About Pain

Most of us have experienced everyday pain, for example:

• Headaches
• minor injuries
• muscular pain, for example following exercise.

These pains don’t last long and often don’t need treatment.

All pain we feel is affected by:

• how we are feeling generally
• our past experience of pain
• any concerns we have about the cause of the pain
• if we are worried and distressed about how pain may affect us in the future
• if we have unpleasant thoughts, feelings and memories (even if these are not about pain)
• if we have anxiety, depression, Post-Traumatic Stress Disorder, previous emotional upsets or other mental health problems.

Types of Pain

Pain is usually described as acute (short-term) or chronic (long-term) pain (this is usually more than three months).

• Acute painis usually related to an obvious injury such as dental infection, bone fracture or operation.
• Chronic/persistent pain sometimes begins with an injury but the pain doesn’t get better as expected. Common types of chronic pain include low back pain, pain related to arthritis and pain related to injury to a nerve or other part of the nervous system.

Chronic pain is usually not a sign of on-going injury or damage.

It may be to do with changes in the nervous system that occur over time so that the pain signalling becomes self-sustaining over a prolonged period.

• Cancer pain is usually described separately and may be short or long lasting. The pain can relate to the cancer itself or the cancer treatment. Additionally, people with cancer may experience acute or chronic pain unrelated to their cancer.

Acute and chronic pain can range from mild to severe with the difference being how long the symptoms last.

Advice and treatments for different types of pain

Most treatments aim to help you self-manage your pain and improve what you can do.

The NHS website offers advice about how to manage pain. 

Directory for support with Common Pain Conditions

Arthritis https://www.nhs.uk/conditions/arthritis/

Back Pain https://www.nhs.uk/conditions/back-pain/

Fibromyalgia https://www.nhs.uk/conditions/fibromyalgia/

Joint Pain https://www.nhs.uk/conditions/joint-pain/

Migraine https://www.nhs.uk/conditions/migraine/

Neck Pain https://www.nhs.uk/conditions/neck-pain-and-stiff-neck/

Peripheral neuropathy https://www.nhs.uk/conditions/peripheral-neuropathy/

Scoliosis https://www.nhs.uk/conditions/scoliosis/

Pain can be associated with many conditions. Learn more about other conditions on the NHS website.

Pain diary

Your doctor, nurse or pharmacist will explain to you how to take your pain relief medications.

A pain diary will help you and your doctor, nurse or pharmacist to decide whether the pain relief medications you take are suitable for you. 

You might find helpful to fill out a pain diary every time you take your pain relief medication or at least twice a day.

Download the pain diary: https://joinedupcarederbyshire.co.uk/wp-content/uploads/2023/02/Pain_Diary.pdf

Treatments for different types of pain

Chronic pain

Chronic pain can cause low mood, irritability, poor sleep and reduced ability to move around.

Unlike acute pain, chronic pain is difficult to treat.

Most types of treatment help less than a third of patients.

Most treatments aim to help you self-manage your pain and improve what you can do.

Options that are not medicines include:

• electrical stimulating techniques (TENS machine TENS (transcutaneous electrical nerve stimulation) – NHS (www.nhs.uk))
• Acupuncture,
• Getting active and increasing physical fitness
• Psychological treatments such as Cognitive behavioural therapy (CBT)and meditation techniques such as Mindfulness.

Some medicines are commonly used long term for pain.

For example, gabapentin, pregabalin, duloxetine, amitriptyline, nortriptyline and non-steroidal anti-inflammatory medicines (such as ibuprofen).

Useful leaflets on each of these medicines can be found on the Faculty of Pain Medicine website.

Opioids, such as morphine and codeine, are medicines prescribed for pain relief.

These very effective in managing short-term pain, such as after an operation, but there is little evidence of significant benefit  for pain that is chronic (lasting more than three months), that is not cancer-related.

Further information on prescription of opiods is available on the NHS England website.

There are also serious harms associated with opioids and the risk of dependency when taken long-term.

A leaflet (PDF) on use of opioids for pain is available on the Faculty of Pain Medicine website.

For chronic or on-going pain, that is not cancer-related, many people find other methods that do not involve medicines more effective. 

For specific advice on your treatment, please speak to your doctor or pharmacist.

If you decide you would like to reduce or stop your opioid medicine, it is important to do this slowly to avoid withdrawal effects.

Your healthcare professional will be able to help you create a plan that works for you.

Neuropathic Pain

Neuropathic pain is a type of chronic pain associated with injury to nerves or the nervous system.

It may include

• sciatica following disc prolapse
• nerve injury following spinal surgery
• pain after infection such as shingles or HIV/AIDS
• pain associated with diabetes
• pain after amputation (phantom limb pain or stump pain)
• pain associated with multiple sclerosis or stroke.

Medicines may be used to treat neuropathic pain but are usually not very effective and only tend to work for a small proportion of people.

You may not benefit from the first drug tried so you may need to try more than one drug to try and improve symptoms.

Cancer Pain

Cancer pain is usually associated with an obvious source of tissue damage and may be acute or chronic.

Neuropathic pain can occur with cancer diagnoses and treatments (such as radiotherapy).

Because cancer pain treatment, particularly at the end of life, is often for a short duration, it is usually more successful than chronic pain treatment.

People who recover from cancer or who survive a long time with cancer may have pain that is more difficult to treat.

This video is about stopping opioid medicines for those who are considering this or would like to be more aware of the effects of opioid medicines; https://www.youtube.com/watch?v=MI1myFQPdCE

This video explains the types of pain; https://www.youtube.com/watch?v=RWMKucuejIs

This video that may help those with persistent pain; https://www.youtube.com/watch?v=jIwn9rC3rOI&t=10s