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Chronic pain syndrome

Dolor chronicus · Syndrom chronické bolesti

What it is

Pain that has outlived its cause and become a condition in its own right.

Symptoms & signs

  • Pain over 3 months
  • poor sleep
  • low mood
  • reduced activity
  • fear of movement
  • medication dependence

🚩 Get help if…

  • call 112 / 911 now Thoughts of suicide with a plan
  • see a doctor soon New weakness, numbness or loss of bladder or bowel control
  • see a doctor soon Pain with fever, weight loss or night sweats
  • see a doctor soon Needing ever higher doses of painkillers

Where it strikes

Medical treatment

  • Multidisciplinary pain programme trials support
  • Graded exposure trials support
  • Antidepressants for pain — small average effect mixed evidence
  • Opioid tapering, done slowly mixed evidence
  • CBT and ACT trials support
  • Treating the sleep and the mood underneath trials support

Natural & lifestyle

  • Pacing and graded activity
  • exercise (any kind, consistently)
  • sleep repair
  • mindfulness
  • social re-engagement
  • avoid boom-and-bust

Emerging & experimental

  • Virtual-reality analgesia
  • closed-loop neurostimulation
  • psilocybin trials for pain reframing

Alternative, off-label & anecdotal

Approaches used outside the guidelines, with what their supporters report and what testing has found so far.

  • Acupuncture — large analyses show modest relief in chronic pain, only slightly more than sham needling mixed evidence
  • Cannabis — small benefit in trials mixed evidence
  • Low-dose naltrexone — small trials early / small studies
  • Kratom — used by many to replace opioids; addiction and liver injury reported anecdotal / traditional

ICD codes