Persistent (Chronic) Pain

An overview of the reasons for persistent or chronic pain.
Main text provided by the Institute of Osteopathy
Supplemental text provided by Chew Valley Osteopathic and Therapies Practice

We all feel pain from time to time. When someone injures themselves, specific nerves recognise this as pain, which in turn triggers the body's repair mechanism. As the problem resolves, the pain tends to improve and usually disappears within 3-6 months. This type of pain could be argued to be beneficial: if it hurts you are likely to try and avoid doing whatever it is that has caused the pain in the future so you are less likely to injure yourself in that way again.

Occasionally the pain continues even after the tissue healing has finished. When pain continues after this point, it becomes known as persistent (or is sometimes referred to as chronic) pain. This type of pain is not beneficial and is a result of the nerves becoming over-sensitised, which means that a painful response will be triggered much more easily than normal. This can be unpleasant, but doesn't necessarily mean that you are doing yourself any harm simply by moving*. You could think of this as a sensitive car alarm that goes off in error when someone walks past.

Persistent pain is very common and effects over 14 million people in the UK alone. It often does not respond to conventional medical interventions and needs a different kind of approach, but there are many things that you can do to manage your pain yourself with the support of your osteopath, your family and loved-ones. Keeping active, performing exercises and stretches** recommended by your practitioner can help, learning to pace as well as setting goals and priorities are all very important and can help you to maintain a fulfilling lifestyle.

Persistent or chronic pain patients often talk of "balancing on a very fine line" between keeping active and fit, and staying rested and relaxed, all of which are extremely important in successful pain management. While this can sound very difficult, the vast majority of patients report that this becomes a natural way of life after sufficient practice. New patients can easily feel overwhelmed by the prospect of being in pain every day, even when there is technically "nothing wrong", but successful management is possible for most patients, although time and experimentation is needed to achieve this. It is worth nothing that, given enough time, many patients report that their pain bothers them less than it once did, even though it has not faded or changed. Research would suggest that this is the result of the brain simply becoming "used to it" and failing to register it so prominently, much like a persistent noise ceasing to be irritating over time; it is still there but the brain becomes so used to it, it no longer hears it unless effort is made to do so.

It is however important to remember that the initial purpose of pain is to warn us that there is something wrong. New or changed pain should always be taken seriously and checked by a medical practitioner. It is also important to note that not all persistent pain is the result of damaged or over-sensitised nerves: some persistent pain can be the result of persistent injury that has gone past the point of efficient healing, and must therefore be cared for differently. It is therefore extremely important that the cause of persistent pain is diagnosed and understood by the patient, to ensure that appropriate treatment and care is undertaken.

*Persistent pain that gets worse during movement or weight bearing, or that suddenly changes in behaviour, should be not be ignored. New injuries can sometimes be masked by pre-existing persistent pain, so any changes in persistent pain should be noted and checked by your osteopath or other medical practitioner.

**While exercise and keeping active is important in the management of persistent pain or injury, it is very important that these exercises and activities are appropriate for your needs. It is therefore highly inadvisable to embark on any exercise or stretch programme without consulting with your osteopath first.