Chronic Pain: Why You Shouldn't Ignore It

Pain is the No. 1 cause of disability in the United States, but relief is often at hand.

Medically Reviewed by Brunilda Nazario, MD on February 26, 2007

Remember your gruff high school coach's advice for treating an injury? "Just walk it off."

Turns out your coach should have been sidelined for making a bad call, because while this strategy might have worked for the odd skinned knee, it's downright dangerous for serious pain. Still, a staggering one in 10 Americans reports that he or she has had regular pain for more than a year. Pain is the No. 1 cause of disability in the United States. So why can't we find relief?

Experts say that some people get the wrong diagnosis from their doctor. Others never seek help because they just get used to the pain. Or they assume that pain is inevitable, like gray hairs, and don't bother fighting it.

But you should never settle for chronic pain. You shouldn't have to.

"Pain is the body's red alert," says Anne Louise Oaklander, MD, PhD, an associate professor of neurology at Harvard Medical School. "You must always listen to it."

Although pain treatment was once more of an afterthought -- as doctors focused only on treating the underlying cause -- pain management is becoming an important part of medical care. In other words, pain isn't just a symptom of something else: It's a condition that needs to be treated.


What Is Chronic Pain?

Any pain that goes on for more than three to six months is considered chronic. According to a 2006 report by the CDC, the most common types of pain are:

Another common cause of chronic pain is nerve pain, the result of conditions such as diabetes and shingles.

The effects of chronic pain vary from minor to catastrophic. Chronic pain is much more than just the sensation of pain. It seeps into the rest of your life. It can keep you awake at night, leaving you exhausted. It disrupts your family life. It can affect your work -- or even prevent you from working at all.

Ideally, pain is meant to be felt briefly. That stinging, aching, or throbbing sends helpful messages, like "Drop that red-hot pot handle" or "Remove your hand from the hornets' nest." After a while, it goes away.

But some pain doesn't. All it takes is an injury that doesn't heal correctly, or joint deterioration, or nerve damage, and the pain-signaling system breaks down. Your pain isn't giving you a helpful message anymore -- it just hurts.

If you have chronic pain, your gut instincts may work against you. If your knee hurts when you walk, you naturally want to walk less. But if you walk less, your muscles can weaken. The fatigue that comes with pain can immobilize you, causing weight gain and worsening physical health. Sometimes, exercising through chronic pain -- under a doctor's supervision, of course -- is the only way to decrease it. So we'll chalk one up to your high school coach. In this particular instance, walking it off might be just what the doctor ordered.


Treating Pain

Many treatments are available. Some are over-the-counter medicines such as acetaminophen (Tylenol) and nonsteroidal anti-inflammatory drugs (NSAIDs), such as aspirin, Advil, and Motrin. Others are prescription painkillers, injections and nerve blocks, and high-tech surgeries. Treatment focuses on both easing the pain and treating the underlying cause, if possible.

But getting the right treatment can be tricky. Oaklander says that some doctors may be too quick to give up. If your doctor can't seem to help, get a referral to an expert. If you have arthritis pain, see a rheumatologist. If you have migraines, see a neurologist. Or you could seek out a pain specialist.

No matter what, listen to your pain, Oaklander says. If you have chronic pain, don't ignore it -- and never accept it.

Migraine Pain? Partner With Your Doctor

Migraine headaches are a common type of chronic pain; more than 28 million people in the United States have them. Treating this type of pain starts with developing a good partnership with your doctor. These tips will help you describe the pain you're feeling -- and they are useful for other kinds of chronic pain, too.

  • Keep a journal. Start taking notes a few weeks before your next appointment. Record when you have migraines, how severe they are, and other relevant details, including: stress levels; sleep patterns; foods or alcohol that may have triggered a migraine; and other possible triggers, such as menstrual periods, exercise, or even sex.
  • Be specific. Explain how your pain affects you in concrete terms. Do you suffer from auras? Areyour migraines so bad that you have to leave work? Do you have nausea or light sensitivity? Do migraines prevent you from doing things you enjoy?
  • Be honest. It's crucial that your doctor know about all other medicines you use, including herbal medicines and supplements.
  • Ask for a referral. If your doctor can't ease your pain, ask to see a specialist, such as a neurologist who focuses on treating migraines. This isn't an insult to your health care provider -- it's how the system is supposed to work, says Oaklander.

Show Sources

Published March 1, 2007.

SOURCES: American Academy of Family Physicians web site: "Chronic Pain: How to Get Relief." American Society of Anesthesiologists web site: "The Management of Pain." National Center for Health Statistics: Health, United States, 2006. News release, National Center for Health Statistics. Anne Louise Oaklander, MD, PhD, associate professor of neurology, Harvard Medical School; director of the Nerve Injury Unit, Massachusetts General Hospital, Boston.

© 2007 WebMD, Inc. All rights reserved. View privacy policy and trust info