Chronic pain syndrome: Symptoms and treatments

 

There’s a lot of confusion surrounding what chronic pain syndrome truly means. Some people use the term interchangeably with chronic pain – that is, debilitating pain that continues for longer than three months. But while there are many similarities between the two, they aren’t quite the same thing.
 

 

What is chronic pain syndrome?

 
The idea of chronic pain syndrome was first described in 1987. Back then, experts suggested that chronic pain syndrome had links to psychological and socioeconomic factors, and that its definition was not confined to the experience of pain (i).
 
Nowadays chronic pain syndrome is often more simply described as something that affects people with chronic pain who have other symptoms beyond pain alone – depression for instance (syndromes are linked collections of symptoms as opposed to diseases that have one central cause). These other symptoms – which might be described as complications of chronic pain – can trigger a vicious cycle, as they often make the original pain worse.
 
In a nutshell, if you have chronic pain syndrome it means you have experienced more than just pain for longer than three months. And that as a result, you will probably need different treatments, not just for your pain but for your other symptoms too.
 
Unfortunately, chronic pain syndrome isn’t well understood or even acknowledged by many health practitioners. It can, however, have an understandably significant effect on your day-to-day life and wellbeing.
 
Because of this lack of awareness, we don’t really know how many people experience chronic pain syndrome. Yet some US-based sources suggest that, of the 20 per cent of Americans thought to experience chronic pain, around half go on to develop chronic pain syndrome (ii). And while it can affect anyone of any age or any gender, chronic pain syndrome is often thought to affect more women than men.
 

What causes chronic pain syndrome?

 
It’s not clear why some people with chronic pain develop chronic pain syndrome while others don’t. The causes of chronic pain, on the other hand, are well understood. Chronic pain often starts after you’ve had an injury or surgery. It may also be caused by a variety of medical conditions – here are just a few examples:
 

• Arthritis 

• Osteoporosis 

• Fibromyalgia 

• Back pain (including sciatica and piriformis syndrome) 

• Headache

• Migraine 

• Temporomandibular joint disorder 

• Diabetes 

• Nerve damage (neuropathy) 

• Lyme disease 

• Irritable bowel syndrome 

• Inflammatory bowel disease 

• Chronic fatigue syndrome 

• Endometriosis 

• Post-herpetic neuralgia (a complication that can affect people who have had shingles) 

• Acid reflux 

 

What mental illnesses are associated with chronic pain syndrome?

 
It has been suggested that chronic pain can become so severe for some people that it begins to affect their mental wellbeing. This probably won’t surprise anyone who has ever lived with pain on a long-term, day-to-day basis – even if you haven’t experienced chronic pain yourself, it’s not hard to imagine how it might affect every aspect of your life, not to mention how it might get you down emotionally.
 
Depression is thought to be a particularly common symptom that accompanies pain in chronic pain syndrome. Depression can increase pain sensitivity, which means it makes your pain worse, and that can make you more depressed – and so on, and so on.
 
Other symptoms you may experience include:
 

• Anxiety

• Sleeping difficulties 

• Headache 

• Poor appetite 

• Mood swings

• Irritability

• Panic attacks

• Fatigue 

• Low libido 

• Concentration difficulties

• Suicidal thoughts

 
People with chronic pain syndrome can also experience other types of issues, such as relationship or family problems. They may even lose their jobs if pain makes working impossible which can result in financial difficulties. Chronic pain syndrome can also lead to drug or alcohol abuse as a coping mechanism. In time people with chronic pain syndrome may also become more isolated from others, including friends and family members. All of these things can increase your stress levels, which in turn can make your pain more severe.
 

Who is at risk of developing chronic pain syndrome?    

 
If you’re female you have a higher risk of developing chronic pain syndrome than if you were a man. But anyone with chronic pain can develop chronic pain syndrome if their pain starts to affect their mental health and emotional wellbeing. Those who are already affected by depression or other underlying mental health problems are thought to be particularly at risk. Others who may also be at risk include the following:
 

• Socially isolated people who lack social support

• People struggling with financial problems

• People with high stress levels

• People with sleeping difficulties who are persistently tired

 
Some sources suggest smokers, people who are living with obesity and the over-65s have a higher-than-average risk of developing chronic pain syndrome too (iv).
 

How is chronic pain syndrome treated?

 
Treatments for chronic pain syndrome are often the same as those for chronic pain, including pain-relieving medication, physical therapy and acupuncture. They will also include ways of relieving the other symptoms that come with the pain.
 
The treatments you’ll receive will depend on the non-pain symptoms you’re experiencing. For instance, if you’re experiencing depression with chronic pain, your GP or specialist may recommend antidepressants (which can also reduce pain signals). Talking therapies such as cognitive behavioural therapy may also be useful, as they may help you develop more positive thoughts about your pain as well as tackle some of the other emotional difficulties you may be experiencing.
 

How to cope with chronic pain syndrome    

 
There are other things you can do yourself that may be useful. Some of the things that may help combat chronic pain are outlined in our articles Living with chronic pain and coping strategies and Natural pain relief: herbal remedies. 
 
You may find the self-help suggestions in some of our other mental health articles useful too, including our guides to depression and anxiety, stress, insomnia, headache, panic attacks, poor appetite, tiredness and fatigue, low libido and suicidal feelings.
 
Making sure your lifestyle is as healthy as possible is always a good strategy. Staying physically active will, for instance, help your body cope with pain as well as emotional issues such as depression.
 
Eating a healthy, nutritious diet can also be beneficial – see our article on diet and mental health, to find out how what you eat can help support your mental wellbeing. So whenever you can, try to have at least five portions of fruit and vegetables every day, as well as starchy carbs to give you energy, some protein, some dairy foods and a small amount of healthy fats (with limited amounts of sugary and fatty foods).
      

Supplements to support chronic pain syndrome

 
If you struggle some days to eat healthily – or eat much at all – you may want to consider topping up your diet with a daily multivitamin and mineral supplement. Not sure which multivitamin is for you? Read our guide to multivitamins and daily requirements for details about some of the different multivitamin and mineral formulations that are available. Meanwhile some of the other supplements that may be helpful, especially when it comes to controlling your pain levels, include the following:
 

PEA   

 
Short for palmitoylethanolamide, PEA is a fatty acid produced naturally by the body and is found in all cells, tissues and fluids including the brain. You can also get it in foods such as soya beans, peanuts, eggs, flaxseed and milk.
 
An endocannbinoid-like chemical that belongs to a family of fatty acid compounds called amides, PEA is often described as an alternative to CBD, as both substances are thought to have similar properties including the ability to reduce pain and inflammation. Researchers, however, suggest PEA is safer than CBD, since it has been studied more extensively and has a more robust safety profile (v) with no known side effects (vi). A review of 16 clinical trials and meta-analysis also confirms PEA has painkilling actions (vii).
 

Magnesium 

 
Found naturally in the body, magnesium is needed for more than 300 biochemical reactions including muscle and nerve function. It has been studied in a variety of pain conditions, with researchers finding it may help with the pain of conditions such as fibromyalgia, headaches, migraines, period pain, post-herpetic neuralgia, diabetic neuropathy and back pain (viii) – though they add that more large-scale studies are needed to better understand how magnesium may help manage chronic pain. 
 

High-strength fish oils  

 
The omega-3 fatty acids found in oily fish – called DHA and EPA – may help with reducing pain and inflammation, with numerous studies since the 1980s suggesting they provide a degree of pain relief. One study, for instance, suggests omega-3 fish oil supplements appear to be a safer alternative to anti-inflammatory pain medicines for the treatment of neck or back pain (ix). Researchers elsewhere suggest omega-3s may work in a similar way to over-the-counter painkillers (x).   
 

Turmeric  

 
Curcumin is the active antioxidant substance in turmeric and is widely believed to have anti-inflammatory properties. Scientists are indeed discovering more about turmeric’s possibilities for pain relief – one review of 10 studies, for instance, concludes turmeric may be beneficial for pain caused by arthritis of the knee, and that the effects of taking it are similar to those of taking anti-inflammatory painkillers (xii).
 

Looking for more information?

 
There’s lots more information on a range of the conditions that cause pain in the pain section of our pharmacy health library. If you have chronic pain syndrome you may also want to take a look at our mental health section for more information on coping with a variety of mental health conditions.

 

References:

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2. Available online: https://austinpaindoctor.com/chronic-pain-syndrome

3. Available online: https://www.webmd.com/pain-management/chronic-pain-syndrome-overview

4. Available online: https://www.painscale.com/article/what-is-chronic-pain-syndrome-cps

5. Clayton P et al., Palmitoylethanolamide: A Potential Alternative to Cannabidiol. J Diet Suppl. 2021 Nov;28;1-26. Available online: https://www.tandfonline.com/doi/full/10.1080/19390211.2021.2005733

6. Clayton P et al., Palmitoylethanolamide: A Natural Compound for Health Management. Int J Mol Sci. 2021 May;22(10): 5305. Available online: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8157570/

7. Gabrielsson L, Mattsson S, Fowler CJ, Palmitoylethanolamide for the treatment of pain: pharmacokinetics, safety and efficacy. Br J Clin Pharmacol. 2016 Oct;82(4): 932–942. Available online: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5094513/

8. Hyun-Jung Shin, Hyo-Seok Na, Sang_Hwan Do, Magnesium and Pain. Nutrients. 2020 Aug;12(8): 2184. Available online: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7468697/
   
   Park R et al., Efficacy and Safety of Magnesium for the Management of Chronic Pain in Adults: A Systematic Review. Anesth Analg. 2020 Sep;131(3):764-775. Available online: https://journals.lww.com/anesthesia-analgesia/fulltext/2020/09000/efficacy_and_safety_of_magnesium_for_the.20.aspx

9. Maroon JC, Bot JW, Omega-3 fatty acids (fish oil) as an anti-inflammatory: an alternative to nonsteroidal anti-inflammatory drugs for discogenic pain. Surg Neurol. 2006 Apr;65(4):326-31. Available online: https://www.sciencedirect.com/science/article/abs/pii/S0090301905007743?via=ihub

10. Ye J, Ghosh S, Omega-3 PUFA vs. NSAIDs for Preventing Cardiac Inflammation. Frontiers in Cardiovascular Medicine. 2018;5: 146. Available online: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6205954/
    
    DiNicolantonio JJ, O’Keefe JH, Importance of Maintaining a Low Omega–6/Omega–3 Ratio for Reducing Inflammation. Open Heart. 2018;5: e000946. Available online: https://openheart.bmj.com/content/openhrt/5/2/e000946.full.pdf

11. Available online: https://www.nhs.uk/live-well/eat-well/food-types/fish-and-shellfish-nutrition/

12. Paultre K et al., Therapeutic effects of turmeric or curcumin extract on pain and function for individuals with knee osteoarthritis: a systematic review. BMJ Open Sport Exerc Med. 2021;7(1): e000935. Available online: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7812094/

 

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Disclaimer: The information presented by Nature's Best is for informational purposes only. It is based on scientific studies (human, animal, or in vitro), clinical experience, or traditional usage as cited in each article. The results reported may not necessarily occur in all individuals. Self-treatment is not recommended for life-threatening conditions that require medical treatment under a doctor's care. For many of the conditions discussed, treatment with prescription or over the counter medication is also available. Consult your doctor, practitioner, and/or pharmacist for any health problem and before using any supplements or before making any changes in prescribed medications.

 

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