Expert Q&A: “Just Dealing With” Chronic Pain

Q: With both fibromyalgia and osteoarthritis, I have constant pain. Even with treatment, it never goes away completely. I’ve just been “dealing with it.” Is that OK?

Chronic pain is not a problem you should just put up with; in fact, you should be dealing with chronic pain in ways that are effective. This is important because an increasing number of studies show serious consequences of having chronic pain. It may cause damage to certain areas of the brain, just as chronic stress does. Chronic pain also may lead to psychological problems, such as depression; social problems, such as isolation or decreased earning potential; and functional problems, such as decreased activity or disability.

Overall, people do far better when they're aggressively dealing with chronic pain and with their chronic pain-inducing condition(s). You should treat pain as long as the treatments you use do not have side effects that exceed the benefits. More and more research is showing that many of the most effective treatments for chronic pain of any type are techniques that you can do yourself, i.e. self-management strategies. Start by trying to become more active, and make sure you are getting good quality sleep. Nearly any type of exercise can be helpful, including aerobic, stretching and strengthening. Activity and exercise often help improve fatigue and other symptoms as well. There is increasing evidence that treatments such as acupuncture/acupressure, mindfulness, yoga, Tai Chi and meditation can be helpful in many patients.  

Medications can also be helpful. For moderate-to-severe knee osteoarthritis (OA), the supplement glucosamine may provide some relief, as may the right combination of analgesics or nonsteroidal anti-inflammatory drugs (NSAIDs). There are three drugs specifically approved for use in fibromyalgia, as well as many drugs that have been shown to be effective but are not specifically approved. 

Tell your doctor that the treatments you tried previously are not resolving your chronic pain, and then work with him to find the right combination of treatments for you. It may take some time, but the result will be worth the effort.

Daniel Clauw, MD
Professor of Anesthesiology, Medicine (Rheumatology) and Psychiatry
Director, Chronic Pain and Fatigue Research Center
University of Michigan

Published May 21, 2021