When it comes to chronic pain syndrome, there is no universal definition, but it is often explained as pain that has persisted for longer than 12 weeks, or beyond what would be expected to have been a normal healing period.
The term ‘chronic pain syndrome’ is an umbrella term used to define long-term pain which can arise from a variety of different sources. One of the most common triggers of chronic pain disorder is an injury, such as one caused by a road accident or fall, where the pain lingers after the initial physical damage has healed – with no obvious cause.
In some circumstances, the symptoms of chronic pain syndrome do not arise until a long time after the injury has occured, which can prove confusing and frustrating for both the patient and medical professionals alike.
In many cases of chronic pain syndrome, pain relieving drugs are prescribed in order to manage the pain, however, this can cause some undesirable side effects for the patient, such as drowsiness, dizziness or digestive problems. This forces many sufferers to turn to alternative therapies, such as acupuncture, reiki and mindfulness techniques in order to alleviate the pain.
If you’re looking to claim compensation for chronic pain, you will need to be able to prove that an accident or injury caused by another’s negligence was to blame for your chronic pain symptoms.
The value of your chronic pain compensation payout will depend on the severity of your symptoms and the long-term effects it has had on your working capabilities and need for care. When making a claim, medical experts will be instructed to assess your symptoms and advise on the effects your accident has had, and will have on your life.
Compensation claims will generally need to be made within three years of knowledge of the negligence that caused your chronic pain symptoms. However, the courts do have discretion to allow late claims in some circumstances.
The value of your chronic pain compensation claim will depend on how the injury has affected your life, working capabilities, and your need for care and assistance, both in the short-term and long-term – meaning compensation can vary from case to case.
The reason for this huge variation in compensation payouts is due to the fact that each of these heads of claims are calculated on a case-by-case basis. For example, a young person in a high-paying job who will never be able to return to work will receive a higher award of damages for the significant long-term impact on their life.
However, if a more senior person who is close to retirement in a low-paying job was to claim, they will receive a lower award of damages for the same injury, due to the fact that their life will be impacted for a shorter amount of time.
This case-by-case evaluation makes it difficult to estimate a compensation payout for chronic pain, however, if your injury has had a severe, long-term impact on your life, then you can expect to receive a significant amount of compensation
Everyone has suffered pain at some point in their lives, whether it’s an excruciating headache, backache or toothache. Whatever the cause, pain can take the joy out of everyday life and when it’s alleviated, there’s usually a huge sense of relief.
However, try to imagine if that pain were a permanent feature, something that you were forced to deal with from the moment you opened your eyes in the morning until the time you went to bed and often throughout the night too, disrupting your sleep.
Chronic pain disorder is a severely debilitating condition and one which has devastating consequences on the quality of life, regardless of the cause. The unremitting nature of chronic pain syndrome means that sufferers are forced to rely on a cocktail of drugs and medications, often with limited success.
Here’s a closer look at chronic pain disorder and what it really means.
Chronic pain syndrome – a definition
Although an unpleasant sensation, pain is an essential part of the body’s protection mechanisms, alerting us to the presence of a problem. Once identified, the trigger can be dealt with, enabling the pain to subside.
Chronic pain disorder is a very different beast, serving no useful purpose and persisting within the body long after the trigger – if there was one – has been eradicated.
There is no universal definition of what qualifies to be identified as chronic pain and it’s this lack of a consensus which can mean patients receive varying degrees of treatment from their doctors.
Generally speaking chronic pain is distinguished as pain which has persisted beyond 12 weeks and has gone beyond what a regular healing period could generally be expected to last.
Chronic pain may be related to an ongoing condition, such as rheumatoid arthritis, or it may be pain that is still present long after recovery should have taken place, such as post-surgery, and there may be no obvious reason for the persisting symptoms. In some cases chronic pain arises without any identifiable trigger or cause, arising out of the blue.
Current medical opinion suggests that unexplained chronic pain is caused due to a malfunction in the nervous system, with pain signals being sent to the brain even though there is no damage to the tissues in the body.
The degree of pain suffered can vary very significantly with some patients forced to endure excruciating levels of pain while others have continuous low grade symptoms. The pain can be utterly incapacitating or it may be episodic but the one common feature is that it doesn’t remit or relent, the pattern is continuous.
How chronic pain disorder is treated
Once again there’s a wide variation in how chronic pain in treated, partly because it can arise from a number of different causes.
Musculoskeletal conditions such as osteoarthritis and back pain are notorious for causing ongoing pain which is very difficult to treat and alleviate and very often it’s simply a case of trying to manage the symptoms rather than offering an effective cure.
But although a cure may not be possible, the cases in which there is an easily identifiable cause can be less problematic when the diagnosis is one by exclusion.
Conditions such as Fibromyalgia and Complex Regional Pain Syndrome are often met with skepticism and sufferers can face accusations of malingering. Even once diagnosed, the protocols for treating the conditions aren’t as well established as other diseases and less is known about the likely progression or evolution.
For any kind of chronic pain, the overall treatment can depend heavily on the medical team, with far more disparity in the regimes than in other areas of medicine.
Problems and complications
Chronic pain is a particularly subjective problem, with the extent of the distress and suffering being caused varying widely from person to person.
For those at the more severe end, it can be difficult to get the degree of suffering taken seriously, often being labelled with being overly-sensitive, or even worse, exaggerating their symptoms.
It’s also important to understand that pain rarely occurs in isolation. Other symptoms can include sleep difficulties, fatigue, lethargy, muscular aches, reduced stamina and mood changes such as depression and anxiety.
When faced with the emotional toll of dealing with chronic pain it’s perhaps not surprising that many people suffer related psychological problems, such as anxiety and depression. These conditions by themselves can be extremely disabling but when coupled with pain, they can be extremely incapacitating, affecting not just the ability to work but also personal relationships and family life.
The information contained on this page is only intended to be a guide and does not constitute medical advice. Please consult your doctor if you are suffering from any of these conditions.
Headache, toothache and backache are common pains that can cause annoyance for a short period of time. But what if there was little prospect of the pain subsiding and that instead of gaining relief, you would have to battle the unpleasant sensation every day?
That’s the reality of life for those who suffer from chronic pain syndrome.
Incapacitating and debilitating, chronic pain disorder can appear as a result of a number of different causes, but the end result is the same – a never-ending battle against what can be a deeply distressing condition.
The definition of chronic pain disorder
There’s no universal definition of chronic pain syndrome, but it’s often described as pain that has persisted for longer than 12 weeks or beyond what would be expected to have been the normal healing period.
Chronic pain syndrome is an umbrella term used to capture long-term pain which arises from a variety of sources, being caused by both known and unknown triggers.
In some cases, the pain can be attributed to known causes, such as nerve pain related to diabetes or the musculoskeletal pain associated with osteoarthritis.
The pain may be related to something which was been understandable at first, such as post-operative pain, but has now extended beyond what would normally be expected, with no obvious cause creating the persisting discomfort.
There’s also pain which arises out of the blue, and presents with pain as the primary symptom, rather than tagging along as a complication of another condition. These pain syndromes are complex and extremely difficult to treat, with medical science not yet properly equipped to either diagnose or manage the conditions effectively.
A debilitating condition
The degree of pain being suffered may fluctuate on a daily basis, or it may be more constant.
Some individuals have good days and bad days, often triggering a bad day by overdoing things on a day when they feel better!
There are lots of ways pain can be managed, with varying degrees of success, but at times the treatment itself can cause unwanted symptoms too, such as nausea, dizziness and drowsiness.
Therefore both the pain, and sometimes the treatments too, can result in a condition which is extremely debilitating, impacting on an individual’s ability to function.
Pain is exhausting to deal with and managing it on a long-term basis is hard for an individual to have to face. Fatigue, emotional distress and depression therefore often accompany chronic pain disorder, as the person battles to constantly deal with their symptoms.
Types of pain
As can be seen from the information above, there are lots of different possible causes for pain, but it’s even more complicated than that. There are many different categories and types of pain, and it’s essential to understand the nature of the pain in order to treat it effectively.
Neuropathic pain relates to the nerves, with pressure being put on one or a group of nerves, which in turn sends pain messages to the brain.
Nociceptive pain describes tissue damage and inflammation, such as being kicked or having a swollen knee.
Neuropathic and nociceptive are two of the main categories of pain but there are many others too.
Idiopathic pain is one which has persisted for a period exceeding six months and for which doctors can find no cause.
Allodynia is a symptom which can often arise in conditions such as fibromyalgia and Complex Regional Pain Syndrome and refers to the sensation of pain being caused by stimuli which wouldn’t normally be painful.
Pain normally arises in the body as a result of a warning system designed to protect against harm, alerting to the presence of something which needs to be dealt with. Although the sensation is unpleasant, acute pain is useful because it serves a purpose. The signals travel through the special nerve fibres to the brain where transmitters ensure the pain message arrives at the right destination.
Chronic pain is rather different and appears to be caused by what can best be described as a short circuit in the body’s wiring. Pain signals are triggered and sent through the fibres for no apparent reason, with transmitters in the brain helping to amplify the effect.
As the pain signals pass through the emotion and mood centres in the brain, there’s an interaction with low mood somehow worsening the signals and creating more transmitters to pass the message along.
Chronic pain disorder, therefore, arises in the body but can be worsened by transmitters in the brain, including those responsible for mood and emotions, creating a very undesirable result.
Unlike acute pain, chronic pain signals serve no useful purpose and rather than alerting to a danger appear to simply be a malfunction in the bodily system. Unfortunately, as yet, doctors are not able to rectify the “short circuit” and are limited to simply trying to manage the symptoms, hoping they will ultimately burn out and disappear.
DISCLAIMER: The above information should not be used to substitute for medical advice and is provided for the purposes of guidance only. If you are suffering from any of the symptoms or conditions described, medical attention from a qualified professional should be sought immediately.
Pain can be an alarming and distressing symptom, overwhelming daily life and disrupting an individual’s ability to function on even the most basic level.
Chronic pain syndrome sufferers are often forced to deal with these symptoms on a daily basis, and with no immediate resolution in sight, it can be simply exhausting.
In some cases, chronic pain disorder is linked to a known condition; this may not make it any easier to bear but it can be reassuring to know the cause. For others, there’s no diagnosis and this can add an extra layer of stress to the ongoing pain and discomfort.
Here’s a closer look at some of the causes of chronic pain syndrome.
Perhaps one of the most common triggers of chronic pain disorder is an injury, for example caused by a road accident or a fall. However, long after the initial physical damage has healed, the pain lingers on with no obvious cause. In some circumstances, the onset of chronic pain syndrome does not begin until sometime after the injury has occurred which can prove confusing for the patient and medical professionals alike.
There’s a myriad of conditions which can cause chronic pain, such as arthritis, ankylosing spondylitis and lupus, and it’s also possible to suffer persisting pain following surgery too.
Unfortunately, being aware of the cause or trigger of the pain doesn’t offer any guarantee that it will be effectively treated. Persistent pain can be broadly split into two different categories; neuropathic and nociceptive pain.
Neuropathic pain is typically caused by pressure on a nerve which in turns sends the message up to the brain to interpret as pain. The pressure can be caused by a number of different triggers including infection, toxins or autoimmune problems and you may not feel the pain in the region in which the trigger is present. For example, pressure on nerves in the neck may often be felt as numbness in the hand and arm.
Nociceptive pain is a term used to describe tissue pain, such as that which could be felt if you burned yourself or banged your knee. It arises from swollen and inflamed tissues rather than directly from pressure on nerves.
There are other types of pain too such as idiopathic, psychogenic and allodynic.
Just because there’s a diagnosis doesn’t mean it’s clear cut and an individual may suffer from a number of different types of pain. As the treatments for each will be different, and have varying degrees of success, it’s essential to determine not just the underlying condition but the type of pain being experienced.
No identifiable trigger
There are a number of conditions where there’s no obvious trigger or cause, and pain itself is the primary presenting symptom (rather than accompanying restricted movement as in back pain, for example).
For these individuals, diagnosis can be rather more convoluted, with no tests or investigations which can provide an answer. In many cases it’s simply diagnosis by exclusion; ruling out all other possible causes and making a clinical judgement based on presenting symptoms.
Because of the subjective nature of this kind of condition, diagnosis can take far longer and some patients never receive a diagnosis at all with doctors unwilling to give out a “label” without clear-cut, objective proof.
In many cases patients with this kind of chronic pain face accusations of malingering, either spoken or unspoken, and a lack of understanding from their peers, friends, family and sometimes even their doctors.
Some of the conditions which give rise to chronic pain include but aren’t limited to fibromyalgia, Complex Regional Pain Syndrome, headaches, Post Whiplash Injury Syndrome and Myofascial Pain Syndrome.
Not an imaginary condition
Dealing with any kind of pain on a chronic basis is simply exhausting; both physically and emotionally so a number of individuals go on to develop related psychological conditions such as anxiety and depression.
This doesn’t mean that the condition is ‘all in their head’ but simply that the burden of dealing with so much pain has taken its toll.
The assumption that chronic pain without an identifiable cause is entirely psychological is an unfortunately common view and some patients find they don’t receive the help they need as a result.
In some cases antidepressant medication can be prescribed for chronic pain even if no psychological conditions are diagnosed. This is because the pain signals which reach the brain also pass through the “emotional centres” and there’s some evidence that using antidepressants can help to inhibit some of the transmitters which pass along pain messages.
No-one suffering from pain should ever feel that they should “man up” or “pull themselves together”; chronic pain is a devastating condition and not an imaginary symptom.
The probable path for chronic pain sufferers depends greatly on the underlying cause. For progressive or degenerative conditions such as osteoarthritis, without invasive treatments such as knee or hip replacements, only limited relief is likely to be gained.
The outcome for primary pain syndromes is far more uncertain, with much more research required into the subject. Some individuals are able to make a full recovery; others make a partial recovery while some people continue to struggle with the condition for the rest of their life.
External factors can influence the degree and duration of pain being experienced so it’s important not to simply accept pain that worsens. Being involved in an accident for example can significantly worsen pain, or delay recovery.
There are a range of treatments which can help including painkillers, alternative therapies and a rehabilitation programme including exercise, but the exact outcome of these interventions will depend on the underlying condition.
If you are suffering from any of the conditions described on this page, you should consult a doctor for appropriate assessment and treatment. The information contained here is for information purposes only and is not intended to replace medical advice.
Living with chronic pain syndrome can be exhausting and completely dominate each and every day so managing it effectively is a priority.
The treatment prescribed for chronic pain will partly depend on the underlying cause, and the individual’s doctor’s own preferred regime.
The effect of living with chronic pain can be so incapacitating, it can leave individuals desperate to try anything to feel better but ironically in some cases, the treatment can cause a whole new set of problems too.
Painkillers may seem like the obvious solution but they are only effective in around 60% of cases and carry significant risks. Here’s a more comprehensive view of what treatments those with chronic pain disorder could try.
Pain relieving medication
Analgesia, or painkillers as they are often referred to, are often the first line of attack in treating chronic pain syndrome but they may only have a limited effect.
Different types of pain medication can be combined to get the maximum effect possible, as they work in different ways on the body.
NSAIDs – Non Steroid Anti Inflammatory Drugs – are a common type of painkiller, some of which can be purchased over the counter, such as Ibuprofen. These work in the body by blocking the effects of a particular group of enzymes which contribute to the production of both pain and inflammation. This is why NSAIDs can help not just with the management of pain, but also the reduction of inflammation too.
Paracetamol is a surprisingly powerful drug when taken on a regular basis and is believed to work by blocking another enzyme in the central nervous system. It can help to lower high temperatures but has no effect on inflammation.
Opioids are an extremely powerful type of medication and work by binding to receptors and decreasing a body’s reaction to pain and increasing tolerance levels. Codeine and Tramadol are two types of opioid painkiller often used.
The problems with painkillers
All of the above different groups of drugs can be combined in a cocktail to produce the strongest possible effect. Although there’s no risk of overdosing by combining different types of medication, taking the maximum dose of painkillers does carry a substantial risk of developing a new set of problems.
Strong painkillers often produce side effects which can be as debilitating as the chronic pain syndrome, causing nausea, dizziness and drowsiness. In some cases this means an individual will be unable to drive, or even stay awake, or their digestive system could suffer some very unpleasant effects.
Many side effects either wear off or lessen as the body becomes used to the drug, but then the risk of addiction develops. This is particularly a problem for drugs such as codeine.
Regularly taking drugs such as codeine can result in an unwitting addiction, and going without the medication will cause headaches and pain. The person will then take a painkiller to get rid of the pain, and the cycle starts again.
There’s unfortunately no easy answer for individuals that require high levels of painkiller medication regularly and it can be difficult to differentiate the cases where painkiller addiction is becoming a problem from those where chronic pain disorder is causing the symptoms.
Depending on the cause of pain, the doctor may opt to try a different type of drug, other than traditional analgesia to try and relieve the pain.
Anti-convulsants are frequently used, with drugs such as gabapentin and carbamazepine prescribed with a reasonable degree of success.
Unfortunately there can be significant side effects with this type of medication particularly at the higher dosages.
Triptans can be used, particularly for chronic pain disorder caused by cluster headaches or migraines, and work by changing the actions of serotonin in the brain which can prevent the release of other pain-causing chemicals in the body.
Another type of common treatment is antidepressants, particularly tricyclics such as Amitriptyline. These work on the neural transmitters and prevent pain messages being sent, by stopping the re-absorption of key chemicals in the nervous system.
Some people can be reluctant to take antidepressants because of the stigma that surrounds them, or may think that their doctor doesn’t believe their pain is a real condition. The dosage prescribed for pain is typically quite different to an antidepressant dosage and there’s no suggestion that the chronic pain is imaginary. Antidepressants can have a very powerful effect on the body as well as the mind, and can help to alleviate symptoms of pain in a different way.
Many of these alternative types of drugs take longer to work than simple analgesia and may take several weeks before an effect is felt.
Drugs are not the only answer to managing chronic pain; alternative medicine or therapies and self-help approaches can be surprisingly effective, especially when used in an overall pain management programme.
Acupunture can be used to manage Chronic Pain. Acupuncture is available on the NHS in some parts of the country and has shown to be helpful in combatting chronic pain.
Because pain signals travel through the mood centres in the brain, learning how to remain positive and manage negative emotions more easily can also help to reduce the symptoms. Yoga, breathing techniques and meditation can all be effective but it’s a good idea to attend a class to learn how to do this properly for maximum effect.
Low impact exercise can help with chronic pain, as the movement can trigger the release of feel-good endorphins such as dopamine, which can result in improved tolerance for pain. The exercise can also help to alleviate stiffness and pain caused by a lack of movement in the joints. Cycling, swimming and walking are all good ways to start.
Of course, not everyone is able to exercise and medical advice should always be sought before embarking on a programme.
This article is intended to provide a guide only and is not a substitute for medical advice. If you need help with chronic pain, you should contact a doctor or other suitably qualified medical professional.
Arthritis Research Campaign
St Mary’s Court
St Mary’s Gate
Derbyshire S41 7TD
Tel: 0870 850 5000
Arthritis & Musculoskeletal Alliance (ARMA)
18-20 Bride Lane
Tel: 020 7842 0910/11
18 Stephenson Way
T: 020 7380 6555
Helpline 0808 800 4050
Helpline for those under 26: 0808 808 2000
Offers self-management courses
National Rheumatoid Arthritis Society
Unit B4 Westacott Business Centre
Berks. SL6 3RT
Tel: 01628 823524
Helpline: 0845 458 3969
16 Elmtree Road
Tel: 020 8977 5474
Helpline: 0870 950 0275
PO Box 6323
Tel: 07811 222 044
Think-Back is not a registered charity
Tel: 01302 310 123
RADAR (Royal Association for Disability and Rehabilitation)
12 City Forum
250 City Road
Tel: 020 7250 3222
Minicom: 020 7250 4119
Irritable Bowel Syndrome (IBS) Network
53 Mowbray Street
Sheffield S3 8EN
Tel: 0114 272 32 53
St James’ House
Essex RM1 1BA
Tel: 01708 731 251
National Osteoporosis Society
Manor Farm, Skinners Hill,
Camerton, Bath BA2 0PJ
Helpline 0845 450 0230
Action on Pain
20 Necton Road
Norfolk PE32 2DN
Tel: 01760 725993
Helpline: 0845 603 1593
62-66 Newcraighall Road
Edinburgh EH15 3HS,
Tel: 0131 669 5951
Helpline: 0300 123 0789
The Pain Relief Foundation
Clinical Sciences Centre
University Hospital Aintree
Tel: 0151 529 5820
8 Oxford Road
Tel: 0151 284 3822
The Comprehensive Guide to Back Pain and Neck Pain: Causes, Relief, and Treatment
A 39 year old man was injured when a forklift truck reversed into him and knocked him over. It was established that his employer was liable for the accident in which he suffered a back injury. He suffered from chronic back pain. He could not return to his previous employment and was limited in relation to DIY. It was felt that the injury was not likely to be permanent. He would benefit from a pain management course and would have to perform clerical work in the future.
The Judge preferred the opinion of the Claimant’s expert, a medically qualified consultant in pain management, and rejected the Defendant’s expert’s view that degenerative changes were the cause of the pain. This man was suffering with a chronic pain syndrome and he was awarded £195,831.
This man was 42 when he lost his balance on a ladder and fell to the ground, landing heavily on his right foot. The accident was the employer’s fault and in that accident the Claimant sustained a fracture to his right heel.
He was in hospital for 48 hours and had to avoid bearing weight on the injury for 6 weeks. He had physiotherapy input to be able to walk unaided but this was unsuccessful. He developed a chronic pain syndrome and underwent a joint fusion. That also failed to reduce the pain and he relied heavily on crutches to walk. He also suffered from reactive depression and chronic illness behaviour syndrome. He would never be able to return to his former position and his dependence on strong medication meant that he would have difficulty coping with sedentary and non-manual occupations.
The Claimant won an out of Court settlement of £425,000.
If your chronic pain was triggered or made worse by an accident or trauma or if your previous solicitor advised you to settle for too little, you may be entitled to compensation. As a successful chronic pain solicitors, we will act on your behalf to handle your case in a caring and professional manner to ensure you receive maximum compensation.