Opinion

Icome across a patient suffering from chronic pain nearly every week. What strikes me most about this group of people is how impacting on their lives this condition is – often leading to relationship or family breakdown, depression and anxiety, low self-esteem, and reduced ability to work or contribute in other ways.

I have no doubt it is incredibly hard for sufferers and their families, and yet we know very little about why some people develop chronic pain and others don’t and, worst of all, as doctors we aren’t very good at managing it effectively.

So what is chronic pain, and what can you do if you or a loved one are unlucky enough to be in this position?

The word ‘‘chronic’’ in medicine doesn’t have anything to do with severity, but is about duration – anything described as chronic is ongoing, as opposed to short-lived. So chronic pain really means pain that has been there for a long time, sometimes defined as more than 12 weeks. I prefer an alternative, less specific, definition, which states that pain persisting for longer than the body should have taken to heal or recover can be considered chronic in nature.

I think of chronic pain as the body ‘‘adapting’’ to having pain, then perpetuating the pain long after the actual trigger has gone, hence pain itself becomes the problem, not the primary cause.

We often think of chronic pain in relation to backs, but actually it can occur anywhere in the body – other common sites include the head, neck, pelvic area, and genitals (especially in women), abdomen, and limbs. The pain can vary hugely too, from a burning type of ‘‘neuropathic’’ or nerve pain, to a low constant ache, and everything in between.

We don’t really know exactly how common it is, but probably around 20 per cent of us will have a degree of chronic pain at some point – a huge figure if you think how disabling it can be for those at the severe end of the spectrum. Chronic pain usually