Medically Reviewed and Written By: Kathleen O’Shea Northrup, MD
What Causes Chronic Pain?
When people think of pain, they frequently imagine injuries like fractures or burns or pain from illnesses like strep throat or appendicitis. This type of pain is known as acute pain, meaning it comes on fairly quickly and is expected to resolve after the underlying problem goes away.
Chronic pain is defined as pain lasting longer than three months. An illness or injury may have triggered it- perhaps a bad fracture resulting in a nerve injury or a slipped disc in your back. But if the discomfort persists beyond three months, this would be considered chronic pain. Any part of the body can experience chronic pain, and over 25% of adults in the US have experienced chronic pain.
So what causes chronic pain? Sometimes, the answer to this question is obvious, but other times it is unclear. Some of the most common causes include:
- Arthritis
- Back pain
- Cancer
- Chronic pain at the site of a prior injury
- Complex regional pain syndrome
- Endometriosis
- Fibromyalgia
- Irritable bowel syndrome
- Migraines
- Neck pain
- Neuropathy
- TMJ Syndrome
- Trigeminal neuralgia
Psychogenic Pain
These are just a few of the many possible causes. Sometimes it is clear what is triggering the chronic pain- progressive arthritis or metastatic cancer for example. The illness or injury may have healed in other cases, but the pain remains. In still other cases, there may not have been any physical trigger.
This is called psychogenic pain and is thought to be related to low levels of endorphins in the blood (endorphins are the hormones that trigger positive feelings.) People with high levels of stress, depression, and anxiety are more likely to experience psychogenic pain.
Additional Causes of Chronic Pain
The development of chronic pain can be influenced by various risk factors, including older age, underlying medical conditions such as arthritis or neurological disorders, and previous injuries or surgeries that have led to continued discomfort. Genetics likely play a role too. Psychological factors like depression and anxiety can increase pain perception, and certain lifestyle elements such as an unhealthy diet, poor sleep, not enough exercise, and obesity also increase the risk.
The reason someone develops chronic pain may not be clear- but what is clear is that getting out of a cycle of chronic pain can be difficult. When someone is experiencing chronic pain, it may understandably cause them to feel depressed and irritable. The pain may also impact their ability to sleep.
Lack of sleep can lead to more irritability, depression, and pain. This vicious cycle can make an already difficult condition feel that much worse. Sometimes doctors suggest that people suffering from chronic pain consider medications for depression or anxiety, knowing that these conditions can go hand-in-hand. This doesn’t mean that the pain is “all in their head”; rather, it is a way to acknowledge the many ways chronic pain can affect a person’s life.
Is Chronic Pain a Diasbility?
Chronic pain can certainly feel like a disabling condition, and for many people, it is. It can interfere with a person’s ability to work, engage with society, and function throughout the day. In fact, the Americans with Disabilities Act states that someone can be considered disabled if they have a “physical or mental impairment that substantially limits one or more major life activities," which certainly could include chronic pain. This means those with chronic pain should receive protections against discrimination and have equal access to employment opportunities and public services. This legal recognition is an important means of protecting people’s rights.
However, the question of whether chronic pain is a disability becomes more complex when things like Social Security Administration benefits are considered. Chronic pain itself is not on the official “Listing of Impairments” that would qualify someone to receive Social Security benefits. There needs to be a different “approved” diagnosis that is causing chronic pain to receive benefits. This is partly due to the subjective nature of pain and the fact that pain is impossible to measure. This subjectivity has led some to argue that chronic pain should not be automatically classified as a disability, as it might be challenging to establish consistent rules to decide what would qualify as chronic pain.
The other argument against calling chronic pain a disability is that labeling it this way could make those who suffer from it feel helpless. It is felt to be preferable to empower those with chronic pain to take control of the management of their symptoms and engage with society rather than frame them as disabled.
The Bottom Line
Whether chronic pain is considered a disability or not does not diminish the fact that it impacts the lives of millions of people per year. Finding a treatment plan that manages its physical, mental, and social aspects can help reduce the impact chronic pain can have on your life.
Joining a supportive community like PatientsLikeMe.com allows people with chronic pain to ask for advice, share their experiences, and get support.