PUTTING on a brave face is something the British are renowned for, and it seems this extends to pain too.
It’s estimated that about 10 million Britons suffer with chronic pain, but recent research suggests that many people are soldiering on without help. A survey by Lloyds Pharmacy found that 77 per cent of people with chronic pain had suffered for years, and almost half, 47 per cent, don’t seek regular help from their GP. Not only that, but two thirds of the 1,000 people surveyed said they had never used a pain clinic or support group.
So what exactly is chronic pain? In simple terms, it’s long-term pain, as opposed to acute pain which comes and goes more suddenly.
Though chronic pain is generally defined as lasting more than three months, some people suffer with it for years, even decades. It can effect any part of the body and may vary in intensity. The causes also vary hugely, ranging from complications following an initial injury or infection, to an ongoing condition such as shingles or arthritis. However, in some cases the exact cause may not be identified.
In contrast, acute pain is usually sharp and warns of disease or a threat to the body, such as a burn, cut or injury. It can be brief or last for a while but not longer than six months, and disappears when the original cause has healed or been treated. Though if it’s unrelieved, acute pain can lead to chronic pain.
But many people suffer in silence even when they struggle to sleep and carry out everyday tasks, like shopping and cleaning. As well as the physical implications, chronic pain can impact on a person’s mental well-being to the point where it can make them feel suicidal.
Ian Semmons, chairman of the charity Action on Pain, which provides support and advice for sufferers, knows full well the extent to which pain can affect quality of life. “Many people tell me that chronic pain is dominating their life, affecting not only their social life and family time, but even their ability to hold down a job,” he says.
But simply putting up with pain just extends people’s suffering, as Dr Austin Leach, a pain medicine consultant at Royal Liverpool University Hospital and council member of the British Pain Society, explains. “If you can put unpleasant symptoms on one side and just get on with your life, you can argue that’s the human condition. However, it can impact on your quality of life and some sensible advice can really help.”
The first step is attempting to identify the cause of the problem, and this means going to see a doctor. “If you’ve got new symptoms, getting a diagnosis is obviously a vitally important step, particularly to exclude treatable or potentially serious conditions,” says Dr Leach. “The earlier appropriate treatment’s given, the better.”
It’s believed that how we perceive pain, and our attitudes towards it, makes a significant difference and with chronic pain, psychological factors are especially important. When pain is detected, different nerves send a number of messages to our brain, such as whether the sensation is heavy, sharp or hot, and how painful it is. A cross-referencing system also kicks in, and past experiences of similar pain in yourself or others you’ve heard about may affect how you experience it.
So if you’ve felt a similar pain before and it wasn’t serious, you may just take a painkiller, have a rest and wait for it to settle down.
But if you’ve heard of someone who had a pain in the same area and it turned out to be a serious illness like cancer, the brain’s attitude to the pain will be different. Similarly, if you’ve suffered in the past with a pain that felt the same, and the agony didn’t shift for months, you may quickly become worried that the pain’s going to last for ages again, which could actually make it worse.
Dr Leach runs a clinic that specialises in chest pain. “Often episodes of chest pain are very frightening, and if people can control their fear, they can control the impact of their symptoms. Learning a relaxation method is almost like self-hypnosis, where you can take yourself into another place. That can be a helpful step if you feel the situation is slipping out of your control,” he says.
“It’s very rare that there’s one thing that’s the answer,” stresses Leach. “It’s usually a combination of things like explanation and education, reassurance, teaching simple techniques like breathing and relaxation methods, and the right medication.
“Often this limits the impact of symptoms to such an extent that people can have a significant improvement in their quality of life.”