Pain is one of the most universal human experiences. Most people think of pain as a warning signal, a symptom that tells them something is wrong. But for millions of people, pain does not go away. Instead, it persists for months or years, affecting sleep, mood, work, relationships and overall well-being. As the understanding of pain has evolved, healthcare professionals have increasingly recognized that chronic pain is often more than a symptom. In many cases, it becomes a disease in and of itself.
September is Pain Awareness Month, a designation that helps bring attention to the challenges faced by people living with chronic pain. Chronic pain affects millions of Americans and is one of the leading causes of disability worldwide.
Understanding chronic pain
Chronic pain is generally defined as pain that lasts longer than three months or continues beyond the normal healing time expected for an injury or illness.
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Find a clinicCommon examples include:
- Chronic low back pain
- Fibromyalgia
- Migraine disorders
- Arthritis-related pain
- Neuropathy (nerve pain)
- Persistent pain following surgery or injury
For some individuals, the source of pain remains obvious. Arthritis, spinal conditions, or nerve damage may continue to generate pain signals. For others, however, doctors may find little evidence of ongoing pain despite significant symptoms. This disconnect can be frustrating for patients who often feel misunderstood or dismissed.
Research has shown that chronic pain is frequently much more complicated than an injury that simply failed to heal. Changes can occur within the nervous system itself, fundamentally altering how pain is processed.
Can Pain Become a Disease?
The short answer is yes.
Acute pain functions like an alarm system. It warns the body of injury and encourages protective behaviors that support healing.
Chronic pain is different.
When pain persists over time, the nervous system can undergo significant changes. The brain and spinal cord may become hypersensitive, causing pain pathways to remain active even after damaged tissues have recovered. In some cases, normal sensations may become painful, while painful sensations become amplified.
Many pain specialists describe this as the body’s pain system becoming stuck in the “on” position.
When this occurs, pain is no longer simply a symptom of another condition. The pain-processing system itself has become dysfunctional. Increasingly, chronic pain is being recognized as a disease of the nervous system, much like diabetes affects blood sugar regulation or asthma affects lung function.
This shift in understanding represents one of the most important developments in modern pain medicine because it validates what many patients have experienced for years: The pain is real, even when a scan or laboratory test cannot fully explain it.
Why Chronic Pain Makes People Feel Sick
Persistent pain places the body under constant stress. The nervous system remains activated, stress hormones may stay elevated, sleep often becomes fragmented, and physical activity frequently decreases.
Over time, these changes can contribute to:
- Chronic fatigue
- Low energy
- Poor concentration
- Memory difficulties
- Headaches
- Digestive problems
- Reduced appetite
- Physical deconditioning
Imagine trying to focus while a fire alarm rings continuously in the background every hour of every day. Eventually, mental and physical exhaustion become inevitable.
Many chronic pain patients describe a sensation similar to having the flu without an infection. The body feels drained, sore and overwhelmed, even when no illness is present.
The powerful connection between pain and mental health
One of the most significant, yet often overlooked, consequences of chronic pain is its effect on emotional health.
Living with pain every day is exhausting. Activities that once brought joy may become difficult or impossible. Relationships can become strained. Career goals may be interrupted. Sleep may be disrupted night after night.
These burdens can contribute to anxiety and depression.
However, the connection goes deeper than the emotional challenges of living with pain. Scientists now know that pain and depression share some of the same brain pathways and neurotransmitters.
This creates a two-way relationship:
- Chronic pain can increase the risk of depression.
- Depression can intensify the perception of pain.
Importantly, this does not mean the pain is “all in your head.”
The pain is real.
Rather, it reflects the close relationship between physical health and emotional well-being. When one suffers, the other often suffers as well. Common warning signs of depression among people with chronic pain include persistent sadness, irritability, hopelessness, sleep disturbances, withdrawal from social activities and loss of interest in hobbies or daily life. These symptoms deserve medical attention just as much as the physical pain itself.
Why chronic pain can feel so isolating
Unlike a broken arm or visible injury, chronic pain is often invisible.
Many people appear healthy on the outside while battling severe symptoms internally. Unfortunately, this can lead to misunderstanding from friends, coworkers and even family members.
Patients frequently hear comments such as, “You don’t look sick,” or “Everyone gets aches and pains.”
While usually intended to be helpful, these statements can leave individuals feeling unheard and isolated.
Pain awareness is important because it helps reduce this stigma. Chronic pain is not simply discomfort. It is a complex medical condition that can profoundly affect every aspect of daily life.
How pain treatment has evolved
The field of pain medicine has changed dramatically during the past 50 years.
In the 1970s and ‘80s, treatment options were relatively limited. Physicians primarily relied on:
- Aspirin
- Acetaminophen (Tylenol)
- Nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen and naproxen
- Opioid medications such as morphine, codeine, hydrocodone, and oxycodone
These medications remain valuable tools today, but each has limitations. Aspirin and NSAIDs can increase the risk of stomach irritation, ulcers, kidney problems and cardiovascular complications. Acetaminophen can damage the liver at high doses. Opioids can provide powerful pain relief but carry risks including dependence, addiction, respiratory depression, constipation and overdose.
As concerns about opioid misuse grew, healthcare providers began embracing more comprehensive and individualized approaches to pain management.
The modern approach to pain management
Today, pain specialists focus on treating the whole person rather than simply masking symptoms.
Successful pain management often combines multiple strategies, including the medications mentioned above, prescription anti-inflammatory medications, nerve pain mediations and certain antidepressants.
These can provide meaningful relief while minimizing some of the risks associated with long-term opioid therapy.
Physical therapy
Physical therapy has become a cornerstone of modern pain treatment. Guided exercise programs help improve strength, flexibility and mobility. Although movement can feel difficult when pain is present, carefully supervised activity often reduces pain and improves quality of life over time.
Behavioral health therapies
Because pain affects both the body and the brain, psychological support has become an important part of treatment. Approaches may include cognitive behavioral therapy (CBT), mindfulness training, stress reduction techniques and strategies for coping with pain.
These treatments do not imply that pain is psychological. Instead, they help patients develop tools to better manage the emotional burden associated with chronic pain.
Interventional procedures
For some individuals, targeted treatments may provide significant relief through:
- Steroid injections
- Nerve blocks
- Trigger point injections
- Radiofrequency ablation
These procedures aim to interrupt pain pathways and reduce symptoms when medications alone are not enough.
Opioids still have a place in pain management
Despite increased caution, opioids remain important in certain situations, including:
- Post-surgical recovery
- Severe traumatic injuries
- Cancer-related pain
- Hospice and palliative care
Today, providers generally use these medications more selectively and carefully while emphasizing monitoring and risk reduction.
New advances in pain relief
Perhaps the most promising development in pain medicine is the emergence of innovative therapies aimed at providing relief without many of the risks associated with traditional treatments. The first entirely new class of pain medication in more than 20 years was approved in early 2025. This new medication works by blocking pain signals in peripheral nerves before they reach the brain. This unique mechanism offers the possibility of effective pain relief without the addiction risks commonly associated with opioid medications.
Researchers are also investigating whether similar therapies may eventually help patients living with chronic pain and nerve disorders.
Sources
- Centers for Disease Control and Prevention (CDC). Chronic Pain Among Adults, United States, 2019-2021
https://www.cdc.gov/mmwr/volumes/72/wr/mm7215a1.htm
[cdc.gov] - Centers for Disease Control and Prevention (CDC). Chronic Pain and High-Impact Chronic Pain in U.S. Adults, 2023
https://www.cdc.gov/nchs/products/databriefs/db518.htm
[cdc.gov] - World Health Organization (WHO). Musculoskeletal Health Fact Sheet
https://www.who.int/news-room/fact-sheets/detail/musculoskeletal-conditions
[who.int] - World Health Organization (WHO). Low Back Pain Fact Sheet
https://www.who.int/news-room/fact-sheets/detail/low-back-pain
[who.int] - Cleveland Clinic. Chronic Pain: What It Is, Symptoms, Treatment & Management
https://my.clevelandclinic.org/health/diseases/4798-chronic-pain
[my.clevela…clinic.org] - Mills SEE, Nicolson KP, Smith BH. Chronic Pain: A Review of Its Epidemiology and Associated Factors in Population-Based Studies. British Journal of Anaesthesia. 2019.
https://pmc.ncbi.nlm.nih.gov/articles/PMC6676152/
[pmc.ncbi.nlm.nih.gov] - International Association for the Study of Pain (IASP). The IASP Classification of Chronic Pain for ICD-11: Chronic Neuropathic Pain
https://pmc.ncbi.nlm.nih.gov/articles/PMC6310153/
[pmc.ncbi.nlm.nih.gov] - Meda RT, et al. Chronic Pain-Induced Depression: A Review of Prevalence and Management. Cureus. 2022.
https://pmc.ncbi.nlm.nih.gov/articles/PMC9509520/
[pmc.ncbi.nlm.nih.gov] - IsHak WW, et al. Pain and Depression: A Systematic Review. Harvard Review of Psychiatry. 2018.
https://pubmed.ncbi.nlm.nih.gov/30407234/
[pubmed.ncb…lm.nih.gov] - Werneck AO, Stubbs B. Bidirectional Relationship Between Chronic Pain and Depressive Symptoms in Middle-Aged and Older Adults. General Hospital Psychiatry. 2024.
https://pubmed.ncbi.nlm.nih.gov/38761582/
[pubmed.ncb…lm.nih.gov] - U.S. Food & Drug Administration (FDA). FDA Approves Novel Non-Opioid Treatment for Moderate to Severe Acute Pain (Journavx™/suzetrigine). January 30, 2025.
https://www.fda.gov/news-events/press-announcements/fda-approves-novel-non-opioid-treatment-moderate-severe-acute-pain
[fda.gov] - U.S. Food & Drug Administration (FDA). Journavx (suzetrigine) Prescribing Information.
https://www.accessdata.fda.gov/drugsatfda_docs/label/2025/219209s000lbl.pdf
[accessdata.fda.gov]
