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What causes chronic pain?

Chronic pain means the pain lasts longer. It doesn’t go away, or it goes away for a while and then comes back. "Chronic" means something going on for a long time. Chronic pain starts the same way as any other pain, but if the injury doesn’t heal, the danger receptors keep sending messages to the brain, and the brain keeps sending pain messages back. The nerves become sensitive to make sure the messages get through easily, but if this goes on for too long, the nerves can become hypersensitive. This means they send damage messages to the brain, even when the injury has healed. This fools the brain into sending pain messages. This means that you can feel pain even when the injury has healed. In chronic pain, the messages are delivered non-stop to the brain. This means the pain never lets up.

Dr. Akash Bajaj, MD
Pain Medicine Specialist

Chronic pain can be caused by many different factors, but many times the exact origin is mysterious. Often conditions that accompany normal aging may affect bones and joints in ways that cause chronic pain. Other common causes are nerve damage and injuries that fail to heal properly. Some kinds of chronic pain have multiple causes. Back pain, for example, may be caused by a single factor, or any of the following: years of poor posture, improper lifting and carrying of heavy objects, being overweight, congenital condition such as curvature of the spine, and a traumatic injury.

Disease can also be the underlying cause of chronic pain. Rheumatoid arthritis and osteoarthritis are well-known culprits, but persistent pain may also be due to such ailments as cancer and multiple sclerosis.

In many cases, however, the source of chronic pain can be a very complex and difficult mystery to untangle. Although it may begin with an injury or illness, ongoing pain can develop a psychological dimension after the physical problem has healed. This fact alone makes pinning down a single course of treatment tricky, and it is why health care providers often find they have to try a number of different types of curative steps.

There can be multiple pathophysiologic mechanisms at play with chronic pain, so it is important to focus treatment on addressing each potential exacerbating component. Speak with your physician, usually a pain management doctor, to develop a custom treatment plan for your issue.

Rick Olderman
Physical Therapy Specialist

Most chronic pain is the result of years of poor movement habits, habits that have taken on the guise of “natural” movement, even though these are actually unnatural and harmful habits (also called movement dysfunctions or movement faults). For instance, you will discover that many people who experience hip or knee pain have pelvic muscles that don’t move well. The pelvis houses the muscles that control the hips and knees. When those muscles don’t perform well, excessive movement and pain can result. This excessive movement causes pain. Correcting these issues results in patients sensing they are using their leg in a different way, yet it feels better.

Fixing You: Hip & Knee Pain: Self-treatment for IT band friction, arthritis, groin pain, bursitis, knee pain, PFS, AKPS, and other diagnoses

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Fixing You: Hip & Knee Pain: Self-treatment for IT band friction, arthritis, groin pain, bursitis, knee pain, PFS, AKPS, and other diagnoses

Hip and knee pain are often a result of poor pelvic muscle performance in combination with poor walking habits. This combination creates tracking problems in the hip socket or excessive rotation at...

Many different theories try to explain chronic pain. The exact mechanism is not completely understood. In general, it is believed that the nerve pathways that carry the pain signals from the nerve endings through the spinal cord and to the brain may become sensitized. Sensitization of these pathways may increase the perceived pain out of proportion to the source of the pain. Stimuli that ordinarily are not perceived as painful, such as light touch, can be amplified or changed by these sensitized pathways and experienced as pain.

Sometimes, even after the original injury or disease process has healed, sensitized pathways continue to send signals to the brain. These signals feel just as real and sometimes worse than the pain caused by the original injury or disease process.

Imagine an old television set or computer screen on which the same image is continuously projected. This image is eventually burned into the screen. Even when the screen is turned off, the image can still be seen on the screen. In the same manner, after the original source of pain is healed or no longer present, chronic pain patients may continue to feel pain. Although this is an over-simplification of what may happen in chronic pain, it helps explain the basic concept.

Sue Hitzmann
Fitness Specialist

The cause of chronic pain is connective tissue dehydration, which is a result of our repetitive habits and postures, and leads to stuck stress in the body. Watch fitness expert Sue Hitzmann describe how the Melt Method works to combat chronic pain.

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Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.