Chronic or Persistent Musculoskeletal Pain
Persistent pain

Persistent pain affects the muscles, joints and bones and has lasted for more than 3 months. It is a common problem effecting as many as 3 out of 10 adults in the UK. Persistent pain can affect any part of the body and can be felt in one or more body areas at the same time.

Pain can start following an accident or injury but often onsets gradually, without an obvious cause. Scientific research shows that pain that lasts longer than 3 months is likely to be due to changes in the nervous system rather than as a result of ongoing damage or injury.  Therefore, tests such as x-rays and MRI scans that look at the state of tissue are often negative or inconclusive and therefore are not often needed. This means that pain is a result of a sensitised nervous system, which x-rays and scans are unable to detect.

What should I do?
Evidence shows that if people with persistent pain engage with simple pain management strategies it can improve their function, mental health and quality of life. This active approach is the most effective way of management persistent pain. Things you can do to help your-self include;

Learning about the causes of persistent pain
Remain active by planning, prioritising and pacing your activities
Talk to friends and family about how they can support you to stay active
Learning ways to improve your mental health
Using meditation and or relaxation techniques
Improving your sleep
Speak to your employer about ways of adapting your role / work environment

The aims of pain medication is to offer relief and then to enable people to return to previous activity levels. Although medication can be useful, it is often not a cure for persistent pain and a can cause a number of unwanted side effects. Therefore, any medication should be carefully considered to see if it is effective. Sometimes it is helpful to reduce or stop pain medication as the costs (side-effects including causing pain!) outweigh the benefits. People should carefully follow advice from a qualified professional regarding the use of pain medication and always follow the instructions on the packet. Remember you can ask your local pharmacist if you are unsure about the use of medication.

Pain and activity

Although persistent pain rarely indicates serious injury, it often affects people’s ability to work, socialise and exercise. Overdoing or underdoing activity can result in increased pain levels because the nervous system becomes more sensitised. This leads to people avoiding day to day tasks because they fear making their pain worse. This reduction in normal activity can results in worsening physical and mental health and can lead to financial difficulties and other social problems.

Pain and mood

People experiencing persistent pain often report a negative effect on their mental health with feelings of anxiety and depression being common. This is because of the way the nervous system responds to pain. Unfortunately, this can lead to a vicious cycle where pain and mood interact making matters worse. Motivation can be effected and people can become withdrawn and worried.

Useful links for persistent pain

Pain Management Toolkit Website
The Pain Toolkit
Understanding pain in less than 5 minutes
23 and 1/2 hours: What is the single best thing we can do for our health?
Tame the Beast A range of evidence based resources and information to help you understand and manage persistent pain.
Tempero-mandibular Disorder (TMD) TMD describes a variety of conditions which affect the jaw joints and/or the muscles around the jaw.  This leaflet contains advice and information on coping with TMD.
Escape Pain. An education and exercise programme for people with chronic join pain or osteoarthritis.
We are unable to offer Escape Pain Group sessions during the current social isolation measures
The programme is available online using the Escape Pain Website, Apple iOS and Google/Android apps. Both tools take you through a six week programme, with two session per week, containing:
Exercise videos with simple, easy to follow exercise with clear instructions that were developed so you can do the exercises safely in their homes;
Educational videos with engaging animations giving simple advice and information to help you understand how to better manage your condition;
Individual progress chart to track your improvement over time.​
An Introduction to Mindfulness
Developed by clinicians from the Pain Management Team at Newcastle Hospitals NHS Foundation Trust. Tracks include Mindful Breathing, Body Scanning, Meditation, Values and Self-Kindness.
Persistent Pain Management
This educational film has been produced by the Pain Management Service and the Newcastle Pain Management Program Team. It has been developed to support patients and carers to better understand persistent pain. With a better understanding patients are more able to make informed choices regarding their pain management and how they may use self-management techniques to improve their quality of life.
Osteoarthritis Information Booklet
Developed by Versus Arthritis this useful booklet provides information about osteoarthritis and how to manage your condition.
Physiotherapy Pain Association (PPA) Resources
A range of resources to support you in managing your pain including online pain management programmes, video resources, apps and books.