Chronic pain
December 16, 2025
What Is Chronic Pain?
Chronic pain refers to pain which persists for longer than we would expect it to, and is typically present for longer than 3 months. The reasons for chronic pain are complex and multifactorial, and it is estimated that between 15-25% of adults experience chronic pain. Chronic pain differs from acute pain, which tends to be short term in nature and is typically associated with disease or damage to the tissues. A typical example of acute pain would be the pain experienced after an ankle sprain. This pain is typically well localised and may be also present with signs of visible tissue damage such as bruising. Acute pain is often helpful, as it alerts us to the presence of a problem – and causes us to change our behaviors and facilitate recovery. Acute pain typically improves in a linear fashion as our tissues heal, and is generally completed within 3 months regardless of injury severity.
Chronic pain is less associated with mechanism of injury and instead is linked to changes within our central nervous system, which can result in increased sensitivity of our nerves, even after the tissue damage has healed. Typically, it can be variable in nature, widespread and may present as a burning, tingling or gnawing pain. Chronic pain has a poor correlation with physical harm to our tissues and persists after normal healing has occurred. A good way of picturing chronic pain would be to imagine a fire alarm which fails to switch off, even after the fire has been put out.
5 tips to assist with the management of chronic pain:
Whilst there are many factors which can influence our levels of pain, research has suggested that the following strategies can help to positively influence chronic pain:
1: Exercise
Exercising regularly keeps our muscles strong and our joints supple. Gentle exercise helps activate neural pathways and stimulates the release of our natural painkillers (dopamine and serotonin). It is important that whilst we exercise, we do so in a way which prevents ‘poking the bruise’ – people with chronic often either push through the pain or avoid activity. It is important to develop a regular exercise routine at the correct level of intensity which enables individuals to experience the benefits of exercise whilst reducing the risk of flare ups.
2: Sleep
Sleep is essential for wellbeing, physical functioning and mental health. Approximately 50-88% of individuals with chronic pain report sleep disturbance – with negative impacts on their physical and mental health. There are well established links between sleep deprivation and disease states such as diabetes, depression, cancer, obesity and heart disease. Sleep deprivation is thought to be linked to increased inflammation and chronic pain, with research finding increasing volumes of the inflammatory makers in those who were in sleep debt when compared to a control group. Useful strategies for improving sleep quality include maintaining a regular bed time, reducing screen time prior to bed, creating a dark, quiet environment and participating in regular exercise.
3: Stress management
Stress management is a key component of any persistent pain management strategy. Research has demonstrated that chronic pain is less about persistent harm to tissue health, and more about an overactive nervous system reacting to fears of perceived threat or harm. The body is able to cope with smaller amounts of short-term stress, often by creating physiological changes such as by increasing heart rate or respiratory rate. Over time, chronic stress can lead to increased wear & tear on the nervous system, and inflammatory changes similar to those experienced with sleep deprivation. These changes can contribute to reorganisation of neural pathways which ultimately can cause a lower pain threshold. These findings may typically be seen in those with fibromyalgia or persistent back pain amongst other conditions. Strategies which may improve stress management are best tailored to the individual but may include mindfulness meditation, structured breaks and breathing exercises.
4: Make SMART goals
Managing chronic pain can often be seen a daunting task, as its effects can often impact multiple areas of a person’s life. Goal setting can assist pain management by taking bigger goals and breaking them into a series of smaller, achievable steps. Regular goal setting can improve motivation, relieve anxiety and reduce over and under activity cycling. Evaluating progress with goals can also lead to improved ability to manage symptom flare ups and adjust activity level according. Working with a health professional can often be helpful in the goal setting process, as they are able to provide context, education and support which can improve overall management.
5: Maintain a supportive network
Chronic pain can often cause people to withdraw from their social activities and networks, which in time can lead to increased feelings of stress and isolation and can further exacerbate chronic pain. Withdrawing from social activities can also lead to deconditioning – in which the tissues lose strength, flexibility or endurance, resulting in them to be less able to cope with physical load. Over time this can worsen can increase discomfort with activity, further re-enforcing the negative cycle and increasing the likelihood of further activity avoidance. Maintaining social networks can counter these effects by improving morale and providing stress relief and support, which are factors known to positively improve pain management. Regular fun activities have been proven to promote the circulation of endorphins – natural feel good chemicals which can assist in pain management. Having fun also provides a helpful diversion from the pain and can promote physical activity and social interaction which are good for pain management.