PERSISTENT PAIN

Things to remember | Acute and persistent pain | The impact of pain | Diagnosis | Treatment | The future | Where to get help |  How we can help | More to explore | Download PDF 

Things to remember

• 1 in 5 Australians live with persistent pain
• It can affect us physically, mentally, emotionally and socially
• There are many things you can do to deal effectively with persistent pain
• A team approach, with you at the centre, is the best way to manage your pain

Pain is your built-in alarm system. It makes you aware that something might be going wrong in your body.

Pain is essential for your survival as it makes us do something to protect your body. For example, when you touch the hot surface of a stove, your body feels pain and instinctively pulls away. The pain and your body’s reaction prevents you from hurting yourself any further.

You have danger detectors (nociceptors) spread throughout most of your body. Pain is usually triggered when your brain receives messages from these nociceptors that they detect something potentially harmful.

Your brain evaluates these messages and decides whether your body needs protecting by producing pain. This is a normal reaction that protects you from any further harm.

Acute and persistent pain

Pain may be described as acute or persistent.

Acute pain usually begins quickly and lasts for a short period of time. It’s the pain associated with things like a stubbed toe, a broken bone, a burn or having a tooth removed. Acute pain usually goes away after the underlying problem (e.g. inflammation, injury, infection) has been treated or has healed.

Persistent pain, sometimes called chronic pain, is pain that lasts for more than three months.

What causes persistent pain?

Persistent pain is very complex and may be caused by a number of factors. It may occur alongside conditions such as arthritis, diabetes or fibromyalgia. It may occur after an injury or trauma to the body has healed. And in some cases the cause isn’t known.

Persistent pain is associated with changes to your nervous system (the nerves, spinal cord and brain). Throughout your life your nervous system changes and adapts to help you learn from and deal with different experiences. This is called neuroplasticity.

However sometimes this normal process of adapting and changing becomes abnormal. It’s no longer helpful. Persistent pain is an example of this.

This change affects the way your brain understands the information it receives about pain and things such as touch or movement. Everyday activities that shouldn’t cause pain, may cause pain. Pain may be worsened by staying in one position for short periods. The affected area may be tender to light pressure, and at times to very light touch. Often this pain can spread to nearby areas or to the opposite part of your body. This is often referred to as central sensitisation.

The impact of pain

Although everyone’s experience of living with persistent pain is different, there are many common factors. Pain impacts on us physically, emotionally, psychologically and socially.

It can affect:

• your strength and fitness
• your ability to complete your usual activities at home or work
• your mental health
• social connections
• intimacy
• sleep
• concentration
• your relationships with family, friends and work mates.

Fear of pain and further injury can affect the way you normally do things. Concerns about making things worse can affect the way you move and can make you less active. If this continues, you can become deconditioned or out of shape. It can also increase the chance that pain will continue to persist.

Diagnosis

Your doctor will discuss your pain with you and will:

• ask about your history of pain including
  • if you’ve noticed any patterns, e.g. it’s worse after resting
  • the type of pain, e.g. burning, aching
  • potential triggers
  • things that make your pain worse
  • thing that make it better
• discuss any other health problems that you may have
• conduct a physical exam.

Sometimes your doctor may order a scan or some other test to confirm or rule out a condition. It’s important to note that for some conditions, such as back pain, scans aren’t recommended at all.

Scans have a high rate of false positive findings. That means that the scan will indicate that something’s wrong or abnormal in large numbers of people who have no pain at all.

A false positive may lead to a so-called ‘abnormality’ on a scan being named as the cause of your pain, but it may not be the cause at all.

A thorough examination by your doctor will decide whether scans or further tests are appropriate or helpful in developing a treatment plan that’s right for you.

For more information about questions to ask your doctor before you get any test, treatment or procedure visit the Choosing Wisely Australia website.

Treatment

A team approach, with you at the centre, is the best way to manage your pain and help you continue to do the things that are important to you. Your healthcare team (e.g. doctor, physiotherapist, pharmacist), family, friends and support groups all play a role in this team. But at the heart of the team is you.

There are many options for managing persistent pain—from exercise, to medication, to relaxation techniques.

Read our A-Z guide to managing pain  for more detailed information.

The future

Many factors influence your recovery and it’s difficult to know how quickly you’ll respond to treatment or how your condition will progress over time.

Most acute painful conditions resolve gradually over a few days to a few weeks. A smaller proportion can continue beyond three months and sometimes for much longer.

Despite the ongoing presence of pain, you can improve what you can do and how you feel.

When starting any new treatment, discuss with your doctor how long it may take to achieve your specific goals. If you’re not progressing in the time you’ve discussed, it may be of benefit to seek another opinion to see if a different approach is needed.

Where to get help

• Your doctor
• Physiotherapist
• Exercise physiologist
• Psychologist
• Occupational therapist
• Musculoskeletal Australia
  MSK Help Line: 1800 263 265

How we can help

Call our National Help Line and speak to our nurses. Phone 1800 263 265 or email helpline@msk.org.au

We can help you find out more about :

• arthritis and musculoskeletal conditions 
• ways to live well these condition
• managing your pain
  • read our A-Z guide to managing pain
  • watch our excellent videos on pain, your brain and how you can retrain your pain system.
    • Pain, the brain and your amazing protectometer – Lorimer Moseley
    • Treating pain using the brain – David Butler
• upcoming webinars, seminars and other events

More to explore

• Better Health Channel 
• Beyondblue 
  Support Service – 1300 224 636
• Choosing Wisely Australia 
• Lifeline
  Crisis Support – 13 11 14
• National Prescribing Service
  Medicine Line 1300 633 424
• Pain Australia 
• painHEALTH
• TAC 
• WorkSafe 

Download this information sheet (PDF). 

The whole or part of this material is copyright to the State of Victoria and the Better Health Channel. Reproduced with permission of the Victorian Minister for Health. Users are permitted to print copies for research, study or educational purposes.

Information has been produced in consultation with and approved by: Musculoskeletal Australia.

Produced in partnership with Empower Rehab, a Melbourne based pain management clinic.