Chronic Pain
Chronic pain is highly individualised—it’s important to remember that this is your body and your experience. Many people suffer from chronic pain, which is officially recognised as a disability in Australia. This means that those living with the condition may be eligible for various forms of support, including financial assistance, healthcare services, and other resources.
Understanding Chronic Pain
Chronic pain is not just “in your head.” It is a condition of the nervous system. Typically, pain serves a short-term protective function that resolves with healing. However, when pain persists for three or more months, it becomes a chronic condition that has no benefit and impacts a person’s ability to work, move, sleep, enjoy social or family time, and can cause emotional distress.
This persistence is due to a reprogramming of the nervous system, where pain signals become more frequent, without warning and amplified. The nervous system enters a state of “high alert,” meaning pain can be triggered by sitting too long, moving too much, weather changes, or sometimes for no apparent reason.
Types of Chronic Pain
Chronic pain can be broadly categorised into nociceptive, neuropathic, or nociplastic pain. It’s common to have a mix of these pain types, and pain management is guided by these classifications among other factors.
Nociceptive Pain: This type of pain is associated with tissue injury or damage. Nociceptors signal potential tissue damage. Examples include osteoarthritis, pelvic pain, rheumatoid arthritis, and ankylosing spondylitis.
Neuropathic Pain: This pain is related to injury or disease of nerve tissue. Common conditions include shingles, sciatica, neck or back radiculopathy, trigeminal neuralgia, and diabetic neuropathy.
Nociplastic Pain: This pain arises from altered nociception without clear evidence of actual or threatened tissue damage or disease of the somatosensory system. Examples include Complex Regional Pain Syndrome (CRPS), Fibromyalgia, and non-specific lower back pain.
The Painful Truth
- Chronic pain affects over 3.6 million Australians and is the leading cause of disability.
- There is a significant lack of awareness, education, support, and training for both health consumers living with chronic pain and healthcare professionals treating it.
- Only 1 in 100 Australians living with chronic pain can access multidisciplinary pain management.
- Chronic pain treatment and management are severely underfunded, with most Australians unable to afford out-of-pocket expenses.
- The annual cost of chronic pain in Australia is projected to rise from $139.3 billion in 2018 to an estimated $215.6 billion by 2050.
Treatment and Management
Regular assessment using the 5 A’s:
- Analgesia: Evaluate the effectiveness of pain relief.
- Activity: Assess the impact on daily functioning.
- Adverse Effects: Monitor side effects of treatments.
- Aberrant Behaviours: Identify any problematic behaviours.
- Affect: Consider the emotional and psychological impact.
Periodically review pain diagnosis and comorbid conditions, including substance use disorders.
Have a plan for severe, painful times. You may begin with medications but also consider hot or cold packs, baths, naps, self-hypnosis, stretching or biofeedback.
Develop a plan to make pain less present in your life.
Pain is a signal to change your lifestyle.
Pace yourself but try to find activities that either decrease the frequency or intensity of pain episodes. The interventions that people find useful vary but include therapeutic massage, anti-inflammatory diets, counselling, tai chi, yoga, hypnosis, strength-building, mud and mineral baths, anti-depressants, support groups, stretching and gentle dancing.
You need to find what works for you and do it.
by Donna-Marie Currey
District C1 ALWF Chairperson
