What is Chronic Pain?
If you are experiencing persistent pain that has lasted more than three months beyond the usual or natural healing process of an injury or illness, it can classified as chronic pain. Chronic pain can impact your mobility, mood, sleep, and overall quality of life.
Common causes of chronic pain include:
- Musculoskeletal Conditions such as arthritis, fibromyalgia, and fracture malunion or nonunion can cause long-term pain affecting your bones, ligaments, tendons, and muscles.
- Neuropathic Chronic Pain is nervous system or nerve-related pain that you might feel in the form of burning sensation, sharp pain, tingling, or numbness caused by damage to a nerve. Centralised pain syndrome is another form of neurological condition that can be caused by a stroke, multiple sclerosis, a spinal cord injury, etc.
- Chronic Headaches or Migraines are recurring headaches that can last for a several hours with moderate to severe intensity.
- Post-Traumatic or Post-Surgery Pain is pain that may persist after a psychological or physiological traumatic experience, an injury or surgery. PTSD is a common type of post-traumatic pain.
Chronic Pain Treatment Options
Chronic pain treatment is usually tailored to individual needs based on their condition and symptoms. A multidisciplinary approach is often most effective, combining medical, psychological, and lifestyle interventions.
1. Medical and Pharmacological Treatments
- Pain Relief Medication includes paracetamol, anti-inflammatories, opioids (used cautiously).
- Neuromodulators such as antidepressants or anticonvulsants can help manage nerve-related pain.
- Injections and Nerve Blocks, such as corticosteroid injections or nerve ablation procedures are used for targeted pain relief.
2. Physical and Rehabilitation Therapies
- Physiotherapy and Exercise Therapy can strengthen muscles, improve movement, and reduce pain.
- Occupational Therapy can support daily function and physiological pain management strategies.
- Chiropractic and Osteopathy are manual therapies that may also assist in physical pain relief.
3. Psychological and Holistic Therapies
- Cognitive Behavioural Therapy (CBT) can help manage the emotional impact of chronic pain.
- Meditation, Breathing Exercises, and Biofeedback can reduce stress-related pain.
- Acupuncture and Massage Therapy may help reduce muscle tension and improve circulation that can have a positive effect on chronic pain management.
4. Emerging and Non-Invasive Treatments
- TENS (Transcutaneous Electrical Nerve Stimulation) – A device that sends electrical impulses to block pain signals.
- Regenerative Medicine is an emerging field of research wherein stem cell therapy and platelet-rich plasma (PRP) therapy are being explored to help with certain pain conditions.
- Transcranial Magnetic Stimulation (TMS) is a brain-based non-invasive treatment option showing promise for certain chronic pain conditions.
TMS for Chronic Pain
TMS is a non-invasive, medication-free treatment that uses magnetic pulses to target areas of the brain involved in pain processing. Research suggests that for some individuals, repetitive TMS (rTMS) may help reduce pain intensity and improve overall function.
TMS may be considered when:
✅ Traditional treatments (medications, physiotherapy, nerve blocks) have not provided adequate relief.
✅ The pain has a neuropathic or central origin, such as post-stroke pain or fibromyalgia.
✅ The patient prefers a non-drug approach to managing chronic pain.
How sessions work
- Multiple Sessions Required – TMS is not a one-time procedure; a course of treatment typically involves several weeks of sessions.
- Individualised Approach – TMS parameters may need adjustments based on daily factors, including stress levels, sleep, and caffeine intake.
- Potential Side Effects – Usually mild, such as headaches or scalp sensitivity, but should be discussed with a clinician.
While many people benefit from standard medical and physical therapies, alternative options like TMS are emerging for those who have not found relief through conventional treatments. If you are considering TMS or other advanced pain management options, consult with a pain specialist, neurologist, or rehabilitation physician to determine the best approach for you.
FAQs about Chronic Pain
Acute pain is short-lived, and serves as a warning signal for an underlying problem. Acute pain can last up to a few weeks, or until an injury or until the health condition has healed. Unlike acute pain, chronic pain can continue for months even after the underlying cause has been treated. Chronic pain is complex, and treatment should be tailored to your individual needs.