CHRONIC PAIN
When It Does Not Go Away
What Is Chronic Pain?
Chronic Pain is pain that lasts or recurs for longer than 3 months, or beyond the expected time of tissue healing. Unlike acute pain, which is usually a protective warning signal tied to injury or illness and resolves as the body heals, chronic pain often continues without a clear ongoing protective purpose. It can become a condition in its own right.
In the International Classification of Diseases ICD‑11 of the World Health Organization WHO, developed with the International Association for the Study of Pain, chronic pain is formally recognized. It is divided into chronic primary pain, where pain itself is the main problem, accompanied by significant distress or disability, and chronic secondary pain, which is secondary to another condition such as cancer, neuropathy, musculoskeletal disease, or problems after surgery or injury.
How Common Is It?
In the United States, 2023 data showed that about 24.3 percent of adults, roughly 60 million people, experienced chronic pain in the past 3 months, and 8.5 percent had high‑impact chronic pain that frequently limited work or life activities. Prevalence has risen from around 20.5 percent in 2019. It increases with age, is more common in women, and is linked to lower socioeconomic status, rural residence, and certain demographic groups.
Globally, estimates typically fall in the range of 20 to 30 percent, with some meta‑analyses around 27 percent, making it one of the leading causes of disability and a major public health burden.
Types And Mechanisms
Pain is often categorized by its underlying mechanisms, which frequently overlap:
- Nociceptive: From tissue damage or inflammation activating pain receptors, such as osteoarthritis, injury, or some cancer pain.
- Neuropathic: From damage to or dysfunction of the nervous system, such as diabetic neuropathy, postherpetic neuralgia, or nerve compression.
- Nociplastic: From altered pain processing in the central nervous system without clear ongoing tissue or nerve damage, such as fibromyalgia, some migraines, or pain related to irritable bowel syndrome.
Common presentations include back and neck pain, joint pain and arthritis, headaches and migraines, neuropathic pain, fibromyalgia, and pain after surgery or injury.
The biopsychosocial model is the standard framework: biological factors such as injury, genetics, inflammation, and central sensitization; psychological factors such as mood, catastrophizing, fear‑avoidance, and coping; and social factors such as work, relationships, and socioeconomic stressors all interact. Relationships with depression, anxiety, and sleep problems often run in both directions.
Impact
Chronic pain commonly leads to reduced mobility and function, fatigue, sleep disturbance, mood changes, social withdrawal, and work disability; depression and anxiety affect a large proportion of people with chronic pain. High‑impact chronic pain substantially lowers quality of life. Economic costs, from medical care and lost productivity, are enormous.
Diagnosis And Management
Diagnosis relies on history, including the pain's location, intensity, duration, impact, and what makes it worse or better; a physical exam; and targeted tests such as imaging, nerve studies, and lab work to identify treatable underlying causes when possible. Pain is subjective, so the patient's own report is central.
A proper diagnosis can only come from a thorough professional evaluation by a qualified clinician.
There is no single cure for most chronic pain. Effective care is usually multimodal and personalized, prioritizing function and quality of life over complete pain elimination.
Typical components include:
- Lifestyle, self‑management and therapy: Graded physical activity or exercise, weight management, stress reduction, sleep hygiene, and physical and occupational therapy.
- Psychological approaches: Cognitive behavioral therapy CBT, acceptance and commitment therapy, mindfulness, and pain education have solid evidence for improving function and reducing disability, especially for musculoskeletal pain.
- Medications, tailored to the mechanism: Topical or oral NSAIDs for many nociceptive and musculoskeletal pains; SNRIs, or certain anticonvulsants called gabapentinoids, for neuropathic or fibromyalgia pain; and other agents as appropriate. Long‑term opioids have limited evidence of sustained benefit for chronic pain not caused by cancer and carry significant risks, so guidelines generally prefer non‑opioid options first.
- Procedures: Injections, nerve blocks, neuromodulation such as spinal cord stimulation, or surgery in selected cases.
- Complementary approaches such as massage or acupuncture may help some people alongside other treatment.
Guidelines and reviews emphasize starting with lower‑risk options and combining therapies. Average pain reductions with treatment are often modest, around 30 percent in many studies, but gains in function and quality of life can be meaningful. Research continues on better‑targeted and personalized approaches.
The right treatment for each person is decided with their clinician.
If you are in crisis, call or text 988. In an emergency, call 911.
Important: This is general information based on established medical understanding and recent data. Chronic pain is highly individual. Evaluation and management should be done with a qualified healthcare professional, such as a primary care doctor, a pain specialist, or a multidisciplinary team as needed. Self‑diagnosis or unsupervised treatment is not appropriate. If pain is new, worsening, or accompanied by red‑flag symptoms such as weakness, numbness, unexplained weight loss, fever, or bowel or bladder changes, seek prompt medical care.
Who Do We Help?
Adults living with pain that lasts or keeps coming back, and with the low mood, anxiety and poor sleep that often come with it.
How Can We Help?
Psychiatry and Psychotherapy care for the depression, anxiety and sleep problems that often come with chronic pain, alongside the care of your other doctors.
What Are My Options?
If you are wondering if we could be a good fit for you or have questions about how we can craft your own specialized treatment plan, please reach out to learn more.
For individuals with urgent needs we may be able to offer same-day or next-day appointments to ensure that you get the care you need as quickly as possible.
Accessible And Flexible Treatment Options
Conveniently located in West Lake Hills, we provide expert psychiatric care and psychological testing for patients in
Austin, Rollingwood, Tarrytown, Bee Cave, Lakeway and Surrounding Communities in Central Texas.
Our Mission is to Provide the Best Psychiatric Care and Psychological Testing in Austin. Contact Us today, we love to help!
How To Get Started
1. Fill Out Our Request Form
Submit your Request online
A member of our Patient Care Team will reach out at your convenience.
2. Call Us For Expedited Scheduling
Our team is happy to answer your questions and guide you through the process.