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What Causes Chronic Pain Disorder?

Pain can be an alarming and distressing symptom, overwhelming daily life and disrupting an individual’s ability to function on even the most basic level.

Chronic pain syndrome sufferers are often forced to deal with these symptoms on a daily basis, and with no immediate resolution in sight, it can be simply exhausting.

In some cases, chronic pain disorder is linked to a known condition; this may not make it any easier to bear but it can be reassuring to know the cause. For others, there’s no diagnosis and this can add an extra layer of stress to the ongoing pain and discomfort.

Here’s a closer look at some of the causes of chronic pain syndrome.

Injury

Perhaps one of the most common triggers of chronic pain disorder is an injury, for example caused by a road accident or a fall. However, long after the initial physical damage has healed, the pain lingers on with no obvious cause. In some circumstances, the onset of chronic pain syndrome does not begin until sometime after the injury has occurred which can prove confusing for the patient and medical professionals alike.

Diagnosed conditions

There’s a myriad of conditions which can cause chronic pain, such as arthritis, ankylosing spondylitis and lupus, and it’s also possible to suffer persisting pain following surgery too.

Unfortunately, being aware of the cause or trigger of the pain doesn’t offer any guarantee that it will be effectively treated. Persistent pain can be broadly split into two different categories; neuropathic and nociceptive pain.

Neuropathic pain is typically caused by pressure on a nerve which in turns sends the message up to the brain to interpret as pain. The pressure can be caused by a number of different triggers including infection, toxins or autoimmune problems and you may not feel the pain in the region in which the trigger is present. For example, pressure on nerves in the neck may often be felt as numbness in the hand and arm.

Nociceptive pain is a term used to describe tissue pain, such as that which could be felt if you burned yourself or banged your knee. It arises from swollen and inflamed tissues rather than directly from pressure on nerves.

There are other types of pain too such as idiopathic, psychogenic and allodynic.

Just because there’s a diagnosis doesn’t mean it’s clear cut and an individual may suffer from a number of different types of pain. As the treatments for each will be different, and have varying degrees of success, it’s essential to determine not just the underlying condition but the type of pain being experienced.

No identifiable trigger

There are a number of conditions where there’s no obvious trigger or cause, and pain itself is the primary presenting symptom (rather than accompanying restricted movement as in back pain, for example).

For these individuals, diagnosis can be rather more convoluted, with no tests or investigations which can provide an answer. In many cases it’s simply diagnosis by exclusion; ruling out all other possible causes and making a clinical judgement based on presenting symptoms.

Because of the subjective nature of this kind of condition, diagnosis can take far longer and some patients never receive a diagnosis at all with doctors unwilling to give out a “label” without clear-cut, objective proof.

In many cases patients with this kind of chronic pain face accusations of malingering, either spoken or unspoken, and a lack of understanding from their peers, friends, family and sometimes even their doctors.

Some of the conditions which give rise to chronic pain include but aren’t limited to fibromyalgia, Complex Regional Pain Syndrome, headaches, Post Whiplash Injury Syndrome and Myofascial Pain Syndrome.

Not an imaginary condition

Dealing with any kind of pain on a chronic basis is simply exhausting; both physically and emotionally so a number of individuals go on to develop related psychological conditions such as anxiety and depression.

This doesn’t mean that the condition is ‘all in their head’ but simply that the burden of dealing with so much pain has taken its toll.
The assumption that chronic pain without an identifiable cause is entirely psychological is an unfortunately common view and some patients find they don’t receive the help they need as a result.

In some cases antidepressant medication can be prescribed for chronic pain even if no psychological conditions are diagnosed. This is because the pain signals which reach the brain also pass through the “emotional centres” and there’s some evidence that using antidepressants can help to inhibit some of the transmitters which pass along pain messages.

No-one suffering from pain should ever feel that they should “man up” or “pull themselves together”; chronic pain is a devastating condition and not an imaginary symptom.

Likely outcome

The probable path for chronic pain sufferers depends greatly on the underlying cause. For progressive or degenerative conditions such as osteoarthritis, without invasive treatments such as knee or hip replacements, only limited relief is likely to be gained.

The outcome for primary pain syndromes is far more uncertain, with much more research required into the subject. Some individuals are able to make a full recovery; others make a partial recovery while some people continue to struggle with the condition for the rest of their life.

External factors can influence the degree and duration of pain being experienced so it’s important not to simply accept pain that worsens. Being involved in an accident for example can significantly worsen pain, or delay recovery.

There are a range of treatments which can help including painkillers, alternative therapies and a rehabilitation programme including exercise, but the exact outcome of these interventions will depend on the underlying condition.

If you are suffering from any of the conditions described on this page, you should consult a doctor for appropriate assessment and treatment. The information contained here is for information purposes only and is not intended to replace medical advice.

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