Embrace it

Acute (short term) pain is an essential response to danger and we should be grateful for it; a rare genetic mutation leaves some individuals unable to feel pain and at great risk of burns and injury. Pain is your signal to move away from danger, stop using a damaged or broken body part or is a natural part of healing.

But not for more than three months

Chronic (long term) pain that lasts more than three months serves no useful function and can make life thoroughly miserable. It affects up to one-in-four people and common causes are osteoarthritis (“wear and tear” of joints such as knees), lower back pain, nerve pain due to shingles, diabetes, chemotherapy or postoperative pain. It is notoriously hard to treat chronic pain; prevention or early intervention is the best bet. Start with your GP to get a diagnosis and rule out any treatable underlying cause. Ask for referral to a pain clinic if the condition is becoming persistent and not improving.

Try Tens

Transcutaneous electrical nerve stimulation (Tens) is a battery-operated device with two pads that you put on your skin to create an electrical current. It “distracts” the brain and increases chemical endorphins – the brain’s natural painkillers. Tens is cheap (available on Amazon), safe and has no serious side effects. The evidence is mixed and limited, and positive effects tend to wear off in time, but it is certainly worth a try.

Get stoned?

Several countries including Canada, Australia and the Netherlands allow marijuana for medicinal use and it is a popular choice for many in chronic pain. But an authoritative review has shown that cannabis is not an ideal method of pain control. There is limited or inadequate evidence for a benefit in nerve, cancer or joint pain and “treatment with cannabis-based medicines is associated with central nervous and psychiatric side effects,” says the report. Mind you, the same lack of robust evidence and potential for harm can be laid at the door of many prescribed painkillers.

Hot chilli peppers?

Capsaicin is the chemical that puts the kick into chillies; it causes burning in any tissue it comes into contact with and so can block pain messages to the brain if rubbed on to a painful part of the body. Low dose capsaicin cream is available on prescription or over the counter. A high-strength patch called Qutenza is available from pain specialists and gives a chemical “haircut” to hypersensitive nerve endings. The patch is placed on the area of skin causing pain, such as a patch of shingles, an amputation stump or mastectomy area and left on for an hour. Pain relief may last three months or longer after a single application.

Go online

You can be referred to an interactive, intensive pain management programme online called Pathway Through Pain by local NHS pain clinics, physiotherapy or mental health services. The pain toolkit is a series of 12 videos that helps people to self-manage persistent pain. The British Pain Society provides useful expert advice, while Painsense apps are free to download.

Keep moving

It is tempting and understandable to do less and less as pain becomes persistent. But evidence shows that, no matter how hard it is, it is best to keep active, stay at work and only take enough painkillers to allow you to keep moving.