Chronic pain is far more than a punchline about that one relative who complains about everything. Like most invisible disabilities, it’s often complicated. Chronic pain can’t always be summed up with a simple if-then-because explanation. As with chronic stress and anxiety, there are many causes, outcomes, and definitions of chronic pain. For the sake of this article, it will be helpful to remember that chronic pain and acute pain are closely related but different. Both are forms of nociception, the body’s process of pain perception (Taylor & Stanton, 2020).
Knowing how to distinguish the differences and similarities between acute and chronic pain, the various types of chronic pain, and where they overlap can be very beneficial. Acute pain is the body’s direct response to tissue damage (including nerve damage), and it usually disappears once the tissue has been repaired. Medical professionals define acute pain as pain that lasts for less than six months. This is the body’s alarm system. Chronic pain, on the other hand, begins as acute pain and continues to affect the individual even after treatment has taken place (Taylor & Stanton, 2020).
There are also several different types of chronic pain, all lasting for at least six months. Chronic benign pain is generally unresponsive to common treatments and varies in severity and location. A good example of this is something that about one-third of Americans experience: persistent lower back pain. Recurrent acute pain, as its name suggests, is pain that recurs as episodes of acute pain. A fairly common example of this is chronic migraines. Then there’s chronic progressive pain. This is pain that progressively worsens over time and is typically associated with degenerative disorders like cancer or arthritis (Taylor & Stanton, 2020). Again, it’s good to remember that in most medical contexts, the word “chronic” simply refers to a condition that persists for six months or more. Though for those living with it, the experience is much more than a timeframe.
How This Affects Sufferers
Once you understand the differences between chronic and acute pain, it’s much easier to sympathize with a chronic pain sufferer. Almost everyone who can read this can understand what prolonged pain might feel like, except those with conditions like congenital insensitivity to pain (CIP) and related conditions, of course (NORD, 2025). But I’ll save these conditions for another time.
Chronic pain can be so persistent and overwhelming that it interferes with daily tasks. However, it’s worth remembering that acute pain is often necessary for survival. These often minor pains are the body’s way of communicating potential danger from our environment. They are the things that trigger unconscious adjustments, like rolling in our sleep or quickly pulling our hand from a hot stove. This is likely why excessive pain is the most common reason that people seek a doctor’s help(Taylor & Stanton, 2020).
It’s also important to remember that the severity of the pain is not necessarily proportional to its cause. Because of this, allopathic medicine often treats pain as a secondary symptom with almost no coverage of it in medical training. This implied lack of importance often causes doctors to ignore or downplay the relevance of a patient’s pain, causing some patients to ignore or downplay their own symptoms, treatments, and diagnoses. This, in turn, can lead to patients spiraling into depression and anxiety. It may even cause them to use potentially unnecessary treatments just to avoid the pain that they “know” will be ignored (Taylor & Stanton, 2020).
This doesn’t just apply to physical pain either. Psychosocial pain uses the same neurocircuitry as physical pain, meaning that stress and anxiety are directly connected to physical pain and its severity (Taylor & Stanton, 2020). For this very reason, it’s essential to view chronic pain through an integrative health lens. It’s important to include the body, mind, and social environment in chronic pain treatments.
Because chronic pain involves the nervous system, as well as other body systems, it may help to remember how the nervous system works. The sympathetic nervous system (SNS) is the body’s automatic functions manager, monitoring things like heart rate and digestion, to name a few. This is the system that is triggered directly by stress and potential threat, activating what is commonly known as the fight-flight-freeze response. When triggered, pupils enlarge, heart rate and lung functionincrease, digestion slows, and so on. This response is possible due to the release of specific neurotransmitters. Once the perceived threat has passed and the response is deactivated, the parasympathetic nervous system (PNS) takes over and responds with the opposite actions to calm things down and restore balance(Cleveland Clinic, 2022).
This is where chronic pain, anxiety, and stress can significantly strain the SNS and gradually increase risks of developing other health issues. Genetic conditions can also affect the SNS, but prevention and treatment are fairly straightforward in most of these cases. Making sure to get a varied and nutritionally balanced diet, limiting drugs and alcohol, staying active, and following your doctor’s advice can all help to prevent and treat unnecessary strain on the nervous system (Cleveland Clinic, 2022).
Allopathic Treatment Options
As mentioned before, allopathic medicine, commonly called Western medicine, defines chronic pain as pain lasting for six months or longer. According to 2020 statistics, chronic pain affects around 116 million people in the US and accounts for a total of around $560 billion per year in medical expenses. These high numbers, combined with the high cost of care, have led to an extremely high number of opioid prescriptions and drastically increased rates of addiction. Unfortunately, the results from this process have made pain control a big business for capitalism (Taylor & Stanton, 2020).
As I touched on before, pain is the result of the nervous system sending chemical messages to the brain when body tissue is damaged in some way. Specialized nerve cells called nociceptors detect this tissue damage and send the chemical messages to the brain. The brain then decides what specific sensations, pain intensity, and overall experiences are appropriate. The body then responds with the necessary muscle contractions, changes in breathing, and other pain-blocking mechanisms. Essentially, the brain and body play a complicated and constant game of telephone (Taylor & Stanton, 2020).
How Painkillers Work
The question now is, what do painkillers do inside the body? The brain naturally produces its own pain-killing molecules called endogenous opioid peptides. A study in the 1970s found that the same mechanism responsible for these peptides could be mimicked with opiates, drugs made from plants chemically similar to the peptides naturally produced by certain parts of the brain and specific receptor sites throughout the body. These substances bind to the same receptor sites and suppress pain signals. Certain types of stress, namely acute stress, can actually cause a phenomenon called stress-induced analgesia (SIA), increasing the production of our naturally occurring endogenous opioid peptides and potentially explaining why high-stress moments might increase our pain threshold (Taylor & Stanton, 2020).
Traditionally, allopathic pain management has focused on pharmacological, surgical, and sensory processes of blocking and reducing the chemical messages before they reach the brain. These allopathic pain management methods often include prescription drugs, nerve blockers, implants, or electrical stimulation. However, effective integrative and psychological methods are becoming more popular and more accessible. This is leading to an increase in self-management and self-advocacy for chronic pain sufferers. Still, effective pain management often means different things for different people. For some people, well-managed pain means that they no longer feel pain and are otherwise healthy. For others, this means complete numbness to all sensation, including pain in the affected area, or significantly reduced and/or tolerable levels of pain (Taylor & Stanton, 2020).
The most common method of pain management is the use of prescription drugs. But technically, any substance that effectively blocks nerve signal transmission can be called a painkiller. Though it’s still important to remember that, as with any treatment, there are inherent risks and side effects. Some painkillers may be less effective in certain circumstances. Some may have serious side effects like addiction, inability to focus, overdose, paralysis, and many more. Even the widespread concern about addiction can lead sufferers and medical professionals to err on the side of caution and under-medicate or underestimate what is truly sufficient for the particular individual (Taylor & Stanton, 2020). This is where the tricky art of balance takes an active role.
Mind and Body
When it comes to holistic pain management, remembering the psychosocial factors that contribute to pain is essential. Over time, long-term pain can lead someone to develop coping mechanisms that worsen symptoms and make effective treatment more difficult to find, causing a downward spiral of physical pain feeding into emotional pain, which feeds back into physical pain (Taylor & Stanton, 2020).
Chronic pain can even alter a person’s lifestyle. Severe symptoms can prevent them from socializing with others, make daily activities nearly impossible, and lead to isolation. Others may see this as nothing more than anti-social behavior, inadvertently contributing to the downward spiral. Certain behavioral tendencies and pre-existing conditions (e.g., introversion, passive coping styles, PTSD, anxiety, and depression) can exacerbate chronic pain. However, studies show that people with chronic pain typically score higher on the Minnesota Multiphasic Personality Inventory (MMPI) for the psychological profile subcategories of hypochondriasis, hysteria, and depression, a classification unfortunately referred to as the “neurotic triad.” While this may help healthcare professionals diagnose and treat chronic pain, the name itself may also affect the mental health of those it refers to (Taylor & Stanton, 2020).
Integrative Treatment Options
Because chronic pain is more than just long-lasting discomfort, it’s important to address the problem from multiple angles. One of the most important aspects of this is appropriately managed social support. Knowing what helps lessen the pain, rather than simply delaying it, can be truly beneficial. This may be as simple as working with biofeedback (ie, controlling and acknowledging awareness of bodily sensations), relaxation exercises, and/or distraction techniques, as well as some of the more hands-on approaches. In some cases, simply staying active can help maintain function and help the healing process. Counterirritation, mildly irritating an unaffected area to interrupt the pain signal, can also be used as a form of distraction (Taylor & Stanton, 2020).
Unsurprisingly, relaxation and biofeedback exercises commonly used for stress and anxiety can also be used for chronic pain by helping to reduce muscle tension and increasing blood flow as the body tries to reestablish homeostasis. Another, less common form of this is a type of mental counterirritation using the painful or stressful situation in a made-up scenario. For example, if my back is hurting me on a walk, I can try to imagine that the reason my back hurts is that I have to deliver a very important message by hand. Alternatively, I can tell myself to name every sound I hear or name an animal that starts with each letter of the alphabet. Either way, distraction techniques are often most effective when used with another pain control method, like breathing exercises (Taylor & Stanton, 2020).
In fact, studies have shown that active coping skills like these can help chronic pain sufferers manage all different types of pain, while passive avoidant coping skills are generally linked to poor pain control. It’s also important to acknowledge when sufferers’ pain management efforts have been successful and celebrate these moments, a metaphorical pat on the back that can further mental healing.
Modern integrative outpatient programs that require long-term commitment and an honest evaluation from the treatment team have evolved from the clinical pain management programs of the 1960s. The programs combine physical, psychological, and educational aspects, and require everyone who participates in them to acknowledge that their experiences, pain, and treatments will be unique. For this reason, each patient receives individualized evaluations, program plans, and support systems that consider their individual treatment needs. Furthermore, pain management programs often provide a range of therapeutic options that tend to emphasize relapse prevention (Taylor & Stanton, 2020).
Group therapy, for example, can help to reduce catastrophic thinking patterns that tend to worsen the overall experience of chronic pain. Writing exercises like journaling are also a great way to express all of the overwhelming emotions that come with an invisible disability like chronic pain or anxiety, a practice that I can personally relate to. However, when medication is a part of the treatment plan, relapse prevention has to be a key part of the treatment plan as well (Taylor & Stanton, 2020).
Advocacy, No Really
On a personal level, I cannot overstate the importance of advocacy, both for yourself and for loved ones. I’ve lost count of the number of times that I wish I’d stood up for myself when it came to healthcare. Thankfully, I have family and friends who have always cared enough to support me when I needed them. But not everyone has that. I could go off on a tangent about the decades that it took me to get my three diagnoses. But I’ll save that for another article. Let’s stick to the topic at hand.
Anyone who’s experienced prolonged pain can tell you just how inadequate the classic pain scale is. Specific descriptions of how the pain hurts, its intensity, and its location or locations can be crucial for proper care. A sharp throbbing pain may call for a completely different treatment than a tingling cold pain would. Even pain behaviors, how someone acts when in pain, tell an important story. The way a person changes their posture or gait to avoid pain can show just how severe and/or chronic their pain is. Because of the protective nature of pain, emotional and physical reflexes are also important to note. Relying solely on a 1-10 pain scale is simply inaccurate and unhelpful for everyone involved (Taylor & Stanton, 2020).
Herbal Treatment Options
Along with the many relaxation exercises and other integrative therapies mentioned, there are also herbs and essential oils that can help with chronic pain. A lot of people’s first thought after reading this will probably have something to do with medical cannabis, and I fully support the appropriate use of cannabis. But for several legal and ethical reasons, I’m not going to go into that here. To be very clear, I am not a doctor. I do not currently have the experience or authority to recommend dosages outside of what I have read. For this, please talk to your doctor and/or experienced medical herbalist. That said, there are some herbs I would recommend chronic pain sufferers look into.
Cinnamon (Cinnamomum zeylanicum) is a common culinary spice found in lattes and baked goods. However, it can also be used in many medicinal ways. Most commonly, it’s used for joint and muscle support, headaches, and other related issues. It can also be used in several forms, including as an essential oil, a powder, in tea, and as a tincture(Lull, 2025).
Ginger (Zingiber officinale) root has been used for centuries throughout Asia. The tea, dried and powdered root, extract, and essential oil have historically been used for inflammation and mild pain relief. When taken daily for several months, it has been shown to help with arthritic pain, swelling, and stiffness. Combining it with cinnamon can also help enhance the calming warmth that often soothes minor pains (Lull, 2025). My family and I also use it with lemon for stomach aches and digestive issues.
Marjoram (Origanum majorana), a common culinary herb in the Mediterranean, can also be used medicinally. The essential oil can help with minor pain, digestive issues, nervous system health, and joint, muscle, and cartilage health. The tea can be used to help with ear, nose, and throat (ENT) support. Because of its natural analgesic and anesthetic properties, it is also a good herb for menstrual cramps (Lull, 2025).
Peppermint (Mentha x piperita), is a strong and clean flavor widely known for its use in desserts. While it is energizing, it’s traditionally used to relax and soothe the body. When diluted or added to other remedies, the essential oil can be used to relax muscle cramps, nerve pain, and general stress. This diluted essential oil applied to the temples can also help relieve tension headaches. Mixing the dried herb with chamomile and lavender can be useful for menstrual symptoms and what I like to call “the holiday aftermath” (Lull, 2025).
English Lavender (Lavandula angustifolia), while best known for its calming scent and flavor, is also very useful medicinally. The essential oil can actually speed the healing process when used appropriately to treat these burns. Inhaling and/or using the essential oil in a bath can also help to relieve headaches, post-surgical pain, and minor joint pain (Lull, 2025). I have also had good results with similar issues when using the dried herb as a tea.
Some less common herbs can also help with other types of pain symptoms. For example, black cohosh (Actaea racemosa, formerly Cimicifuga racemosa) has traditionally been used as an antispasmodic herb for muscle pain, nerve pain, and spinal injuries caused by whiplash and other related issues. California poppy (Eschscholzia californica) has been used for insomnia in children and for general pain. Too much, however, can do just the opposite, leading to headaches and fatigue (Noveille, 2016).
Other equally helpful herbs should be used with care and guidance. Corydalis (Corydalis turtschaninovii, C. Yanhusuo) is actually a genus of herbs containing over 300 species that has been used medicinally for intense pain. However, it should always be used with caution and guidance from an experienced herbalist, as it has some very serious contraindications and should always be avoided during pregnancy. That said, Corydalis has been used for chronic pain, insomnia, nervous system disorders, blood flow issues, and Chi stagnation for a very long time. A more common herb, predominantly used for migraines and arthritic inflammation, is Feverfew (Tanacetum parthenium). However, it’s been known to cause allergic reactions in those with allergies to the Asteraceae botanical family. Like corydalis, it should also be used with guidance and avoided during pregnancy (Noveille, 2016).
Still other herbs can play multiple roles in herbal pain relief. Pine bark extract has also been shown to help with the inflammation and the pain caused by arthritis (Lull, 2025). St. John’s wort (Hypericum perforatum), a well-known herbal antidepressant, is also very useful for neuralgic and rheumatic pain. Willow (Salix alba), the original source for over-the-counter painkillers like aspirin, can be very useful for general pain, fever, gout, and rheumatic pain. Several Native American peoples have historically used willow for these very purposes (Noveille, 2016). However, it’s important to remember that some holistic remedies can have unwanted side effects and interactions. Always use these with proper caution and the guidance of an experienced practitioner.
References
Lull, V. (2025). 6 Herbs to Alleviate Aches and Pains. ACHS Holistic Health & Wellness Blog. https://achs.edu/blog/herbs-help-aches-pains/?_hsenc=p2ANqtz-_eADhyz0iDtuMIGgrnlw8R6KtTAZSMkJZK3HNu4m9sf4Fe6aaK1cm1XhcUNlmj3oi81bG8EALU-wh8KR7JHcrut1rzWvfvQj6Yr0LpWpTmXG2MIo8&_hsmi=356797881
Taylor, S. & Stanton, A.L. (2020). Chapter 10. Health Psychology (11th ed). McGraw Hill. ISBN: 9781260253900
Cleveland Clinic (2022). Sympathetic Nervous System (SNS). Cleveland Clinic. https://my.clevelandclinic.org/health/body/23262-sympathetic-nervous-system-sns-fight-or-flight
NORD (2025). Congenital Insensitivity to Pain (CIP). National Organization of Rare Disorders. https://rarediseases.org/rare-diseases/congenital-insensitivity-to-pain-cip/
Noveille, A. (2016). 12 Traditional Herbs That Ease Pain. Herbal Academy. https://theherbalacademy.com/blog/12-traditional-pain-relieving-herbs/
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