Many people don’t realise that there is a change in how our bodies process pain if it has been going on for longer than 3 months.

Acute or short-term pain is usually in response to injury, trauma or damage to the body such as nerve damage, broken limbs etc. In acute pain the use of pain medication can be very effective.

However after 3-6 months the original damage to the body has usually healed or settled as much as it is going to (unless it is due to an inflammatory condition). The pain that is felt is then due to the body becoming oversensitive and giving off pain signals in an uncontrolled way. In this case it is called long-term or persistent pain.

No-one knows why this happens in some people, but it is a common condition that affects more than 1 in 5 of us (British Pain Society). This kind of pain needs managing in a different way to acute pain.

Does this mean that the pain is all in my head?

No. Although the original damage or trauma may have healed or settled, the feeling of pain is still very real. This just means that treatments that focus on the original injury are not likely to be effective and it has to be managed in different ways.

This five minute external video gives a good explanation of this.

This external leaflet from Live Well With Pain also gives a good explanation of this.

Why don’t painkillers exist in persistent pain?

The term ‘painkiller’ is misleading as it implies that the medicine will kill or fix pain completely.

Although pain medication can play a part in managing persistent pain they do not work for everyone, and even if you get some benefit they are unlikely to remove all of the pain.

Some people also find that the side effects, which can occur in up to four out of every five people taking pain medication (Faculty of Pain Medicine), can be more of a problem than the pain.

Please see the additional support section for links to websites that can give you more information about pain and its treatment.

What about inflammatory pain?

Inflammatory pain, such as arthritis, can also be different as it may be due to continuing damage to the body. This needs managing differently, and may also not respond to some types of pain medication. In these cases medications aim to limit the damage and treat the cause, and could include anti-inflammatory medicines such as ibuprofen or steroids, or medicines that modify the response to the pain. Surgery may also be useful for some types e.g. hip replacements in osteoarthritis. However if these medicines don’t work for you it may be that the damage is no longer active, and the pain has become persistent.