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What Causes Chronic Pain?

Causes of Chronic Pain

There are actually many possible causes of chronic pain. For some people, the pain may have started with an injury or infection, but it persisted long after the initial source of pain resolved. Other people may have chronic conditions that cause pain, such as arthritis or cancer. For others, the original cause or ongoing source may be unknown.
 
Some of the more common causes of chronic pain include:
   
Some people may have more than one reason for their pain. Regardless of what is causing it, chronic pain is a serious condition that should be effectively treated. Knowing the underlying cause can help healthcare providers recommend the most appropriate treatment.
 
Lower Back Pain
Most people will experience lower back pain at some point in their lives. Fortunately, low back pain is usually not serious and only lasts for a short time before going away on its own. Back pain that persists for several months, however, is considered chronic back pain.
 
Chronic lower back pain is usually treated with pain medicines. Other treatments, such as physical therapy and yoga, may also be effective (see Lower Back Pain Relief for more information). Even with treatment, however, your pain may not completely go away. It is important to stay as active as possible because inactivity can actually make your back muscles more sensitive to pain.
 
Arthritis
Arthritis is any of several conditions that affect the joints in the body. You may not realize that there are over 100 different kinds of arthritis. Osteoarthritis and rheumatoid arthritis are the most common types. Other arthritis conditions include gout, lupus, and ankylosing spondylitis (see Types of Arthritis for more information about these and other kinds of arthritis).
 
Treatment for arthritis will depend on the specific type a person has. Regardless of the treatment used, the goals generally remain the same: to minimize pain and improve function and quality of life (see Arthritis Treatment).
 
Cancer
Cancer pain can occur due to the cancer itself, or it can be a consequence of cancer treatment. Not everyone who has cancer will experience pain, but many will. Pain is more likely to be a problem in the advanced stages of the disease. Opioid (narcotic) pain medicines are normally used to treat pain from cancer, though other treatments may be used as well. Fortunately, when appropriately treated, most cancer pain can be well managed through the use of medicines. 
 
Headache
We've all experienced it at one time or another -- that annoying pain or discomfort in the head or facial area that makes it hard to think, work, or do everyday activities. Headaches are one of the most common pain complaints. For most people, headaches are an occasional occurrence, appearing from time to time. That's not the case for people who experience chronic daily headaches.
 
A person is generally considered to have chronic daily headaches if they experience a headache for at least 15 days out of the month for three months or longer. The persistent nature of chronic headaches causes a great deal of distress. They are often very painful and can be difficult to successfully treat.
 
There are several types of chronic headache. The most common are migraine headaches, cluster headaches, and tension headaches. Treatment will vary, depending on the specific type of headache (see Headache Treatment for more information). The most successful treatment approaches will combine medications with nonmedication strategies.
 
Keeping a headache diary can help people track how often their headaches occur, as well as identify and manage headache triggers. Relaxation techniques and stress management have also been shown to be useful in managing chronic headaches.
 
Fibromyalgia
Fibromyalgia is a chronic condition associated with widespread pain and tenderness throughout the body. In addition to pain, people with fibromyalgia often experience fatigue, sleep problems, and problems with memory.
 
Treatment of fibromyalgia usually involves medication and nonmedication approaches. Nondrug treatments include exercise and cognitive behavioral therapy (CBT). CBT can help people adjust how they think about their condition.
 
The U.S. Food and Drug Administration has approved three medicines to treat fibromyalgia:  milnacipran (Savella®), duloxetine (Cymbalta®), and pregabalin (Lyrica®). These medicines reduce pain and improve function in people with fibromyalgia. In addition, although they are not specifically approved to treat the condition, other medicines have been shown to help manage symptoms of fibromyalgia (see Fibromyalgia Treatment to read about the medications a healthcare provider may recommend for this condition).
 
Neuropathic Pain
Neuropathic pain occurs when there is damage to the nerves or a problem with the nervous system. It doesn't feel like the typical pain people associate with being in pain. People who have neuropathic pain feel burning, stinging, and pricking sensations.
 
The sensations can affect any part of the body, and are extremely uncomfortable. They may be severe enough to interfere with a person's ability to sleep, eat, and otherwise function normally.
 
There are many different neuropathic pain conditions. One type, diabetic neuropathy, occurs when diabetes causes nerve damage. Postherpetic neuralgia is another type of neuropathic pain; it occurs after an outbreak of shingles.
 
Because nerve pain responds to medicines that work on certain chemicals in the brain known as serotonin and norepinephrine, healthcare providers often recommend treatment with antidepressant medicines like milnacipran or duloxetine. This is because antidepressants work on the same brain chemicals. Antiseizure medications are also used to treat neuropathic pain since they help control overactive nerve cells. 
 
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