Pain can be linked to long-term health conditions like arthritis, or it might start after an illness, injury, or surgery. Sometimes, pain can begin without a clear cause. For some people, pain improves over time. But for others, it continues beyond the usual healing period. The pain might come and go or even spread to other parts of the body.
There is no single cure for long-term pain. Medical treatments like medication, physiotherapy, or injections may not always help.
Learning more about your pain is an important first step. It can help you find better ways to manage it and lessen how much it affects your daily life.
Pain is defined as “an unpleasant sensory and emotional experience associated with, or resembling that associated with, actual or potential tissue damage,” (The International Association for the Study of Pain 2020).
The experience of pain is both physical and emotional and is not reliably related to an amount of ‘damage’ within the body. Instead it is how the body warns us that something might be wrong.
Pain is a protective mechanism; a response from our nervous system to the perception of threat, that we feel in the body. It is our internal alarm system, making us aware of actual or potential harm by creating pain. The nervous system works like a large computer system, with messages traveling up and down from our body to our brain. Sometimes those messages get mixed up, and the brain struggles to interpret the information properly, leading to pain when it isn’t needed.
As the brain’s pain and emotional centres are interconnected, this means that part of that information processing is done by the emotional centre. This helps explain why pain can feel more intense when we are angry, anxious, or sad. It also sheds light on why pain may increase when there are other changes in our lifestyle, such as higher stress levels, poor sleep, or unhealthy diet and exercise habits.
Here are some links and factsheets to help you learn more.
Pain is a complex feeling that involves both physical and emotional symptoms. Physically, it can cause things like muscle tension, headaches, fatigue, stomach issues, and changes in body temperature. Emotionally, it can make us feel frustrated, angry, sad, or anxious. Our mind is constantly working to understand all of this, while we’re also dealing with everyday life stresses. When we’re living with pain, we might start to notice other effects, such as:
The good news is that learning about pain and finding ways to manage it can really help. When you understand pain and learn how to cope with it, you can reduce its impact on your life and start feeling better. Our pain rehab team is here to support you every step of the way.
Whether it’s exercises, everyday physical activity, walking or other outdoor activity, gentle practices such as yoga, mindful movements, or t’ai chi we know that regular movement can soothe the nervous system and is beneficial for the body. Consider daily opportunity for gentle movements as well as exercise.
Please visit our resources page for more information
Tips for approaching movement: PACE IT!!
Living with pain and fatigue means your nervous system is often on high alert, which makes taking time to relax important—even if you don’t feel super stressed. You might not even notice tension in your body, since it could feel like “normal” for you now. Using relaxation techniques can help you manage pain, especially during flare-ups or tough times. There are many methods available online, like guided exercises on YouTube or apps. Most of these focus on breathing exercises as the main part of relaxation. Relaxation can take different forms, like a creative hobby, or even just slowing down something you usually rush through, like walking, washing the pots, or simply doing one thing at once.
Relaxation might not come easily at first—it takes practise. It’s best to start practising when you’re feeling okay so you can build your skills in a way that’s easier. You can try guided relaxation routinely, or use mindful awareness practises to help you to know when you need to relax.
OUR TOP TIPS
Look in the relaxation section of our Resources page!
Resources
Mindfulness is the practice of paying attention to what’s happening right now—your thoughts, feelings, and what’s going on in your body.
In everyday life, we often go on “autopilot,” doing things without really thinking about them, just following our habits. When we’re on autopilot, we might react to pain in automatic ways that aren’t helpful, based on old patterns of thinking.
By practicing mindfulness, we can become more aware of what’s happening in the present moment. This awareness helps us have more control over how we respond to pain. It can help us take better care of ourselves, ease the resistance we feel toward pain, and improve both our pain and overall well-being.
Mindfulness also helps us be more open to positive experiences and can make us feel more connected to others.
For more information on mindfulness, visit the Mindfulness section our Resources page.
Resources
Many people are told to “accept” their pain, but it can feel like giving up or that nothing more can be done. This can make people try to push through the pain, even if it makes them feel worse, or avoid things they care about because they feel defeated.
When we focus on who and what really matters to us in life, we can start actively making room for pain by learning and practising skills to manage it and support oursleves.
Acceptance is not an end point to reach or a box to be ticked. It is an ongoing process of adapting and being flexible, that helps us move towards our values while taking account of the limitations pain can bring.
When we make active choices to do things that matter to us, perhaps with some adaptations, then acceptance is here.
Quality rest means giving your body and mind a break from activities like moving, talking, or thinking. It’s different from sleep, and it helps your body recharge in a way that’s specific to you.
Rest is important because it lowers your heart rate, blood pressure, and breathing; reduces muscle tension and helps calm your nervous system; helps activate hormones that control your body’s reactions; supports digestion, mental clarity, and the body’s ability to heal and grow. Importantly, it does not affect your ability to sleep at night!
Be Proactive, Not Reactive
Quality rest should be something you do regularly, not just when you’re too tired. Finding the best way for you to rest is key. There are many ways to rest and relax, and it can look different for each of us, at different times. Try and consider what you need:
Try adding short, frequent rest breaks to your day, starting with just five minutes. Experiment with different ways to rest, how long you rest, and how often to see what works best for you.
Now that you know how important rest is, why not try giving yourself permission to rest and feel better?
It is common for people with persistent pain to struggle with sleep – getting comfortable and being wakeful. Many things can get in the way of a good night’s sleep. Some of these we can act upon; some are out of our control. We can work with the R.E.S.T. approach to make change to help influence our sleep habits:-
Understanding how our habits, throughout the day and night influence our sleep, and working with our internal, circadian rhythms. Establishing an effective, regular routine can really help.
Giving ourselves the optimal conditions for a good night’s sleep, and developing ways to strengthen our brains bed-sleep connection.
Considering biological and lifestyle factors that may affect our sleep quality, eg caffeine, nicotine, alcohol, diet, etc and how to make changes.
Understanding the role of the mind at nighttime. Learning skills to tackle a busy mind and our narrative around sleep.
Getting a Good Night’s Sleep
Living with long-term pain can make life feel smaller. You might stop doing things you used to enjoy, and you may start focusing more on your pain and how to make it go away. This can make you feel like you’ve lost part of who you are.
But having ongoing pain doesn’t mean you can’t live a meaningful and satisfying life. Learning more about pain and taking care of your whole self—your body, mind, and lifestyle—can help you manage pain better and support your recovery.
Thinking about what matters most to you (your values) can help you make good decisions, set goals that feel right for you, and start moving forward again.
Reaching your goals might take some problem-solving, flexibility, and even changing the path you thought your life would take. But even with these changes, life can still feel rich, rewarding, and full of purpose.
We often feel stressed when life’s demands feel bigger than what we can handle. When this happens, our body reacts with what’s called a ‘fight or flight’ response. This is a natural reaction that happens when the brain senses danger. It’s designed to help us stay safe.
A long time ago, this response helped our ancestors survive dangerous situations, like running from wild animals. But today, stress is more about everyday problems—like school, work, or health issues. These things don’t always threaten our lives, but they can still make us feel stressed. Because of this, our stress response can stay “switched on” at a low level for a long time.
Pain and stress are closely linked. When we’re stressed, our brain’s threat system becomes more active—and this can make pain feel worse. Stress is a normal part of life, and we can’t always avoid it. But we can learn how to manage it and take better care of ourselves when we feel overwhelmed. Breathing exercises for example are a great way of managing stress.
Breathing techniques
Our minds create thousands of thoughts and images every day—even when we sleep! Most of the time, we don’t even notice them. They just come and go in the background.
But when it comes to pain, our brain pays extra attention. That’s because our brain is always on the lookout for danger, and pain feels like a threat. So it focuses more on pain-related thoughts and feelings.
Our thoughts, emotions, actions, and body are all connected. What we think and feel can change how we behave, and how we respond to pain. For example, if we’re scared that something will make our pain worse, we might start avoiding that activity—even if we used to enjoy it. Over time, we might stop doing more and more things we need or want to do.
Other times, we might push ourselves too hard, especially when the pain feels low. Then we do too much, end up feeling worse, and need extra time to rest. This is called the ‘boom and bust’ cycle. It can make us feel frustrated, sad, or worried about the future.
The good news is: when you start noticing your thoughts and how you react to pain, you can begin to make small changes. These changes can help you feel more in control and improve how you experience pain. Mindfulness practices may help for example.
What are thoughts?
A flare-up is when your usual pain feels worse for a while. This is very common for people who live with long-term pain.
Sometimes, you’ll know what caused the flare-up—like doing too much, being stressed, or not sleeping well. Other times, it can be hard to know why the pain got worse.
Having a plan to help you through a flare-up can make a big difference. A good plan includes different tools and ideas that help you feel more in control and get back on track sooner.
We’re here to support you and can help you create a flare-up plan that works for you.
Talking about pain isn’t always easy, and there are lots of reasons why.
Pain is invisible – People can’t see it, so they might not understand how you’re feeling or what you need.
Pain can change – It’s not always the same. Some days you might feel okay and do more, other days you can’t. This can be confusing for others and frustrating for you.
Pain can change how you see yourself – You might not want to talk about it because you don’t want to worry others, feel like a burden, or admit how much pain affects your life. This can feel lonely and make you doubt yourself.
But talking openly and honestly about pain can really help. When others understand what you’re going through, they can offer better support—both practical and emotional—so you can focus on looking after yourself and managing your pain.
If you’re living with pain, it’s okay to ask for help. You are not alone.
Our team includes doctors, advanced practice physiotherapists, specialist physiotherapists and occupational therapists, pharmacists, nurses, psychological therapists, and wellbeing practitioners. We’ve all had years of experience helping people understand and manage their pain.
You could also take some time to think about what your biggest challenges are and how you would like our service to support you. The British Pain Society has created a helpful decision making tool you can use as a guide.
Pain is very complex, and the short answer is currently there is no cure for long term pain.
However our patients, the research and our own clinical experience tell us that learning ways to live a meaningful life and accepting pain as part of the deal, is what really helps.
It’s normal for pain to vary in its severity. You are likely to have better and worse times with pain.
There are many factors that influence this.
Learning and becoming familiar with your pain and fatigue can really help you to make impactful changes on a daily basis, and develop a plan for times when pain flares up.
Pain is complex to explain and to experience.
We can help you understand your pain, and become more confident in helping others around you to understand pain and your needs more fully.
We have lots of information available to support you, either information only, or during 1:1 pain rehabilitation sessions, or as part of one of our group programmes.
We can work with people individually and in groups.
We’ll start by offering an initial appointment and giving information to you to consider.
You can decide if the pain rehabilitation approach is for you, then get back in touch. See the Pain Rehabilitation Team page for more details.
We offer open appointments for people who have accessed the service.
(If it’s been more than 12 months or it’s a new pain, we’ll ask your GP for an update).
See the ‘contact us’ details.
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