Kinds of chronic pain

Here, pain grows out of another condition. Examples include arthritis, nerve damage, an old injury, an operation, or a headache disorder like migraine. Caring for that condition is often part of caring for the pain.

Sometimes there is no other disease that explains the pain. Pain experts call this chronic primary pain and give fibromyalgia and non-specific low back pain as examples. It is a health condition in its own right, not a mystery or a made-up problem.

About 90% of low back pain has no single disease or structural cause that can be found (WHO).

Pain conditions often travel together. For example, many people with fibromyalgia also live with headaches, migraine, jaw pain or irritable bowel syndrome.

All pain is a personal experience shaped by the body, thoughts, feelings and life around you. That is true for a stubbed toe and for decades of back pain alike.

Back pain can follow an injury, come with age-related changes in the spine, or be linked to conditions like inflammatory arthritis or fibromyalgia. Often no single cause is found.

Things linked to more back pain

• Depression or anxiety
• Desk or physical work that strains the body
• Low fitness after a long inactive spell
• Poor sleep
• Stress

Poor sleep and stress are linked to more frequent and more severe back pain. That does not mean the pain is imagined. It means calming stress and protecting sleep are part of looking after your back.

The World Health Organization recommends a mix of care for low back pain: physical therapies to build strength and movement, psychological and social support, easing physical strain at work, and lifestyle changes like more activity and good sleep.

Neck pain is one of the most common musculoskeletal conditions in the world, alongside low back pain and osteoarthritis.

Like back pain, it often lives in the same loop of tension, worry and poor sleep. Gentle movement and stress relief can loosen that loop.

Some causes of nerve damage

• Diabetes (type 1 or type 2)
• Heavy alcohol use
• Physical injury to a nerve
• Viral infections, such as shingles

Early diagnosis gives the best chance of limiting nerve damage and preventing problems like slow-healing foot sores.

See a clinical provider if you notice

• A cut or sore on your foot that is not healing
• Loss of balance or weakness
• Pain, tingling or numbness in your feet or hands

Pain that is hard to describe can make people feel misunderstood. Long-term pain of any kind is linked with low mood and anxiety, and both can be treated.

In osteoarthritis, the tissues in a joint break down over time. It most often affects the hands, knees, hips, neck and lower back. It is more common with age, but younger people can get it after a joint injury.

Over time it can make everyday tasks like stairs or gripping harder, and it can bring tiredness, sleep problems and low mood.

In rheumatoid arthritis, the immune system attacks the lining of the joints, causing pain, swelling and stiffness. It often affects both sides of the body and can bring tiredness. Women are two to three times more likely than men to have it.

Juvenile idiopathic arthritis begins before age 16. It is the most common type of long-term arthritis in children. Younger children may not complain of pain, so morning stiffness or limping can be early signs.

Migraine usually brings a throbbing headache, often on one side, along with sickness and sensitivity to light and sound. Attacks often last from 4 hours to 3 days. Migraine is more common in women.

Tension-type headache is the most common kind of headache. Episodes are reported by more than 70% of people in some populations.

Stress and tense muscles often play a part, which is why relaxation and slow breathing can be useful tools.

Temporomandibular disorders (TMDs) cause pain and problems in the jaw joint and chewing muscles. An estimated 11.2 to 12.4 million U.S. adults have pain that may be linked to them. They are especially common in women aged 35 to 44.

With widespread pain, the body’s alarm system can become more sensitive overall, not just in one spot. Light, noise, smells and temperature can feel stronger too.

There is no lab test or scan that confirms fibromyalgia. Providers listen to your symptoms and check for other conditions that can look similar.

Feeling very anxious around the time of surgery is the main emotional factor linked to lasting pain afterwards. Low mood, fear of moving and expecting the worst also play smaller parts.

CRPS is a poorly understood condition, usually triggered by an injury, where pain is far stronger and lasts far longer than expected. The skin can become so sensitive that light touch hurts. The limb may swell or change color or temperature.

Care usually brings several professionals together. It includes learning about the condition, physical rehabilitation and psychological support such as CBT. CRPS often slowly improves over time.

Many people feel pain in a limb that is no longer there. It is a real nerve and brain experience, not imagination.

Exercise is a key part of care for back pain, fibromyalgia and arthritis alike. The right kind and amount looks different for everyone.

Poor sleep is linked to more back pain and is common in fibromyalgia and arthritis. A steady bedtime and wake time is a simple place to start.

Support groups, self-management courses and talking with people who share your kind of pain can ease loneliness and teach practical skills.

Treating depression alongside a long-term health condition can improve how you feel overall. Your mood is part of your health, not a side issue.

Some examples

• Aching or throbbing
• Burning, stabbing or shooting
• Dull or heavy
• Pins and needles or numb
• Sharp
• Stiff or tight
• Tender to touch

Things worth noting

• Does it move or spread?
• Is it worse in the morning, at night or after activity?
• What eases it, even a little?
• Where is it?

Telling your provider what pain gets in the way of, like sleep, work, family or hobbies, helps them understand how much it affects you.