What is chronic pain?
The term 'chronic pain' is used to describe pain that has been present a long time -usually months of years. Chronic pain can occur following an injury which has long since healed or due to problems such as arthritis, diabetes or shingles. Sometimes it can occur without any obvious trigger factor. This means that some people will be given a diagnosis for their chronic and some will not. However, in all these cases, the basic cause of the chronic pain is probably that nerves have become irritated and are working differently to normal.
How can I get help for chronic pain?
It is possible that you may have tried many treatments in the past that have
not been very helpful. At the Pain Clinic, we will look at assessing and
managing your pain. Chronic pain quite commonly affects every aspect of a
person’s life: physical activities; mood; family and friends; social activities;
work. To manage the pain well, it is important to look at all of these aspects.
What can I expect from a Pain Clinic?
At your first appointment, you will be seen by a member of the team who will
assess your pain and discuss the possibilities of managing it with you.
Sometimes there are not any further treatments that are suitable for treating
your pain, but you will be given advice where possible on how to manage it
better. However, some of the treatments that may be suitable are explained below.
There are a large number of drugs that are widely used to manage pain.
These range from ‘over the counter’ painkillers to those that can only be
prescribed by a doctor. Most painkillers are very safe a nd can be very
effective. However, some people experience side effects and any potential
side effects will be discussed with you by the doctor or nurse.
Ordinary painkillers are not always helpful for chronic pain – particularly pain
due to nerve damage, sometimes called neuropathic pain. Neuropathic pain
can be helped by drugs that are also used for epilepsy and depression. These
drugs alter the sensitivity of the nerves and the way they transmit pain
Injections of local anaesthetic and long acting steroid (cortisone) can
sometimes be helpful to reduce inflammation and irritation around nerves and
thereby reduce pain.
Pain due to poor circulation may be helped by blocking certain nerves with
local anaesthetic which can reduce pain and improve circulation.
For some pains, deadening the nerves thought to be causing your pain with
heat or cold can be helpful. In some particular cases, it can also be helpful to
destroy the nerves using chemical injections.
Although nerve blocks can be very helpful, unfortunately they do not always
work and can have some side effects. If the doctor or nurse feels a nerve
block may help you manage your pain he/she will discuss this with you in
We all know that rubbing the skin can help pain caused by a minor injury.
Transcutaneous Electrical Nerve Stimulation (TENS) applies the same
principle. Small pads are placed around the area of pain and are connected to
a small battery powered box, which produces a tingling feeling instead of pain.
Pain stops many people from using the part of the body that hurts. This leads
to muscle wasting and joint stiffness, which in turn makes pain and disability
worse. Physiotherapy can help you do more, which in turn will lead to an
improvement in your pain. Getting you back to normal activity is one of the
main aims of the Pain Clinic and all treatments try to help you achieve this.
If you have had ‘hands on’ physiotherapy in the past that has not helped in the
long term, it will not be helpful to repeat this. You may be referred to our
specialist physiotherapist who will discuss exercise, movement and posture
Chronic pain can have a significant impact on people’s lives. It can affect how
people feel, what they can do and their relationships with others. Different
aspect of people’s lives can also affect their pain and how they are able to
manage it.You may be referred to our clinical psychologist if it is felt that it might be
useful for you to explore these aspects of your pain problem.
Pain Management Skills
Pain management skills are physical, practical and psychological techniques
that can help you manage your pain. You may see a member of the team
individually to learn some of these or you may be referred to the Pain
Management Programme where you will see the team in a group.
Dr. Claire Winchurst, Consultant Clinical Psychologist
Ms. Caroline Waterstone, Specialist Physiotherapist