Chronic pain is a complex issue with many definitions and explanations. There’s no single way to explain what causes it, how it affects people or how it is linked to the brain.

Our member Elizabeth Turp, who specialises in chronic pain and illness, says: “Pain can be variable and unpredictable with wide ranging impacts on your quality of life, your relationships and your ability to work and socialise.

"A holistic approach to treatment and management is best, as sometimes the pain can only be managed, not healed.”

What is chronic pain?

The NHS defines chronic pain as pain that continues for longer than 12 weeks despite medication or treatment. Others say it's pain that’s experienced over a long period of time or beyond the expected period of recovery or healing.

Doctors may say it's caused by nerve damage or an over-reactive nervous system response, such as in healed injuries or stress-related conditions. Or it may be due to conditions such as fibromyalgia, endometriosis, rheumatoid arthritis, ulcerative colitis or a spinal injury. 

Long term pain is also a feature of many poorly understood, complex, chronic conditions, such as myalgic encephalomyelitis (ME) or chronic fatigue syndrome (CFS). And it can develop as a side effect of a medical intervention, such as an operation, or damage from a disease, such as nerve damage from diabetes.

Some people may experience chronic pain that has no specific medical or physical cause. But Elizabeth says: "Pain is pain, whether medicine has an explanation for it or not. It has physical and psychological impacts regardless of its cause.”

How does chronic pain affect you mentally?

“Living with pain can be very stressful, scary and isolating so it has obvious effects on your mental health, which may include anxiety and depression,” says Elizabeth.

It can commonly lead to fatigue, which can affect your mobility and productivity, and may harm your self-image and feelings of self-worth.

She adds: “Pain and fatigue can be incredibly challenging and gradually erode your motivation to keep going, leading to mental health problems.”

There are also many misconceptions and lack of understanding of chronic pain, which can have a negative effect on those who are living with it every day. Being told your pain is ‘medically unexplained’ or 'psychosomatic' minimises what you're going through and can be damaging.

“Support is vital,” says Elizabeth, “whether from a loved one, group or professional. The feeling of not being believed can have a negative impact on your mental health."

How can counselling help with chronic pain?

Therapy can give you a safe space, where you can explore your thoughts, feelings and emotions without judgment.

Elizabeth says: “Being seen, believed and supported can help a lot. It can enable you to reach a place of acceptance and develop coping strategies.

“Learning to put yourself into decisions and prioritise self-care is essential to gaining any balance when living with pain.” 

What type of therapy is best for chronic pain?

Your counselling needs to be individual to you and your unique experience of living with chronic pain. Different types of therapy can help in different ways:

  • Acceptance and commitment therapy (ACT) encourages you to accept your thoughts and feelings. You commit to actions to embrace the challenges you face and not avoid them.
  • Compassion-focused therapy (CFT) helps you to respond to your own inner negativity with kindness and compassion.
  • Cognitive behavioural therapy (CBT) helps you to change the way you think and what you do, by focusing on current problems and practical solutions.
  • Integrative therapy draws on different types of therapies to make the counselling specific to your needs.
  • Mindfulness and pacing yourself can also be useful to help you be in the moment and transform the way you relate to and manage pain.

"It's important that you find a qualified therapist with specialist knowledge and experience of working with clients living with chronic pain,” says Elizabeth.