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Chronic pain syndrome: what is it, symptoms, treatment

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Reviewed by Felix Gussone, MD, written by Robert Roy Britt

Last updated: Nov 11, 2021
6 min read


If you have any medical questions or concerns, please talk to your healthcare provider. The articles on Health Guide are underpinned by peer-reviewed research and information drawn from medical societies and governmental agencies. However, they are not a substitute for professional medical advice, diagnosis, or treatment.

Chronic pain syndrome (CPS) is a term that healthcare researchers sometimes use to refer to various types of chronic pain. Though the term is found in popular articles about pain, most scientific papers and other medical texts about chronic pain do not use “chronic pain syndrome.” If they do, they refer to it only in passing without any formal definition.

No matter the term used, if you have “chronic pain syndrome,” your biggest concern is finding pain relief that will improve your quality of life. Below is an overview of chronic pain syndrome, including its causes and symptoms.



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What is chronic pain syndrome?

Pain is often referred to as an unpleasant “sensory and emotional experience” stemming from tissue damage, such as an injury (International Association for the Study of Pain, 2020). When the pain from an acute injury or illness does not go away within the normal recovery time, or it lasts more than three to six months, it is called chronic pain (Treede, 2015). 

Chronic pain syndrome is described differently by various scientists and healthcare providers. Generally, it describes persistent pain that stems from any number of causes, whether injury or illness, and it usually excludes long-lasting pain that’s caused by cancer (Yasaei, 2021). 

When healthcare providers use the term chronic pain syndrome, they might also refer to the combination of chronic pain and complications that make the original pain worse, such as depression, anxiety, and sleep problems (Pearce, 2005). 

Chronic pain syndrome, however it’s defined, has long been thought to involve body-brain connections (Addison, 1984). More recent research confirms this view. For example, some people with chronic pain—frequent headaches and back pain among many other examples—don’t have a clear physical cause that doctors can find (Treede, 2019). 

This doesn’t mean the pain is not real. It just means figuring out the cause of chronic pain syndrome, and therefore how to treat it, can sometimes be really hard for you and your healthcare provider.

Causes and symptoms of chronic pain syndrome

Persistent pain can stem from inflammation, when damaged tissue swells with the arrival of immune cells. It can also happen when the nervous system is damaged, which is called neuropathic pain (Armstrong, 2021).

Though acute pain is triggered by some injury, disease, or perhaps surgery, chronic pain can alter the chemistry and pain signals in the central nervous system, including the spinal cord and the brain. This can mess with our processes and emotions, changing our perceptions of the pain and making it worse. 

Brain scans can actually show with about 85% accuracy whether someone who has experienced their first episode of back pain might eventually develop chronic pain or not (Baliki, 2012). Other research has found differences in brain structure in areas related to stress and anxiety can affect a person’s risk of developing chronic pain (Vachon-Presseau, 2016).

The list of risk factors for chronic pain is nearly endless, from physical issues to mental health conditions. Here are just a few of the most common causes (Mills, 2019; NIH, 2018):

  • Stress, anxiety, depression, and other negative emotions
  • Back injuries or misalignments
  • Other injuries
  • Arthritis
  • Nerve damage (including neuropathy from diabetes and other conditions)
  • Cancer (cancer pain itself as well as pain caused by treatment)
  • Irritable bowel syndrome and inflammatory bowel disease
  • Fibromyalgia
  • Headaches or migraines
  • Endometriosis
  • Surgery

Pain management for chronic pain syndrome

Management of chronic pain depends on several factors. Because healthcare providers often don’t have a good understanding of the complex causes of this type of pain, and because there are so many different potential remedies, experts recommend that you undergo a consultation with a healthcare professional who can come up with multiple approaches for treating the pain (Yasaei, 2021).

Some of the well-regarded remedies for chronic pain syndrome involve lifestyle changes:

Other therapies and treatments may be suggested as part of a comprehensive plan to battle chronic pain (NIH, 2018):

Pain medicines all have side effects, and they have a spotty record for dealing with chronic pain, but they are often suggested as part of a broader treatment plan (Tauben, 2021): 

  • Ibuprofen, a nonsteroidal anti-inflammatory drug (NSAID) is minimally effective, and healthcare providers do not recommend acetaminophen back pain that is chronic.
  • Healthcare providers only prescribe opioids if people do not respond to other treatments as opioids are highly addictive. 
  • Healthcare providers sometimes prescribe antidepressants for chronic pain if other treatments aren’t helpful (Ferreira, 2021).

While scientists try to figure out precisely what chronic pain syndrome is and why some people can’t shake pain that might have no easy-to-diagnose or apparent physical cause, primary care physicians and other healthcare providers recognize that your pain is real. To get to the bottom of your condition, consider visiting a pain specialist to help you design a comprehensive approach to treatment.


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Felix Gussone is a physician, health journalist and a Manager, Medical Content & Education at Ro.