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Am Fam Physician. 2008;78(10):1164

See related article on chronic pain.

What is chronic pain?

It is pain that doesn't go away after six months. It can keep you from doing your normal activities.

How does it happen?

Any injury or illness that causes pain can also cause chronic pain. It can happen when an injury permanently damages your body. It could also be an abnormal nervous system response to injury (for example, “phantom pain,” which is pain that feels like it is coming from a body part that has been amputated). Chronic pain continues even after the illness is over or the injury has healed.

How do I know if I have it?

Your doctor will examine you. You may have to fill out a pain diary that describes your pain. You may also need to have tests or see other doctors.

How is it treated?

The goals of treatment are to improve your quality of life and decrease the pain. The pain is usually treated with medicines (for example, pain killers or antidepressants) and therapy (for example, physical or occupational therapy or counseling). Physical therapy and exercise can make your muscles stronger and reduce pain. Occupational therapy teaches you how to pace yourself to do daily tasks.

Treatment could include exercise, weight loss, living healthier (for example, drinking less alcohol or quitting smoking), and getting regular sleep. Your treatment may not stop the pain, but it should help you to enjoy life more.

What medicines are used to treat it?

Many different medicines are used to treat chronic pain. There are some you can buy over the counter, such as acetaminophen (one brand: Tylenol) or ibuprofen (one brand: Motrin). Other medicines require a prescription, such as opioids, antidepressants, anticonvulsants, and lidocaine (one brand: Xylocaine).

Which medicine your doctor picks depends on what illness or injury caused the pain. Musculoskeletal pain, such as arthritis, can be treated with anti-inflammatory medicines or opioids. Nerve-related pain, such as fibromyalgia, can be treated with anticonvulsants, antidepressants, or lidocaine. Talk to your doctor about the side effects of the medicines.

Where can I get more information?

American Academy of Family Physicians (https://familydoctor.org)

American Chronic Pain Association, Inc. (http://www.theacpa.org)

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