Pain is a signal in your nervous system that something may be wrong. It is an unpleasant feeling, such as a prick, tingle, sting, burn, or ache. Pain may be sharp or dull. You may feel pain in one area of your body, or all over. There are two types: acute pain and chronic pain. Acute pain lets you know that you may be injured or a have problem you need to take care of. Chronic pain is different. The pain may last for weeks, months, or even years. The original cause may have been an injury or infection. There may be an ongoing cause of pain, such as arthritis or cancer. In some cases there is no clear cause. Environmental and psychological factors can make chronic pain worse.

Many older adults have chronic pain. Women also report having more chronic pain than men, and they are at a greater risk for many pain conditions. Some people have two or more chronic pain conditions.

Chronic pain is not always curable, but treatments can help. They include

• Pain Relievers and other medicines
• Acupuncture
• Electrical stimulation
• Surgery
• Physical therapy
• Psychotherapy
• Relaxation and meditation therapy
• Biofeedback

Pain can be classified as acute or chronic, and the two kinds differ greatly.

• Acute pain usually results from a specific injury, disease, and/or inflammation. It generally comes on suddenly, for example, after physical trauma or surgery, and can be accompanied by anxiety or emotional distress. Normally, acute pain is a protective response to tissue damage resulting from injury, disease, overuse, or environmental stressors. The cause of acute pain usually can be diagnosed and treated. The pain is self-limiting, meaning it is confined to a given period of time and severity. Acute pain, however, can become chronic.
  
• Chronic pain is a medical disease that can be made worse by environmental and psychological factors. Chronic pain persists over a long period and can be challenging to manage. People with chronic pain often suffer from more than one painful condition. They also have an increased risk for developing problems with physical functioning, cognition, and emotional reactions. There may be common mechanisms that put some people at higher risk for developing multiple pain disorders. It is not known whether these disorders share a common cause.

An illness or injury often causes immediate or acute pain in your body. Chronic pain is different, and it lasts several months or more past the time of usual healing.

People experience different kinds of chronic pain. People can feel pain in different parts of their body. Sometimes the pain comes with other symptoms, like fatigue, trouble sleeping, decreased appetite, and mood changes. All this can reduce physical activity, flexibility, strength, and energy – making normally enjoyable activities less enjoyable.

Chronic pain is real. While chronic pain may start with a specific injury or illness, once it has persisted for many months or years, nonhelpful changes in the brain and central nervous system often become responsible for maintaining the pain. It can be frustrating to have pain that you feel but others can’t see. No matter what others do or don’t see the pain is real.

Living with chronic pain can be lonely. It may feel like nobody understands your pain or can relate to your experience. Interacting with the world can be a struggle when people do not see you as you see yourself. Loneliness and isolation not only feel bad, but can also cause problems for your physical health and may even make pain worse.

Chronic pain is difficult for family members and friends too. Chronic pain can take a toll on family members and communities surrounding people with chronic pain. Studies have found that spouses of people with chronic pain can themselves have a weakened immune system, worsening physical health, depression, and loneliness.

Take the first step. There are ways to improve your quality of life if you are living with chronic pain. The goal is to be able to function in daily activities and have an enjoyable and fulfilling life. Often the first step is to say yes to a friend’s invitation, walk a few blocks with your dog, or go to the grocery store by yourself.

You are not alone! Chronic pain impacts more than 50 million people in the United States.

Almost all of us have experienced pain of some kind. It’s the most common reason why people seek medical care. But because people feel pain differently, there’s no single treatment that will work for everyone.

Have you ever stepped on a sharp rock, accidentally rubbed your eyes after cutting a hot pepper, or struggled through a long workday with a throbbing headache? It may feel like the pain is happening in your foot, your eye, or your head, but your brain shapes how you experience pain and how you respond to it.

Scientific research funded, conducted, and supported by NIH has changed our understanding of pain―what it is, how it works, and how we experience it.

The many faces of pain

People experience pain in many different ways. Pain can range from the sharp feeling you get from a paper cut or a bee sting to the dull, persistent feeling of a sore muscle. In some cases, it’s constant. In other cases, it comes and goes.

Pain can be acute or chronic:

• Acute pain is the pain you feel when you get hurt or injured. You may have experienced acute pain from an injury such as a cut or a broken limb or from disease or inflammation in the body. Acute pain can be intense and severe, but it typically resolves as your body heals from whatever caused it.
• Chronic pain is pain that lasts much longer―usually months and sometimes even years. Chronic pain sometimes has a clear cause, such as an acute injury, a long illness, or damage to and dysfunction of your nervous system. Sometimes it even happens without any obvious reason.

Different kinds of pain have different causes:

• Nociceptive pain is pain caused by tissue damage. Most acute pain is nociceptive.
• Neuropathic pain is caused by nerve damage or dysfunction. You can experience neuropathic pain from injuries or illness that affect the spinal cord and brain (for example, a slipped disc in your spine) or the peripheral nervous system (the nerves throughout the rest of your body). This kind of pain often feels similar to burning, shooting, or stabbing.
• Inflammatory pain is pain that happens when your immune system activates in response to injury or infection. In addition to causing redness or swelling, it can also make you more sensitive to feelings of pain.

How we experience pain

When you are in pain, it’s because your nervous system thinks that a part of your body is injured or in danger of getting injured (by accidentally touching a hot stove, for example). Pain is a normal sensory signal that something might be wrong and that you should do something about it. You don’t become aware of pain until your brain processes it.

1. When a part of your body is injured, special pain receptors from that area release chemicals called neurotransmitters, which send messages to your brain.
2. The messages travel along nerves to the spinal cord and eventually to the brain, telling it, “Something might be wrong here, pay attention!”
3. Your brain receives and processes these messages, evaluates them, and decides what to do.
4. Your brain sends messages back to your body to react. Depending on the situation, this could mean rapidly triggering the muscles in your body to move you away from whatever is causing your pain. This reaction can feel instantaneous! If you are injured, your brain might also release natural painkillers called endorphins or tell your immune system to start healing the injury.

How acute pain turns chronic

Most of the time, pain is a useful alarm system designed to keep us safe. But sometimes pain signals keep firing even after the body’s tissues have healed.

When pain continues for a long time―such as during a long illness or after a serious injury―it can cause changes to your nervous system, which make you more sensitive to pain. This means that certain stimuli make you feel pain more quickly, and the pain can be more intense and last longer.

Treatment

Your experience of pain is influenced by a complex set of factors that are unique to you, including your genes and biology, past experiences, emotions, and environment. That means that everyone’s pain feels differently. There isn’t a way to measure it objectively, and there isn’t one single treatment that will work for everyone.
Working with your health care provider to understand and treat pain safely and effectively is the best approach. Your pain management will depend on the kind of pain you’re experiencing and what’s causing it. It often involves a combination of treatments, which may include:

• Over-the-counter and prescription medications (such as pain relievers and drugs that reduce inflammation)
• Physical and occupational therapy to improve function and limit pain
• Counseling and therapy to teach skills for coping with pain
• Medical treatments (such as medications and injections) to interrupt pain signals or change how nerves process pain
• Neuromodulation therapies (devices that stimulate nerves or the spinal cord) to reduce pain
• Complementary and integrative therapies (such as acupuncture and mindfulness meditation)

When you are in pain, you may not feel like being active. But getting your body moving – even for just short periods – can decrease your pain and increase your function. Physical activity keeps your muscles strong and your body flexible. It can also relieve joint pain, back pain, neck pain, fibromyalgia, nerve pain, and other types of chronic pain.

For You

Staying active can put you in a better mood in addition to decreasing your pain and increasing your function. Being active helps many people feel more in control of their chronic pain and gives them a boost of self-esteem. Some types of exercise can be done with a friend or in a group – an added social benefit!

Physical activity can help you maintain or reach a healthy weight. Studies show that the likelihood of having chronic pain increases as a person’s weight increases. Extra weight on your body can make your chronic pain worse.

There are many types of activities that can be done with little or no equipment, and you can do these activities in your own home or neighborhood. Find an activity that is enjoyable and realistic for you.

Some examples include:

Walking can easily be adapted to your ability and goals. You can start with just a few minutes and work up to more. Taking your walk outdoors when the weather is nice can also improve your mood.

Swimming and water aerobics are great low-impact alternatives to get you moving without stress on your joints. If you don’t have a pool at home, find a pool with public access nearby.

Yoga and stretching can improve your flexibility and reduce muscle stiffness. Yoga can also calm your mind and body, and improve your sleep quality. You don’t have to go to a studio or have special equipment for yoga.

Tai Chi is a slow-moving, gentle form of exercise that can improve balance, strength, and flexibility.

The good news is you can feel benefits from as little as 10 minutes of activity per day. Many people with chronic pain may feel resting is beneficial or the only thing they can do, but they usually have more energy and less pain once they get moving. It can be hard, but start with just taking one step.

For the Family

Make moving part of the daily routine. Small actions can integrate movement into your family’s life, and it’s a healthy habit that can continue across generations. Starting a family habit of walking around the block after dinner is an excellent step. Make it an ongoing challenge to find the farthest parking space from the grocery store. Choose one stretch to start your family’s morning routine.

Celebrate sticking with your goals. Once your family walks three days in a row, maybe celebrate with watching a movie together. It’s hard to change behaviors and celebrating sticking to a goal can keep the momentum going. It’s worth changing habits; family dynamics and activities are highly influential to members’ health and well-being.

For the Community

Create an active community. Enhance physical activity in schools. Create walkable communities and activity-friendly routes to everyday destinations. Promote and protect the parks and hiking trails in your community. Publicize the available programs at recreational sites, libraries, and other community centers.A healthy, active community around every family and individual helps facilitate taking a step toward better health and wellness.

Inflammation, or the body’s immune response to injury or danger, can be protective to our bodies and activates proteins to protect cells and tissues. Chronic inflammation, however, can be a part of several diseases like osteoarthritis, gout, and fibromyalgia. A healthy lifestyle, including what you eat, can help to decrease inflammation.

For You

Food and drink choices matter. The right mix can help you be healthier now and in the future. Next, to help with inflammation, eat different types of foods that promote health, including:

• Lots of colorful vegetables like dark green, red and orange, blue or purple
• Vegetables like broccoli, cauliflower, cabbage, and brussels sprouts that keep the inflammatory response down
• Foods high in polyphenols like berries, green and black tea, citrus fruits, legumes, nuts and seeds, as well as dark chocolate
• Whole grains like whole wheat bread, brown rice, and quinoa. Be sure that at least half of the grains you eat are whole grains
• Whole or cut-up fruits instead of juices
• Healthy sources of fats and oil like nuts, seeds, and olive oil
• Fish, twice a week, especially fish like salmon that are rich in omega-3 fatty acids
• Plant-based proteins (such as tofu, dried beans, peas), lean proteins, and low-fat dairy (including fermented foods like yogurt and kefir)

For better health, limit some foods. Limiting certain foods can help decrease inflammation. Cut down on the following:

• Saturated fats found in meats that are not labeled as lean, butter, and whole milk
• Trans-fats found in processed foods like coffee creamer
• Added sugars, which are sugars added during processing, like in soda and sports drinks
• Alcohol, no more than 1 drink a day for women and 2 drinks a day for men

Find an expert to help you make changes. Use the "Find an Expert" button at the top of the Academy of Nutrition and Dietetics website to find a registered dietitian nutritionist (RDN) who can fully assess your condition and give advice as you make changes in what you eat and drink. Narrow your search to find an RDN who works in integrative and functional nutrition, meaning a whole-body, personalized way to find health and healing.

Weight loss may help. You may want to start by learning how many calories are right for you. Losing weight may help ease some pain. Learn to make healthier choices while shopping for food on a budget, get healthy recipes with few ingredients, and get moving with exercises that feel good to your body. Sleep is also important to help your body rest, recover, and be ready for tomorrow.

For the Family

Make healthy eating seem possible. Changing what you eat can feel like a big job, but healthy eating isn’t all or nothing. There are many ways to start down the path to healthy eating. You might start by cooking one healthy meal a week or having children pick out new vegetables to try at the grocery store.

Switch to healthier food and drink choices. Small changes can add up to big wins. Small, healthy changes are a great way to add foods with more nutrients while eating fewer foods with added sugars, saturated and trans fats, or sodium. Try changing just one habit at a time. Here are some places to start:

• Add vegetables each day
• Snack on fruits
• Drink mostly water
• Cut down on added sugars
• Eat less saturated fat
• Reduce sodium
• Shift to healthier foods
• Try the Mediterranean Diet or Vegetarian Eating Style

Celebrate success. As your family moves to healthier eating, celebrate the small successes. If you notice benefits like less pain, weight loss, or lower blood pressure, link these changes to the healthier diet.

For the Community

Support healthy eating and habits. Work to add healthier food choices in vending machines and cafeterias. Shop at your local farmers market. Start a community garden. Teach healthy eating in schools. Create a healthy eating environment in which families have access to supermarkets or other places where they can obtain affordable, healthy foods. Have ample water fountains in public places, which offers an alternative to sugar-sweetened beverages.

Chronic pain is real and is important to manage. Healthcare providers can act as a guide to helping you understand chronic pain and how to approach living well with chronic pain.

For You

Diagnosing Chronic Pain

Some pain is normal after an injury or illness, and everybody feels pain at times. When the pain is lasting longer than it should or is keeping you from enjoying life or functioning normally, a consultation with a healthcare provider may be a good step.

It is not always helpful to get imaging studies. Healthcare providers can help you understand if the results of the imaging or diagnostic testing will change the recommended management. X-rays, CTs and MRIs are costly, have risks, and often do not reveal the cause of the pain.

Managing Chronic Pain – Therapy Options

Living life with chronic pain requires taking a first step, which can include different therapies, depending on the type of your pain. Providers can help you get connected with these resources, and can discuss the risks and benefits of each.

Physical Therapy

Physical therapy is a first-line treatment for chronic pain. Physical therapy is when you work with specialized therapists on restoring maximum body movement and physical functioning. This can be accomplished through exercise therapy, stress management, and teaching about nervous system changes that occur with chronic pain. Studies show that physical therapy works to reduce pain, improve function, and can improve global well-being.

Cognitive Behavioral Therapy

Cognitive Behavioral Therapyis a form of psychotherapy that can help you identify and modify your thought and behavior patterns to help retrain your brain, improve quality of life, and take actions towards important life goals. Studies show that cognitive behavioral therapy is a preferred first line treatment for many types of chronic pain. Extensive evidence shows improvement in function and quality of life. Speak with your healthcare provider and check with your insurance carrier to see if this would be covered for your specific condition.

Acupuncture Therapy

Acupuncture is a therapy in which very fine needles are inserted at specific points on the body. Heat or electrical stimulation may also be used at these specific points. Acupuncture can provide significant pain relief and can be a step for patients to begin engaging more fully in self-management activities. Studies have shown that acupuncture can help with many types of chronic pain including back and neck pain, osteoarthritis/knee pain, and headaches.

Massage Therapy

Massage therapymay provide short-term relief from musculoskeletal pain such as neck and back pain, shoulder pain, and fibromyalgia. Please talk to your provider before starting massage therapy, especially if you are pregnant or suffering from certain forms of cancer such as lymphoma.

Other Therapies

Seeing a chiropractor or having spinal manipulation may also be helpful in some chronic pain conditions. Medications may also be indicated, but their risks and benefits should be discussed with your provider.

Some therapies and services may not be covered by health insurance plans. Please check with your insurance carrier and healthcare provider.

Questions to Ask Your Healthcare Provider

You are the expert managing your life with chronic pain and developing a plan with yourself, your family, and community to increase your quality of life. Here are some questions that you could ask your healthcare provider in learning to understand chronic pain and how to live well with it.

• What is chronic pain, and what does it mean for my future health?
• What type of changes can I make to my diet or physical activity to improve my movement?
• Is there a particular therapy that would work well for me? What if I have limited resources?
• What are the non-medication options for management of my condition?
• If medications are involved, do they interact with the other drugs used to treat my heart, stress, or insomnia?
• What can I do to improve my overall health?

If you have questions about opioid or other prescription medications, you can call the Opioid Assistance and Referral Line (OARLine) at 888-688-4222.

For the Family

Family beliefs and actions can impact how someone lives with chronic pain. In particular, a spouse’s beliefs about disability and medication have been significantly correlated with their partner's amount of pain. Family members can support their relative in the journey to living well with pain. Encouraging a person with pain to engage in social and recreational activities, daily household activities, and appropriate physical activity can be an important part of recovery and living well with chronic pain.

Get involved in the therapies. If your family member agrees, go to appointments together. It’s helpful for families to hear about the chronic nature of the pain, and management strategies. Family support of living well behaviors is impactful.

For the Community

Adjust pain management expectations. Chronic pain is complex, and it is important to focus on improving function and quality of life, rather than only on pain reduction. The complete elimination of pain may be unrealistic. However, recovery from chronic pain is possible as is living a healthy and fulfilling life with chronic pain.

Key points

• There is limited evidence that cannabis works to treat most types of acute or chronic pain.
• More research is needed to know whether cannabis works better than other options to manage pain.

Cannabis and pain

Even though pain management is one of the most common reasons people report for using medical cannabis in the United States, there is limited evidence that cannabis works to treat most type of acute or chronic pain.

A few studies have found that cannabis can be helpful in treating neuropathic pain (a specific type of chronic pain caused by damaged nerves). However, more research is needed to know whether cannabis works better than other options to manage pain.

Pain—it’s something we’ve all experienced. From our first skinned knee to the headaches, back pain and creaky joints as we age, pain is something we encounter many times. Most pain is acute and goes away quickly. But in some cases, when pain develops slowly or persists for months or even years, then it’s called chronic pain, and it can be tricky to treat.

Chronic pain is a huge problem. Over 115 million people nationwide—about 1 in 3 Americans—suffer from some kind of long-term pain. It’s the leading reason that people miss work.

NIH-funded scientists are working to better understand and treat chronic pain. They’re uncovering the intricate pathways that lead to long-term pain. And they’re looking for approaches beyond medication that might help you control your pain.

Chronic pain differs in many ways from acute pain. Acute pain is part of the body’s response to an injury or short-term illness. Acute pain can help prevent more serious injury. For instance, it can make you quickly pull your finger away from a hot stove or keep your weight off a broken ankle. The causes of acute pain can usually be diagnosed and treated, and the pain eventually ends.

But the causes of chronic pain aren’t always clear. “It’s a complex problem that involves more than just the physical aspects of where the hurt seems to be,” says Dr. John Killen, deputy director of NIH’s National Center for Complementary and Alternative Medicine. “There’s a lot of accumulating scientific evidence that chronic pain is partly a problem of how the brain processes pain.”

Chronic pain can come in many forms, and it accompanies several conditions including low-back pain, arthritis, cancer, migraine, fibromyalgia, endometriosis and inflammatory bowel disease. These persistent pains can severely limit your ability to move around and perform day-to-day tasks. Chronic pain can lead to depression and anxiety. It’s hard to look on the bright side when pain just won’t go away. Some experts say that chronic pain is a disease itself.

The complexities of chronic pain can make it difficult to treat. Many of today’s medications for chronic pain target inflammation. These drugs include aspirin, ibuprofen and COX-2 inhibitors. But if taken at high doses for a long time, these drugs can irritate your stomach and digestive system and possibly harm your kidneys. And they don’t work for everyone.

“With hard-to-treat pain, the opioids are also used, sometimes in combination with the other drugs,” says Dr. Raymond Dionne, who oversees some of NIH’s clinical pain research. Opioids include prescription painkillers such as codeine and morphine and brand-name drugs such as Vicodin, Oxycontin and Percocet. Opioids affect the processes by which the brain perceives pain. If used improperly, though, opioids can be addictive, and increasingly high doses may be needed to keep pain in check.

“As with all drugs, you have to find a balance between effectiveness and side effects,” says Dionne. He and other researchers have studied potential new pain medications to learn more about how they work in the body. But for the most part, pain medications are similar to those used 5 or more decades ago. That’s why some researchers are looking for approaches beyond medications.

“One thing we know is that currently available drug therapies don’t provide all the answers. Many people find that medications don’t fully relieve their chronic pain, and they can experience unpleasant side effects,” Killen says. “Evidence on a number of fronts, for several conditions, suggests that mind and body approaches can be helpful additions to conventional medicine for managing chronic pain.”

Research has shown that patients with chronic low-back pain might benefit from acupuncture, massage therapy, yoga or cognitive-behavioral therapy (a type of talk therapy).

NIH-funded scientists have also found that people with fibromyalgia pain might find relief through tai chi. This mind-body technique combines meditation, slow movements, deep breathing and relaxation.

But how much these approaches truly help is still an open question. Studies of pain relief can be difficult to interpret. Researchers must rely on patients to complete questionnaires and rate their own levels of pain.

One puzzler is that the exposure to the exact same pain-causing thing, or stimulus, can lead to completely different responses in different people. For example, when an identical heat stimulus is applied to different people’s arms, one may report feeling uncomfortable, while another might say that the pain is extreme.

“How do we account for these differences? We’ve now learned that genes play a role,” says Dr. Sean Mackey, who heads Stanford University’s neuroscience and pain lab. “Some differences involve our personality and mood states, including anxiety.”

Mackey and his team are using brain scans to gain insights into how we process and feel pain. One study found that a painful stimulus can activate different brain regions in people who are anxious than in those who are fearful of pain.

In another study, volunteers were taught strategies that could turn on specific brain regions. One technique involved mentally changing the meaning of the pain and thinking about it in a non-threatening way.

“We found that with repeated training, people can learn how to build up this brain area, almost like a muscle, and make its activity much stronger,” says Mackey. “That led to a significant improvement overall in their pain perception.” The researchers also found that different types of mental strategies, such as distraction, engaged different brain regions.

Another study found that intense feelings of passionate love can provide surprisingly effective pain relief. “It turns out that the areas of the brain activated by intense love are the same areas that drugs use to reduce pain,” says Mackay.

“We can’t write a prescription for patients to go home and have a passionate love affair,” says Mackey. “But we can suggest that you go out and do things that are rewarding, that are emotionally meaningful. Go for a walk on a moonlit beach. Go listen to some music you never listened to before. Do something that’s novel and exciting.”

That’s a prescription that should be painless to try.

Tips for Pain Relief

• Keep your weight in check. Extra weight can slow healing and make some pain worse, especially in the back, knees, hips and feet.
• Exercise. Pain may make you inactive, which can lead to a cycle of more pain and loss of function. Ask your doctor if exercise might help.
• Get enough sleep. It will improve healing and your mood.
• Avoid tobacco, caffeine and alcohol. They can set back your treatment and increase pain.
• Get the right medical help. If your regular doctor hasn’t found a helpful approach for pain relief, ask to see a pain specialist.
• Join a pain support group. Talk with others about how they deal with pain. Share your ideas and thoughts while learning from those in the group.

What Is Chronic Pain?

Chronic pain is when a person suffers from pain in a particular area of the body (for example, in the back or the neck) for at least three to six months. It may be as bad as, or even worse than, short-term pain, but it can feel like more of a problem because it lasts a longer time. Chronic pain lasts beyond the normal amount of time that an injury takes to heal.

Chronic pain can come from many things. Some people get chronic pain from normal wear and tear of the body or from aging. Others have chronic pain from various types of cancer, or other chronic medical illnesses. In some cases, the chronic pain may be from an injury that happened during an accident or an assault. Some chronic pain has no explanation.

How Common Is Chronic Pain?

Approximately one in three Americans suffer from some kind of chronic pain in their lifetimes, and about one quarter of them are not able to do day to day activities because of their chronic pain. Between 80% and 90% of Americans experience chronic problems in the neck or lower back.

How Do Health Care Providers Evaluate Pain?

Care providers generally assess chronic pain during a physical exam, but how much pain someone is in is hard to determine. Every person is different and perceives and experiences pain in different ways. There is often very little consistency when different doctors try to measure a patient's pain. Sometimes the care provider may not believe the patient, or might minimize the amount of pain. All of these things can be frustrating for the person in pain. Additionally, this kind of experience often makes patients feel helplessness and hopeless, which in turn increases tension and pain and makes the person more upset. Conversation between the doctor and patient is important, including sharing information about treatment options. If no progress is made, get a second opinion.

What Is the Experience of Chronic Pain Like Physically?

There are many forms of chronic pain, including pain felt in: the low back (most common); the neck; the mouth, face, and jaw (TMJ); the pelvis; or the head (e.g., tension and migraine headaches). Of course, each type of condition results in different experiences of pain.

People with chronic pain are less able to function well in daily life than those who do not suffer from chronic pain. They may have trouble with things such as walking, standing, sitting, lifting light objects, doing paperwork, standing in line at a grocery store, going shopping, or working. Many patients with chronic pain cannot work because of their pain or physical limitations.

What Is the Experience of Chronic Pain Like Psychologically?

Research has shown that many patients who experience chronic pain (up to 100% of these patients) tend to also be diagnosed with depression. Because the pain and disability are always there and that may even become worse over time, many of them think suicide is the only way to end their pain and frustration. They think they have no control over their life. This frustration may also lead the person to use drugs or have unneeded surgery.

Chronic Pain and PTSD

Some people's chronic pain stems from a traumatic event, such as a physical or sexual assault, a motor vehicle accident, or some type of disaster. Under these circumstances the person may experience both chronic pain and PTSD. The person in pain may not even realize the connection between their pain and a traumatic event. Approximately 15% to 35% of patients with chronic pain also have PTSD. Only 2% of people who do not have chronic pain have PTSD. One study found that 51% of patients with chronic low back pain had PTSD symptoms. For people with chronic pain, the pain may actually serve as a reminder of the traumatic event, which will tend to make the PTSD even worse. Survivors of physical, psychological, or sexual abuse tend to be more at risk for developing certain types of chronic pain later in their lives.