Understanding chronic pain

January 18, 2022 Swedish Health Team

mature woman sitting on the edge of the bed, leaning over with pained look on her face.


In this article:

  • Chronic pain lasts longer than the expected period of healing.

  • 1 in 5 Americans experiences chronic pain most days or every day.

  • Swedish Pain Services offers a wide range of care options and resources.

When you have chronic pain, it invades every aspect of your life. The pain may come and go or become a lasting presence. It varies in intensity and can limit or prevent your ability to work, participate in physical activity and complete many activities of daily living. For many people, it dramatically reduces their quality of life.

Research shows pain is a constant companion for the 1 in 5 Americans who live with chronic pain. It’s the primary cause of disability and the number one reason people visit their doctor. Although chronic pain can be frustrating, there are resources that can help.

What is chronic pain?

There are two types of pain:

  • Acute pain occurs suddenly and is typically prompted by an injury, inflammation or illness. It’s a signal to your body that something’s wrong that fades as healing takes place.
  • Chronic pain lasts a long time, sometimes years, and doesn’t always have a recognizable cause or endpoint.

“Chronic pain is generally defined as pain that is beyond the expected period of healing,” says Sharon Hsu, Ph.D., clinical psychologist for Swedish Pain Services.

Chronic pain can occur anywhere in your body. It may be the result of an injury or infection. Or it could accompany an ongoing health issue such as arthritis, nerve damage or cancer. For some people, there is no known cause.

Symptoms of chronic pain

The average day for someone with chronic pain varies, according to Dr. Hsu. “Some patients have constant pain throughout the day. Some patients’ pain gets worse as the day goes on. Some patients deal with episodic pain. Many experience pain-related sleep difficulties,” she explains.

Once chronic pain begins, it can prompt further pain, creating a cycle of constant symptoms that can be difficult to manage. “If our pain experience is like our home alarm system, chronic pain is when the settings for that system are dialed in a way that it gets triggered by the wind or a twig landing on the roof. Due to previous experience, the brain is now on alert and may send pain signals more easily,” says Melissa Hudson, Ph.D., behavioral health provider at Swedish.

Disorders of the spine (neck and low back), large joints (hips, knees, shoulders), muscles and soft tissue are most associated with chronic pain. Its symptoms are unique for each person it affects and may include:

  • Headaches
  • Neck and low back pain
  • Joint pain
  • Burning, throbbing or tingling sensations
  • Excessive fatigue
  • Sleep disturbances
  • Mood changes, irritability and depression.

“Chronic pain can lead to physical limitations or disability. A person may not be able to work due to a disability. From a psychological standpoint, it can lead to stress, depression, and anxiety,” says Dr. Hsu.

Treating chronic pain

Treatment for chronic pain focuses on reducing pain and improving your quality of life. It requires a different approach than treating acute pain, according to Dr. Hudson.

“The way we look at chronic pain changes compared to acute pain,” she says. “When our brain sends signals of acute pain, we naturally ask ‘what is causing this pain, what is the injury?’ But with chronic pain, it is important to explore what factors contribute to the pain experience outside of acute injury. Some factors can include stress, thoughts, feelings and activities.”

Pain treatment depends on the type of pain you’re experiencing, its cause – if known – and your overall health and age. Potential treatments include:

  • Over-the-counter medications such as acetaminophen, anti-inflammatory drugs or topical ointments or patches.
  • Prescription muscle relaxers and pain medications such as hydrocodone, tramadol, and codeine.
  • Various types of antidepressant medications that can help decrease pain or improve mood
  • Anticonvulsant medications for nerve pain such as gabapentin or pregabalin.
  • Complimentary medicine options such as acupuncture and massage.
  • Physical and occupational therapy for strengthening ergonomic training and pain education.
  • Low impact exercises such as walking, biking or swimming.
  • Therapeutic movement training like tai chi and yoga.
  • Behavioral health interventions such as cognitive-behavioral therapy, mindfulness training and counseling.
  • Fluoroscopically guided spine injections like epidurals for nerve pain, facet joint nerve ablations and ultrasound-guided joint injections.
  • Neuromodulation where electrical impulses from a pacemaker-like generator are applied to the spinal cord to block pain signals (i.e spinal cord stimulation).

Care for the caregiver

If someone you care about is dealing with chronic pain, it can be difficult to witness their struggles. At times it may be hard to empathize and easy to lose patience. Those are all normal, understandable feelings for caregivers. Compassion, understanding, and self-care go a long way when caring for someone with daily pain. Just don’t forget to seek out support when you need it.

“It can be challenging for caregivers to understand the cause of pain – which is generally complex – as well as the ongoing limitation and/or disability. Caregivers can help by being compassionate and nonjudgmental,” says Dr. Hsu.

These tips from the U.S. Department of Health and Human Services Office on Women's Health can help prevent caregiver burnout so you can continue to care for your loved one:

  • Educate yourself by taking advantage of available classes and programs that teach you how to care for someone with an illness or injury.
  • Take advantage of community programs such as adult daycare or respite services to give yourself a break when you’re overwhelmed.
  • Accept help from others when it’s offered. You don’t have to do it all. If someone is willing to help, let them!
  • Join a support group where you can share your story, learn caregiving tips and strategies and enjoy connecting with others in a similar situation.
  • Don’t isolate yourself from others. Companionship and emotional support are essential. Make it a priority to stay connected with friends and family.

Getting the help you need

“Patients at Swedish who have chronic pain have multiple options for support,” says Jennifer O’Donnell, PsyD, medical director for Behavioral Health Integration at Swedish. “If they are connected with a primary care provider, they can see our integrated behavioral health providers for help building coping strategies. Patients with more persistent and treatment-resistant pain can be seen by our pain management specialist at Swedish Pain Services where pharmacological and non-pharmacologic therapies can be individually targeted. In many instances, patients can also be evaluated by the clinic’s psychologist with possible admission to a functional restoration program. Functional restoration includes a multidisciplinary team of physical, occupational and behavioral medicine therapists and pain management doctors working with patients in individual and group settings teaching them new skills to better manage pain.”

Swedish Pain Services uses a team approach to better understand your chronic pain. We use a biopsychosocial approach to assess and treat pain which addresses your unique biological, psychological and social needs.

Our multidisciplinary team includes experts with a wide range of specialties, including:

  • Pain management specialists
  • Pain psychologists
  • Physical therapists
  • Occupational therapists
  • Relaxation therapists
  • Pain nurse educators

Our education and resources can help you learn more about chronic pain and manage it effectively. Swedish participates in ongoing clinical research to ensure that safe, innovative treatments are available to everyone we serve.

“Chronic pain management is a shift in thinking from how we deal with acute pain. It can be a process for people to adjust to the pain management process,” says Dr. Hudson. “Compassion and meeting the body where it is are important daily steps in the journey."

Find a doctor

If you have questions about chronic pain, contact the pain services department at Swedish. We can accommodate both in-person and virtual visits.

Whether you require an in-person visit or want to consult a doctor virtually, you have options. Swedish Virtual Care connects you face-to-face with a nurse practitioner who can review your symptoms, provide instruction and follow up as needed. If you need to find a doctor, you can use our provider directory.

Join our Patient and Family Advisory Council.

Additional resources 

Palliative Care and Symptom Management Clinic at SCI

When should you replace that aching joint?

Ouch! What can help your aching back?

This information is not intended as a substitute for professional medical care. Always follow your health care professional's instructions.

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