What Is Chronic Pain?
Pain is one of the body’s protective signals. In the short term, it is designed to encourage rest and help you avoid further harm.
Chronic pain is usually defined as pain that persists beyond the expected timeframe of healing. For many people, pain lasts for three months or longer. It may begin after an injury, illness, or surgery, or it may develop gradually with no single clear trigger.
A key point is that pain is not produced by tissues alone. Pain is an experience created by the brain and nervous system in response to information coming from the body, your environment, and your personal context. That does not mean the pain is “in your head”. It means that pain is influenced by more than one system.
Common Symptoms Associated with Chronic Pain
People describe chronic pain in different ways, and the pattern can vary across the week or month. Commonly reported experiences include:
- Persistent aching, burning, or sharp pain
- Tenderness and sensitivity to pressure or movement
- Stiffness or a sense of reduced mobility
- Fatigue or low energy, especially after activity
- Disrupted sleep or difficulty resting deeply
- Difficulty concentrating, sometimes described as brain fog
- Irritability, low mood, or feeling on edge
People describe chronic pain in different ways, and the pattern can vary across the week or month. Commonly reported experiences include:
Factors That May Contribute to Chronic Pain
Movement Patterns, Load, and Recovery
- Sudden changes in activity, such as doing much more or much less than usual
- Prolonged sitting, repetitive tasks, or limited variety of movement
- Insufficient recovery between demands
- Reduced strength, stamina, or confidence after a period of pain
Stress, Sleep, and Capacity
Previous Injury, Illness, or Medical History
Context and Environment
How the Nervous System Can Be Involved
Pain signals travel from the body to the spinal cord and brain, where they are processed and interpreted. In acute injury, this protective response usually settles as healing progresses.
In chronic pain, the nervous system can become more reactive. Some people develop increased sensitivity, which means that the system reacts strongly to sensations that would not normally be threatening. In clinical and research settings this is often described as sensitisation.
Two terms you may come across are:
- Peripheral sensitisation, where tissues and nerves around a painful area become more irritable
- Central sensitisation, where the spinal cord and brain become more responsive to pain signalling
This does not mean damage is always present. It suggests that the nervous system may be working on a higher alert setting. People can then experience pain with everyday movement, light touch, or levels of activity that previously felt normal.
It is also common for chronic pain to affect mood and concentration. Pain, sleep, and stress share overlapping pathways in the brain, so persistent discomfort can influence emotional wellbeing, and emotional strain can, in turn, change how pain is felt.
What People Commonly Explore to Support Themselves
Build Steady Foundations
- Prioritise regular sleep and a predictable wind-down routine
- Aim for gentle, frequent movement rather than long periods of rest
- Keep meals steady, and stay hydrated
- Take short breaks during the day to reduce prolonged strain
Pacing and Load Management
Reduce Fear Around Movement
Support Emotional Wellbeing
If you are exploring changes, it is sensible to avoid extreme programmes that promise rapid results. Progress is often steadier when it is built around what you can maintain.
What a Consultation Involves at Foundation For Life Healthcare
At Foundation For Life Healthcare, new patients are invited to have an initial conversation before any care begins. The purpose is to understand your situation and check whether the approach is appropriate for you.
A first appointment typically includes:
- A detailed health history, including the timeline of your symptoms
- Discussion of lifestyle factors such as sleep, stress, and activity levels
- A physical assessment, which may include posture, movement, and neurological function
- A clear explanation of findings, alongside options and next steps
Chiropractic is commonly associated with helping low back pain, neck pain, headaches, and sciatica. If your symptoms indicate a need for medical investigation or urgent support, you will be encouraged to seek appropriate care.
When to Seek Medical Advice
Seek urgent medical advice if you experience:
- Severe, sudden, or rapidly worsening pain
- Weakness, numbness, or changes in sensation that are new or progressing
- Changes in bowel or bladder control
- Fever, unexplained weight loss, or night sweats alongside pain
- Chest pain, breathlessness, or symptoms that could suggest stroke
If you are unsure what to do next, contact NHS 111 or speak with your GP.
Frequently Asked Questions About Chronic Pain
How is chronic pain different from acute pain?
Why do symptoms flare up even when I have not done anything unusual?
Can stress make chronic pain feel worse?
Does chronic pain always mean something is damaged?
What is sensitisation?
What is a sensible first step if I feel overwhelmed?
When should I speak with my GP?
What happens before I decide whether to book an appointment?
Condition
New Treatments for Chronic Pain
Researchers are developing new treatments for chronic pain based on a better understanding of how the brain and nervous system work. For example, some treatments aim to “retrain” the brain to process pain differently. Techniques like transcranial magnetic stimulation (TMS), which uses magnetic pulses to stimulate the brain, are being tested to see if they can reduce pain. Another approach is spinal cord stimulation, where a device sends electrical pulses to the spinal cord to block pain signals before they reach the brain.
Chronic pain is not just the result of ongoing injury—it is a condition that arises when the nervous system becomes dysfunctional and over-sensitive. Both the nerves and the brain become involved in the persistence of pain, making it a complex and challenging condition to treat. However, as we continue to learn more about the neurological processes behind chronic pain, new treatments are emerging that aim to reset the nervous system and help people manage or even reduce their pain. Understanding chronic pain as a problem of the nervous system can help people with chronic pain feel more hopeful and informed about their options for treatment.
Gain a Deeper Understanding of Chronic Pain
What is Chronic Pain?
Pain is something we all experience when we get hurt. It is the body’s way of warning us that something is wrong, like when you touch a hot stove and quickly pull your hand away. This is acute pain, which typically goes away once the injury heals.
Chronic pain is different. It doesn’t stop after the body has healed. It can continue for months or even years, even though the original injury might have long since healed. Sometimes, there is no obvious injury at all. Chronic pain can occur when the body’s pain system becomes “over-sensitive” and keeps sending pain signals to the brain even though there is no real danger.
How Does the Nervous System Process Pain?
The nervous system, which includes the brain and spinal cord, is responsible for processing pain. Normally, when you get hurt, sensors in your body (called nociceptors) detect damage and send pain signals through nerves to the spinal cord, and from there to the brain. The brain then processes the signals and you feel pain.
When an injury heals, the pain usually goes away. However, in chronic pain, this process doesn’t work as it should. Even after the injury has healed, your nervous system continues to send pain signals, or sometimes even creates pain without any injury at all. This can happen because of changes or damage to the nervous system itself, making it “over-react” to even normal sensations.
The Role of Sensitisation in Chronic Pain
One of the main reasons for chronic pain is something called “sensitisation.” This means that the nervous system becomes extra sensitive to pain signals. Sensitisation can happen in two main places: in the nerves that detect pain and in the spinal cord and brain that process the signals.
Peripheral Sensitisation: This happens when the nerves in the affected area become more sensitive after an injury or inflammation. For example, after an injury, the body releases chemicals that make pain sensors in the skin and tissues more sensitive. As a result, you might feel pain even from things that normally wouldn’t hurt, like a light touch.
Central Sensitisation: This occurs in the spinal cord and brain, where pain signals are processed. In people with chronic pain, these areas of the nervous system become more sensitive to pain signals. The brain and spinal cord start to “overreact” to pain, even when there’s no actual injury. This can make the pain feel stronger or last longer than it would in a healthy functioning nervous system.
How the Brain Changes in Chronic Pain
In addition to becoming more sensitive, the brain can actually change its structure and function because of chronic pain. These changes are called “neuroplasticity.” In a healthy person, the brain has a balanced response to pain—it recognizes the pain and responds appropriately. But in chronic pain, the brain can reorganise itself in ways that make the pain feel worse.
For example, the areas of the brain that process pain can become overactive or enlarged, causing the brain to misinterpret normal sensations as painful. The brain might even start using the same neural pathways that normally process non-painful sensations (like touch or pressure) to process pain, making things like a simple hug or a light touch feel painful.
How Does the Brain Control Pain?
Your brain has built-in systems that can control pain, like a natural “painkiller” switch. This system can either reduce or increase pain depending on the situation. For example, if you’re injured, your brain can release chemicals that reduce pain. This is part of your body’s way of coping with temporary injuries.
However, in people with chronic pain, this system can go wrong. The brain may lose its ability to turn off pain effectively, or the system that increases pain may become too active. This can result in pain that feels constant and uncontrollable.
Emotional and Psychological Factors
Chronic pain isn’t just a physical issue; it also affects emotions and mental health. People with chronic pain often experience anxiety, depression, and feelings of helplessness. This emotional distress can, in turn, make pain feel worse.
The brain regions that control emotions, like the amygdala and the prefrontal cortex, are involved in the experience of pain. These areas can amplify the emotional response to pain, making it feel more intense or harder to ignore. In fact, the more you worry about pain, the more your brain can focus on it, increasing your perception of it.
Why Is Chronic Pain So Hard to Treat?
Chronic pain is difficult to treat because it involves complex changes in the nervous system. Traditional painkillers, like ibuprofen or opioids, can help with temporary pain, but they don’t address the underlying changes in the nervous system that cause chronic pain.
Medications used to treat chronic pain often target the nervous system more directly. For example, certain antidepressants and anticonvulsants (used to treat epilepsy) can help calm overactive nerve signals. In some cases, doctors may recommend nerve blocks or other treatments to interrupt the pain signals.
Another approach involves managing the emotional and psychological aspects of pain. Cognitive-behavioural therapy (CBT), a type of therapy that helps people change the way they think about pain, can be very helpful. CBT can teach people how to manage their pain by reducing the emotional distress that comes with it.
References
- Apkarian, A. V., & Bushnell, M. C. (2005). Human brain mechanisms of pain perception. European Journal of Pain, 9 (4), 7-14.
- Woolf, C. J., & Salter, M. W. (2000). Neuronal plasticity: Increasing the gain in pain. Science, 288 (5472), 1765-1769.
- Finnerup, N. B., et al. (2015). Pharmacotherapy for neuropathic pain in adults: A systematic review. The Lancet Neurology, 14 (2), 162-173.
- Turk, D. C., & Gatchel, R. J. (2011). Psychological approaches to pain management. Physical Therapy, 91 (5), 700-711.
