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Persistent (chronic) pain

Persistent pain is pain that continues after three months. It affects around three out of ten people. Persistent pain affects everyone differently.  But it can be scary, exhausting and have a huge impact on many areas of your life including mood, sleep, your ability to work and be socially and physically active.

Common causes

It can sometimes occur without any obvious reason. A number of factors have been associated with persistent pain. These include:

  • Following injuries such as a sprain or broken bone.
  • Infections, viral illnesses, or post-surgery.
  • Our genetics (e.g., a family member may have similar symptoms such as longstanding pain).
  • Our environment (e.g., traumatic early life events or ongoing/significant periods of stress).
  • A sudden increase or decrease in your normal activity or exercise levels.
  • Other conditions such as Osteoarthritis, Rheumatoid Arthritis or Fibromyalgia.
  • Following a period of increased stress, worry or low mood.
  • Following a period of poor sleep, fatigue or feeling run down.
  • Other lifestyle factors such as being overweight and smoking.
  • A flare up of pain in any area of the body.

Common symptoms

These include:

  • Pain often in your back, neck, shoulders, hips, knees, feet and ankles.
  • Pain that can be widespread and affects many parts of your body e.g. Fibromyalgia.
  • Headaches, migraines and jaw pain.
  • Pain in any muscles, tendons and/or joints feelings of aching, soreness, tension, burning and stabbing.
  • Feeling sensitive to touch, light, sounds and temperature (heat/cold).
  • Tiredness and poor unrefreshing sleep.
  • Dizziness, irritable bowel syndrome or tummy pain and restless legs and/or cramping.
  • ‘Brain fog’ - difficulty with memory, concentrating and finding words.
  • Feeling low in mood, frustrated, anxious, worried and/or overwhelmed.
  • Your nervous system may have become very sensitive (on high alert) to many things that previously didn’t affect them.

You may experience ongoing symptoms, that may be aggravated by certain activities, and reduced by others, or for no obvious reason.

What can I do to help it?

It’s very important to understand these facts about persistent pain:

  • Pain is ALWAYS REAL and NOT in your mind.
  • It may NOT always be due to an injury or illness.
  • It is RARELY a sign of harm or damage - instead your nervous system has become very sensitive and is in a state of HIGH ALERT.
  • Pain CAN NOT be seen on scans and x-rays and these are often UNHELPFUL in managing persistent pain.
  • Resting and avoiding activity is NOT helpful in the long run and can make the pain worse.
  • Activity and exercise may be painful but are SAFE and will NOT cause you harm or damage.
  • Strong pain medications are RARELY helpful in the long run and can have many side effects.
  • Letting pain guide your levels of activity can lead to a boom-bust cycle of being over and under active, which can make pain and fatigue worse.
  • Just treating the painful area(s) may only help a little in the short term. This is because PAIN is often related to both physical and non-physical factors.
  • Learning about pain triggers by looking at things like your sleep patterns, activity levels and the way you cope with stress and worry, may help you to better understand and manage your pain.
  • Your pain can be treated/managed well and recovery is possible by finding the right strategies and support for you.

Try some of these self-help tips.

  • Apply a heat or icepack to the painful areas (for up to 15 minutes). Never apply heat or ice directly to the skin.
  • Relaxation (e.g., breathing) techniques may help your muscles become less sensitive and calm your nervous system.
  • Keep trying to move regularly. This is safe and helpful for your pain in the long run. It is important to build up gradually – the exercise or activity you enjoy most, is likely to help your recovery.
  • Building a good sleep pattern by setting a regular sleep time, using relaxation techniques, and reducing the use of electronic devices (phones and tablets) just before bed.
  • Breaking down activities into smaller chunks may help avoid doing too much in one go which may cause a flare of pain and fatigue.
  • Try not to feel guilty for taking a rest break, this may help you to control your symptoms better.
  • If you are feeling isolated and although it may seem difficult, try and make contact with friends, family, healthcare professionals and or join a local support group.

When should I seek medical advice?

Call your GP surgery if:

  • Your pain is getting worse.
  • You have tried the self-help tips for 3-4 weeks and are struggling to manage a flare up in your pain.
  • You have been prescribed medication that is not helping you manage your symptoms after an appropriate time period.
  • You notice new symptoms that may be worrying you.
  • You would like further support to develop a long-term management plan.

Useful websites and resources

Accessing information and support to make healthy lifestyle choices

Local support 

Online support