What Happens

In some cases, chronic pain develops after an injury or illness. The pain continues even after you have recovered from the injury or illness. For example, many people who have had a limb amputated report feeling chronic pain in the missing limb (phantom limb pain). Chronic pain can also develop even though you have not had an injury or illness. The result, however, is often the same—a cycle of sleeplessness, inactivity, irritability, depression, and more pain.

Chronic pain may be mild to severe. You may develop pain that comes back from time to time over several weeks, months, or years. Occasional, mild to moderate pain can usually be managed at home. Exercise, good nutrition, regular massages, and pain-relieving drugs—such as acetaminophen or nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen or aspirin—may be enough to manage your symptoms.

On the other hand, you may develop constant chronic pain that is severe. You may be unable to work, and physical activity may be too painful or exhausting. Sleeping at night may be difficult, resulting in fatigue and irritability. Your outlook on life may change and strain your relationships with family and friends. Prolonged pain may restrict your daily activities and eventually lead to disability.

After treatment begins, many things can interfere with your recovery, such as dependency on drugs or alcohol, overwhelming stress, lack of motivation, depression or other mental health problems, or ongoing litigation because of a workers’ compensation claim. If your pain is disabling, you may want to seek an evaluation at a pain management clinic, where a team of health professionals works together to treat your pain.

The lives of your family members, friends, or caregivers can also be affected. The people you count on to help you may also need some support. Family therapy or involvement in a caregiver support program may help.

Call a doctor about chronic pain if:

• Your pain has lasted more than 3 months without a clear reason.
• You are feeling down or blue or are not enjoying the activities or hobbies that you have enjoyed in the past. You may be experiencing depression, which is common with chronic pain.
• You are unable to sleep because of the pain.
• You had an illness or injury that healed, but the pain has not gone away.
• You have a family member or friend who appears to be suffering from chronic pain, and you would like information about treatment.

Watchful Waiting

Watchful waiting is a period of time during which you and your health professional observe your symptoms or condition without using medical treatment. If you are able to control occasional, mild to moderate pain with exercise, healthy eating, massage, and pain relievers—such as acetaminophen or nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen or aspirin—you may not need further treatment from a health professional. However, watchful waiting is not appropriate if your pain is severe or if persistent pain interferes with your life. If you delay treatment, the pain may get worse.

Who To See

If you have mild to moderate recurring pain that cannot be managed at home, you may need to consult one of the following health professionals:

• Family medicine doctor
• Internist
• Nurse practitioner
• Physician assistant
• Doctor of osteopathy

If your chronic pain is moderate to severe and constant, or if treatment does not control the pain, your primary health professional may recommend that you see a specialist, such as one or more of the following:

• Pain management specialist
• Physiatrist
• Physical therapist
• Neurologist
• Obstetrician or gynecologist (for chronic pelvic pain)
• Anesthesiologist
• Psychiatrist, psychologist, or a licensed mental health counselor
• Orthopedic surgeon
• Rheumatologist
• Chiropractor

Often more than one specialist will treat your chronic pain. For example, a primary physician may manage your medicines, and a physical therapist may help you restore function through exercise or other therapies. A professional counselor may help you with coping and depression, and a complementary medicine practitioner may provide alternative therapies such as acupuncture or yoga.

If chronic pain persists and interferes with your daily life despite treatment, you may want to seek an evaluation at a pain management clinic. A pain management clinic is a setting where you receive treatment and learn to cope with chronic pain. Treatment is usually provided by a team of health professionals who work together to address all the possible causes of your chronic pain.