Managing chronic pain

Most, if not all, of us will experience periods of physical pain throughout our lives. Nerves carry signals from our body to our brain communicating there is a problem, and we experience these signals as pain. Pain serves an important purpose, as it is often a symptom of illness or injury. This means it usually subsides at some point throughout the healing process. However, chronic pain is a prolonged experience that can significantly impact a person’s quality of life.

Chronic pain can impact every facet of a person’s life including their ability to work, socialise, exercise and sleep. People with chronic pain are also more likely to experience a range of mental health conditions like depression or anxiety. With one in five Australians over the age of 45 currently living with persistent, long-term pain [1], it is important we continue to better our understanding of chronic pain so that we can improve pain management options and treatment outcomes.

What is chronic pain?

Chronic pain is any persistent pain lasting longer than three months, or beyond the normal expected healing timeframe. Chronic pain can indeed be severe, but the term ‘chronic’ is actually a reference to the persistent nature of the pain rather than a description of its severity. Being a complex condition, everyone’s experience of chronic pain will be different – for some it will be mild, for others severe – but the primary characteristic of chronic pain is that it is frequent and ongoing.

What causes chronic pain?

Chronic pain can arise for several reasons, usually as a result of injury, illness, or a prolonged health condition, but sometimes chronic pain develops with no apparent cause. Some of the more commonly known causes of chronic pain include:

  • Illness or chronic disease such as migraines, osteoporosis, arthritis, or cancer
  • As a result of injury or surgery in cases where there is an abnormal nerve response
  • An underlying health condition such as fibromyalgia, endometriosis or chronic fatigue syndrome

Managing chronic pain

Managing chronic pain requires a multi-faceted and multi-disciplinary approach. While medicines can play a role in providing temporary relief, a holistic response in which a person actively manages their pain will improve the quality of day-to-day living.

It is also important to consider lifestyle factors like regular exercise (such as swimming, walking or yoga), relaxation techniques (such as meditation) and quality of sleep.

Importantly, chronic pain often impacts on mental health, so accessing psychology or counselling services, or engaging with a reputable online self-help service can assist.

Allied health professionals can also play a role in helping a person to manage chronic pain by working closely with a person toward achieving goals that are important to them.

Chronic pain and occupational therapy

Occupational therapists work with people to enable greater participation in meaningful activities. Chronic pain can often interfere with a person’s ability to engage in the activities they enjoy or want to undertake. Occupational therapists work with an individual to develop therapy plans, organise supports or modify their environment in ways that can improve a person’s capacity for engagement and help to minimise the burden caused by chronic pain.

Occupational therapists have the knowledge and skills to undertake comprehensive assessments to understand the scope of impact chronic pain has on a person’s usual functioning. Occupational therapists are also well positioned to develop customised interventions with the aim of improving a person’s ability to participate in meaningful activities. This may include implementing a range of therapy programs, scripting assistive devices, modifying a person’s home to make it more accessible if the person experiences physical or cognitive limitations related to the pain, working with family and/or friends to develop supportive strategies, and more.

Chronic pain and physiotherapy

A physiotherapist who understands pain will work with a person to understand their particular condition and wellbeing needs, with the aim of improving quality of life. Physiotherapists can undertake a comprehensive assessment of a person’s specific needs and recommend tailored interventions, working toward specific outcomes that are important to that individual with a focus on mobility, strength, and flexibility. For example, a physio can develop an exercise program incorporating pain-free or pain-minimising exercises that encourage mobility. Among other interventions, physiotherapists are also skilled in developing and implementing manual therapy programs or providing soft tissue treatments.

Chronic pain and speech pathology

Speech pathologists can also play an important part in a multi-disciplinary approach to pain management. When chronic pain is caused by an injury or health condition that can impact speech, such as a brain injury or stroke, being unable to communicate their needs can negatively impact a person’s quality of life. Speech pathologists can work closely with a person to develop a range of verbal and/or non-verbal communication techniques. Speech pathologists also possess the expertise to identify non-verbal indicators of chronic pain. Being able to communicate the experience of pain and feeling connected with and understood by people in their support network is important for a person actively managing chronic pain.

What if I am experiencing chronic pain?

You are not alone – over the past ten years GPs in Australia have seen a 67% increase in patients presenting with chronic pain [2].

The best place to start if you are experiencing chronic pain is to have a discussion with your GP. They will be able to explore your options and, if appropriate, refer you to specialists, allied health practitioners or a variety of other health service providers.

[1] Chronic pain in Australia, Summary – Australian Institute of Health and Welfare (aihw.gov.au)

[2] Chronic pain in Australia, Summary – Australian Institute of Health and Welfare (aihw.gov.au)