process of getting it, here you will find the answers about the whole journey.

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Where can I find the nearest pain centre?

Use our clinic finder to search for pain centres closest to you and get in touch with pain specialists who can help you finding long-lasting pain relief.

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References:
1. Fayaz A, Croft P, Langford RM, Donaldson LJ, Jones GT. Prevalence of chronic pain in UK: a systematic review and meta-analysis of population studies. BMJ Open. 2016;6(6):e010364. Published 2016 Jun 20. doi:10.1136/bmjopen-2015-010364.
2. Societal Impact of Pain, 2016. Abstract & Background Booklet. https://www.sipplatform. eu/sip2016booklet. Last Accessed: 09 March 2017.

 

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