Today we have a guest post by Anne-Marie D’Acry-Sharpe from Pathways.
Chronic pain is defined as pain which lasts longer than 3 to 6 months, and which “persists past normal healing time and hence lacks the acute warning function of physiological nociception”.
There is a wide range of chronic pain conditions, all with varying symptoms. Even within one individual diagnosis, symptoms can vary from person to person and over time.
While the pain itself is certainly a core symptom of any chronic pain diagnosis, it is far from the only symptom pain patients experience.
Let’s take a look at some accompanying symptoms which, if you don’t live with chronic pain, you may be surprised to learn about.
1. Cognitive issues
Many chronic pain conditions are accompanied by cognitive issues. These can include problems with memory; difficulty speaking clearly; struggles with depth perception; issues with focus; difficulty with attention span and many more.
The causes of these cognitive issues can vary. Sometimes they can be a result of the fatigue which often comes with chronic pain, and non restorative sleep that pain patients often experience.
Cognitive issues can be a side effect of prescribed medications. Long-term pain itself can be so overwhelming for the brain to cope with that it struggles to allocate its resources to other functions, as this study explains.
Other sources have concluded that blood flow within the brain plays a part in these cognitive issues. This study concluded that, “Cognitive impairment in FMS (fibromyalgia syndrome) is associated with alterations in cerebral blood flow responses during cognitive processing.”
Whatever the cause, cognitive issues can be very distressing and even debilitating at times. I live with fibromyalgia and know all too well how ‘fibro fog’ (the name often given to cognitive processing issues that come along with fibromyalgia) can be tough to live with.
Allodynia is defined as, “pain due to a stimulus that does not normally provoke pain”. This means that things as simple as a light touch can evoke extreme pain. In my case, often when I scratch an itch, it sends waves of intense pain throughout my body.
Allodynia can accompany pain conditions like fibromyalgia, migraines, complex regional pain syndrome (CRPS) and postherpetic neuralgia.
Hyperalgesia is defined as, “increased pain from a stimulus that usually provokes pain”.
For example, something which would usually cause a relatively small amount of pain, such as stubbing your toe or a paper cut, instead causes a great amount of pain similar to if you had a severe injury.
Pain conditions such as fibromyalgia and neuropathic pain are typically accompanied by hyperalgesia. This study states that, “15-50% of patients with neuropathic pain” experience hyperalgesia.
Paraesthesia is likely something we have all experienced in the form of ‘pins and needles’. Paresthesia can occur in any area of the body and can be experienced as, “tingling or numbness, skin crawling, or itching.”
Conditions including fibromyalgia and chronic fatigue syndrome commonly include paraesthesia as a symptom.
5. Sensory overload
Sensory overload is sometimes referred to as hypersensitivity. It means that pain patients are often overwhelmed by noises, sounds, lights, smells and other environmental factors.
The brain has a difficult time processing sensory information especially when it’s in extremes, for example in crowds or very loud places. This is common with chronic fatigue syndrome, complex regional pain syndrome (CPRS) and fibromyalgia.
It can be a very distressing symptom.
One study on fibromyalgia and sensory issues discovered that, “The FM group reported significantly increased sensory sensitivities to both somatic (tactile) and nonsomatic (eg, auditory and olfactory) sensory stimuli “
While a study on sensory problems associated with CRPS concluded that, “SMD (Sensory modulation dysfunction) is significantly associated with CRPS”
6. Temperature regulation issues
Some chronic pain conditions, such as fibromyalgia and chronic fatigue syndrome, cause patients to struggle to regulate their temperature. Patients can also be more sensitive to heat and cold, leading to hot flashes. It can even lead to patients finding heat or cold painful.
This study explains that, “In addition to decreased body temperature, several characteristics of fibromyalgia syndrome suggest altered thermoregulatory activity.”
7. Balance problems
Many individuals with chronic conditions struggle with balance issues, making them feel unsteady on their feet and even leading to falls at times.
This 2019 study on balance in patients with chronic lower back pain concluded that, “balance is impaired in individuals with chronic low back pain when compared to healthy individuals.”
This study sampled 83 participants with varying chronic pain conditions for balance issues and found that, “47% of our participants indicated a recent fall, much higher than the 30% fall-rate for people over 65 years old.”
8. Increased period pain
Some chronic pain conditions can lead to increased pain around the time of a patient’s period. Often cramps and other pains associated with periods can be worsened for those with chronic pain.
Some chronic pain conditions, such as endometriosis, are intrinsically linked to the menstrual cycle.
9. Skin rashes and sensitivity
The skin can become more sensitive and easily irritated with some chronic pain conditions. Skin rashes can occur and even dry, red or sore skin. This is a common symptom in complex regional pain syndrome (CRPS).
Crepitus is the sound that joints make when they move, particularly in patients with arthritis. Arthritis Health describes crepitus as, “any grinding, creaking, cracking, grating, crunching, or popping that occurs when moving a joint.”
We all tend to experience some mild crepitus at times, but this can become a more regular occurrence with a chronic pain condition.
You can find out all you need to know about chronic pain in our guide to essential knowledge about chronic pain.
Treede, R. D., Rief, W., Barke, A., Aziz, Q., et al, (2015). “A classification of chronic pain for ICD-11.” Pain, 156(6), 1003–1007.
Munguía-Izquierdo, Legaz-Arrese A , Moliner-Urdiales D, Reverter-Masía J., (2008), “[Neuropsychological performance in patients with fibromyalgia syndrome: relation to pain and anxiety].” Psicothema. 2008 Aug;20(3):427-31.
Montoro CI, Duschek S, Muñoz Ladrón de Guevara C, Fernández-Serrano MJ, Reyes del Paso GA, (2015), “Aberrant cerebral blood flow responses during cognition: Implications for the understanding of cognitive deficits in fibromyalgia.” Neuropsychology. 2015 Mar;29(2):173-82.
He Y, Kim PY., (2019), “Allodynia” StatPearls, Treasure Island (FL): StatPearls Publishing; 2020 Jan
Jensen TS, Finnerup NB., (2014), “Allodynia and hyperalgesia in neuropathic pain: clinical manifestations and mechanisms.” Lancet Neurol. 2014 Sep;13(9):924-35
National Institute of Neurological Disorders and Stroke, (2019), “Paresthesia Information Page”.
Wilbarger, J. L., & Cook, D. B. (2011). “Multisensory hypersensitivity in women with fibromyalgia: implications for well being and intervention.” Archives of physical medicine and rehabilitation, 92(4), 653–656.
Bar-Shalita, T., Livshitz, A., Levin-Meltz, Y., Rand, D., Deutsch, L., & Vatine, J. J. (2018). “Sensory modulation dysfunction is associated with Complex Regional Pain Syndrome.” PloS one, 13(8), e0201354.
Larson, A. A., Pardo, J. V., & Pasley, J. D. (2014). “Review of overlap between thermoregulation and pain modulation in fibromyalgia.” The Clinical journal of pain, 30(6), 544–555.
Berenshteyn Y, Gibson K, Hackett GC, Trem AB, Wilhelm M., (2019), “Is standing balance altered in individuals with chronic low back pain? A systematic review”. Disabil Rehabil. 2019 Jun;41(13):1514-1523
Arlene Schmid, Marieke Van Puymbroeck, Jennifer Portz, et al, (2016), “Chronic Pain is Associated with Impaired Balance and Falls”, Archives of Physical Medicine and Rehabilitation, Volume 97, Issue 10, E116, October 01, 2016
Johns Hopkins Medicine, (2020), “Period Pain: Could It Be Endometriosis?”
NHS, (2019), “Symptoms-Complex regional pain syndrome”.
Rachel Brakke, MD, (2016), “What Is Crepitus?” Arthritis-Health.
About Ann-Marie D’Arcy-Sharpe:
Ann-Marie D’Arcy-Sharpe is 33 years old and works as a freelance writer and blogger. She lives with bipolar disorder, fibromyalgia and arthritis.
She writes for Pathways Pain Relief, a chronic pain relief app and blog. The app is created by pain patients and backed by the latest pain science. The app uses mind body therapies to help pain patients achieve natural, long lasting pain relief.