Diagnosing Chronic Pain

Published on Nov 28, 2018
Medically reviewed by Freda Lewis-Hall, MD, DFAPA

Pain is personal. Everyone reacts to pain differently. Some people may put on a brave face and keep the complaining to a minimum, while others feel the need to talk about it and get immediate help. But pain is our body's way of letting us know that something may be wrong, and so it shouldn't be ignored. It's important to be able to accurately describe your pain so that you and your doctor can identify the cause and take appropriate action.

Before we dive into chronic pain, let’s talk a little about acute pain.

What is the difference between Acute pain and Chronic pain?

Pain is complex and can show itself in different ways. We’re all familiar with acute pain—the sensation triggered by our body’s nervous system to alert us to actual or possible injury and spurs us to seek help. It usually starts suddenly. It can last for hours, days or weeks, but usually goes away when the body heals. Think post-surgery, broken bones, kidney stones, cuts and burns. However, some people with acute pain may go on to develop long-lasting (or chronic) pain.

It has been estimated that approximately 1 in 5 to 1 in 6 Australians and New Zealanders live with chronic pain. This is pain that lasts for three months or longer. A person may have pain even after an injury heals. Some people may suffer from chronic pain even where there is no past injury (or tissue or nerve damage) at all.

Chronic pain may be caused by tissue damage from trauma or inflammation, nerve damage, or a dysfunction of the body’s nervous system. Examples of chronic pain include back pain, cancer pain, and arthritis. People with chronic pain often also experience fatigue, sleep problems and mood changes.

When Should I See My Doctor About Chronic Pain?

If you experience any of the following, it is time to book a doctor’s appointment:

  • When pain starts to interfere with your personal relationships and your ability to do your normal daily activities
  • If your pain is persisting despite pain medicine and rest
  • If you are suffering from pain lasting 3 months or longer

Some symptoms could also be a “red flag”, such as being sensitive to light, so if there is anything you are unsure about, talk to your doctor as soon as possible.

Importantly, if you are taking pain medications, always take them as directed by your doctor or pharmacist. Do not to exceed the amount listed on the packaging label.

How is Chronic Pain Diagnosed?

It’s not always easy to express what you’re feeling, especially when you’re in pain. And unfortunately, there is no precise test that can measure or locate your pain. So doctors rely on you to explain how it feels. It may be useful to describe the sensation of your pain, such as:

  • Aching
  • Tender
  • Sharp
  • Shooting
  • Hot
  • Burning
  • Nagging
  • Numbness
  • Intense
  • Stabbing
  • Tingling
  • Dull
  • Throbbing

Doctors also use tools to help assess the pain you are experiencing. Some may ask you to rate your pain from 0 to 10, where 0 means you have no pain, and 10 is the most intense pain imaginable. Or they may show you pictures of various faces with different expressions of pain and ask you to select the face that best matches how you feel about your pain.

Additionally, your doctor will likely perform a physical examination and may order blood tests, X-rays, or other diagnostic tests to help find the cause of the pain. You may also be asked to keep a pain diary to bring to your appointments.

Living with Chronic Pain

Chronic pain is not always curable, but keep in mind that just as pain is a very personal experience, your pain management strategy should be tailored to your specific needs.

And lastly, do not be ashamed. If you are in pain, tell your doctor. If you are not getting the help you need, it may be time to find a doctor who specialises in treating chronic pain – a pain specialist. Your relief starts with you and your willingness to speak up!

Learn more about the Types and Causes of Chronic Pain.

Freda Lewis-Hall, MD, DFAPA, is a physician and the Chief Medical Officer at Pfizer Inc.

[1] [2] [3] [4]

References

  • 1. Health Direct. Chronic Pain. Accessed 27 September 2018.
  • 2. Health Navigator New Zealand. Accessed 27 September 2018.
  • 3. National Institutes of Health. Pain Management. Accessed August 8, 2018.
  • 4. Stanos S, Brodsky M, Argoff C, et al. Rethinking chronic pain in a primary care setting. Postgrad Med. 2016;128(5):502-515.
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