Chronic pain is pain that lasts at least three months or beyond the normal healing period of an illness or injury. It can be continuous or intermittent and vary in intensity. It can be caused by chronic diseases, injuries or other medical conditions (inflammation, nerve dysfunction, etc.), but also stress, anxiety or depression.
Chronic pain can have repercussions on health and reduce the physical and mental capacities of the affected person, but it can also cause socioeconomic difficulties for them and their loved ones. The consequences of chronic pain, include, for example:
limitation of daily activities
fatigue
depression, anxiety or irritability
social isolation
interpersonal difficulties
challenges encountered when working
Although chronic pain is recognized as a disease in its own right, it is often misunderstood and underestimated. This lack of understanding can lead to negative reactions and prejudice that can add to the suffering of the people concerned. Lack of support, a stressful work environment or poor quality of life can also make chronic pain worse.
Pain management
Chronic pain can have a major impact on people’s daily lives, affecting work, leisure activities and personal relationships. By learning how to manage the pain, people can reduce its negative impact and continue to participate in activities that are important to them.
While there is no one size fits all solution to treat chronic pain, there are several approaches that can help manage it effectively:
medication: painkillers, anti inflammatories, antidepressants or antiepileptics, depending on the type of pain
psychological support: cognitive behavioural therapies, relaxation, meditation and stress management
physical and functional rehabilitation: physiotherapy, adapted physical exercises to improve mobility and strength
medical or surgical procedures: sometimes necessary to treat the cause of the pain
alternative approaches: acupuncture, osteopathy or energy therapy can sometimes complement conventional treatments
Other medical conditions and disorders associated with chronic pain must also be taken into account to ensure quality management. For example, anxiety, depression, the perception of disability, imagining the worst possible scenario, fear of moving because of the pain, sleep disorders and the duration of the painful episode can contribute to the pain persisting even longer. In addition, in collaboration with the patient and other health care professionals, the doctor will take into account the history of the condition and the complexity of the chronic pain in order to establish an effective intervention plan to manage it.
Pain prevention
Some practices can prevent the onset or worsening of pain:
ergonomics: adopting good postures and using ergonomic equipment avoids physical strain
regular and appropriate physical exercise: activities such as stretching, walking or yoga can help maintain mobility and reduce pain
knowledge of risk factors (stress, sleep, etc.)
a balanced diet: eating nutritious foods promotes good overall health
Pain self management
Strategies can also be used to actively manage pain on a daily basis:
regular and appropriate physical activity
relaxation techniques: meditation, deep breathing and progressive muscle relaxation can reduce stress and tension, which can reduce the perception of pain
stress management: learning how to manage stress through enjoyable activities and time management techniques can help reduce pain
changing internal dialogues: replacing negative thoughts with positive and realistic ones can improve mood and pain perception
social support: talking with friends, family or support groups can provide valuable emotional support
monitoring using a pain diary makes it possible to detect the triggers
When to consult
The rapid and appropriate management of chronic pain makes it possible to limit its effects on daily life. Regular consultations and comprehensive support make it possible to better understand and manage pain over time.
In case of moderate, stable pain, contact a health professional or a pharmacist. If necessary, you may be referred to a pain management clinic or a physical rehabilitation centre.
Pain management clinics
Pain management clinics are specialized services for people who have had chronic or persistent pain for more than three months. Their mission is to provide quality care based on the latest research on chronic pain. They offer diagnostic examinations, treatments, multidisciplinary care and services and medical follow up. Care is provided by an interdisciplinary team composed of anesthesiologists, clinical nurses, neurosurgeons, physiatrists, physiotherapists and psychologists. When necessary, patients may be referred to specialized chronic pain management centres for further care.
Who can obtain services at a pain management clinic
To obtain services at a pain management clinic, you must:
have been experiencing persistent pain for more than three months and have difficulty carrying out your daily activities
not have obtained conclusive results following previous treatments
How to obtain services at a pain management clinic
Appointments at a pain management clinic are obtained on the recommendation of a health professional or a nurse practitioner specialized in primary care.
Physical disability rehabilitation centres
To better meet the needs of people over 18 years of age who have chronic pain and complex problems, specialized services are offered by the teams from the physical disability program in physical disability rehabilitation centres (PDRCs). These services aim to improve accessibility and continuity of care in collaboration with teams of professionals including specialists in rehabilitation, psychology and social disciplines. Some teams also include doctors and nutritionists. Although less frequent, there are also experts in pharmacy, sexology and nursing.
How to obtain services in a physical disability rehabilitation centre
In most regions, people can apply themselves. Doctors, specialized nurse practitioners and other health professionals can also refer patients to chronic pain management services in PDRCs.
Once eligibility has been confirmed, the person is referred to the appropriate service, based on their situation and needs. At this stage, the type of professional needed, priority level, program and group activities are determined. If the needs are complex, an interdisciplinary approach is proposed, in which several professionals collaborate.
People at risk
In Canada, about one in five people and one in three older adults suffer from chronic pain. Chronic pain is more common in women than in men, and especially among women 65 years of age and older.
About two thirds of people living with chronic pain report moderate to severe intensity and 50% of them have had it for more than ten years. The number of people affected by chronic pain increases with age, making it a significant health problem among older adults, and especially for Québec, which has one of the fastest growing aging populations in the world.
According to the results of a pan Canadian survey, the three leading causes of chronic pain reported by adults are arthritis and joint pain (36.2%), pain in the spine, including the neck, thorax and lower back (20.4%), and pain associated with trauma, including osteoporosis (15%).
Chronic low back pain is one of the six most common health conditions in developed countries. It is one of the three most reported complications among musculoskeletal disorders, which are expected to increase in the coming years. Chronic low back pain is more common in people aged 65 and over.
Help resources
Consult a doctor or specialized nurse practitioner for a personalized treatment plan.
Many organizations and associations (page in French only) work to improve the management of chronic pain and support patients in their care journey. They offer practical information, advice and spaces for discussion for the people concerned.
Join support groups to share your experience and get advice.
Finally, look for information online. Reliable information and resources on chronic pain management are available: