Do I Have Chronic Pain? Understanding the Signs and What You Can Do About It

We all experience pain – a stubbed toe, a pulled muscle. It's our body's alarm system. But what happens when the alarm keeps ringing even after the danger is gone? That lingering pain, without a clear cause or lasting long after an injury heals, could be chronic pain.

The Centers for Disease Prevention and Control (CDC) estimates that over 20 percent of Americans live with chronic pain. But, Jacob R. Hascalovici, M.D., Ph.D., an interventional pain medicine neurologist at Hackensack Meridian Neuroscience Institute at Hackensack University Medical Center, and associate professor of Neurology, Hackensack Meridian School of Medicine, says you don’t have to live with chronic pain. “Many people don’t realize it, but there are many treatment options to alleviate chronic pain and help you regain control of your life,” says Dr. Hascalovici. 

What is Chronic Pain

Chronic pain is defined as pain that lasts longer than three months and interferes with your daily life. Unlike acute pain, which comes on suddenly (like a sprained ankle or post-surgery pain), chronic pain can last for months or even years. 

“There are many types of chronic pain. Your pain may feel dull or sharp, burning or aching. It might come and go, or be constant. For some people, it’s in the neck, back or joints. For others, it’s widespread muscle soreness, radiating pain symptoms in the arms or legs or joint stiffness,” says Dr. Hascalovici, director, division of Pain Neurology at Hackensack.

Self-Check: Could I Have Chronic Pain? 

Many people don’t realize they suffer from chronic pain. Dr. Hascalovici says if you aren’t sure if you suffer from chronic pain, ask yourself the following questions:

• Have I had pain most days for the past 3 months or longer?
• Does my pain interfere with work, sleep or everyday activities?
• Do I feel tired, anxious or frustrated because of the pain?
• Have I tried over-the-counter medications with little relief?
• Have I been told “there’s nothing wrong” but still feel pain?

If you answered yes to one or more questions, it may be time to talk to a chronic pain specialist. “You don’t have to live in pain. Relief is possible, and a pain specialist can help you find the best way to manage your pain so you can enjoy everyday activities,” says Dr. Hascalovici. 

Diagnosing Chronic Pain

Once you determine whether you might have chronic pain, Dr. Hascalovici says the next step is to find the source. “Before we can treat chronic pain, we need to know the underlying cause,” says Danielle Lee, M.D., pain neurologist at Hackensack University Medical Center and Palisades Medical Center, and assistant professor of Neurology at Hackensack Meridian School of Medicine.

Your doctor will begin with a thorough physical exam to determine how long you have had pain and how it impacts your everyday life. They may also recommend additional diagnostic tests including X-rays or MRIs to help aid in the diagnosis and guide the treatment.

Dr. Lee says there are four main categories of chronic pain: 

• Musculoskeletal (your muscles and bones)
• Nerve or neuropathic (damage to the nervous system)
• Visceral or internal organ pain due to inflammation, disease, damage or injury
• Nociplastic pain, which originates in the brain or spinal cord, but is experienced in the body

How to Treat Chronic Pain

The good news is that you can treat chronic pain and improve your quality of life. Dr. Hascalovici says that once you and your doctor determine the cause of your chronic pain, you can find a solution that works for you. 

Lifestyle modification

Before trying medication or more invasive treatment options, Dr. Hasalovici suggests lifestyle modifications. Some of the lifestyle modifications he recommends include: 

• Diet: Eating a healthy diet of fruit and vegetables can help improve pain. Some fruits and vegetables, like berries and kale, contain antioxidants that help reduce inflammation. 

• Exercise: A 2023 review of more than 100 studies on exercise and chronic musculoskeletal pain found that sedentary behavior and physical inactivity were associated with chronic pain. Exercise can also aid sleep, which is restorative and an important healing factor in chronic pain patients.

• Mindfulness: This is a form of meditation that can help people breathe and manage pain through being present and performing breathing exercises. 

Physical and occupational therapy 

Physical and occupational therapy are valuable tools for managing chronic pain and improving overall function. 

Physical therapy focuses on improving mobility, strength and range of motion. A physical therapist will assess your individual needs and develop a tailored treatment plan that may include exercises, manual therapy techniques, and modalities like heat or ultrasound to reduce pain and inflammation and improve physical function. 

Occupational therapy aims to help you regain independence in daily activities. An occupational therapist will work with you to develop strategies and adaptive techniques to perform tasks that may have become difficult due to pain or limited mobility. This can include things like dressing, bathing, cooking and working. 

Occupational therapy can also involve specialized interventions like hand therapy to improve fine motor skills or driver rehabilitation to help you regain driving independence. They'll also help you navigate real-life scenarios, such as making dinner, going up and down stairs, or getting in and out of the car, to ensure you can safely and effectively navigate real-life scenarios such as making dinner and going up and down stairs. 

Medication

In some cases, Dr. Lee says medication may be necessary to manage your chronic pain. “There are a variety of medications that can be used to control pain. We may not be able to eliminate your pain completely, but our goal is to reduce your pain significantly and improve your overall quality of life,” she says. 

Some types of medications Dr. Hascalovici recommends include:

• Nonsteroidal anti-inflammatories (NSAIDs); for example, ibuprofen, aspirin, etc.
• Acetaminophen
• Muscle relaxers
• Nerve pain medications (anticonvulsants, some antidepressants)
• Oral steroids
• Low-dose naltrexone
• Newly FDA-approved sodium channel blockers (alternative to opioid pain relievers)

Injections

Depending on the source of your pain, injections may provide longer-lasting relief. “Injections can target specific pockets of pain, which provide more localized relief,” says Dr. Hascalovici. There are several different types of injections available depending on your source of pain. 

• Trigger point injections: These help to relax tight muscles, often in the neck.
• Joint injections: Steroid injections into arthritic joints may reduce pain and inflammation and improve range of motion or function. If there is swelling in the joint (effusion), it can be drained as well.
• Nerve block: These injections use local anesthetics to “block” pain from a source by numbing its nerve supply and often help make a diagnosis.
• Epidural: This injection done under X-ray guidance delivers a mixture of medication close to the nerves of your spine and is often used for sciatica and painful conditions of the lower back and legs.
• Radiofrequency ablation: These are pain injections/procedures that focus on burning the nerves to manage pain

Counseling or behavioral therapy

If you have trouble coping with your chronic pain or it’s preventing you from enjoying daily activities despite treatment, Dr. Lee says counseling could be an option. “Chronic pain can cause depression and anxiety, which can often exacerbate symptoms. Counseling and behavioral therapy can provide you with the tools to change your outlook and conquer your pain,” he says. 

If necessary, your physician can also prescribe antidepressants to help you manage depression and anxiety. 

Next Steps & Resources

• Meet our experts: Jacob Hascalovici, M.D. and Danielle Lee, M.D.
• To make an appointment with our experts or a doctor near you, call 800-822-8905 or visit our website.
• Learn more about Interventional Pain Management at Hackensack Meridian Health.

The material provided through HealthU is intended to be used as general information only and should not replace the advice of your physician. Always consult your physician for individual care.