--- title: Chronic Pain description: Chronic pain is pain that persists beyond normal tissue healing. You will learn how the nervous system produces and amplifies pain, what the evidence shows for exercise, psychological therapies and medication, and how to manage long-term pain. category: health-medicine subcategory: medical-sciences difficulty: beginner, intermediate, advanced url: /subject/chronic-pain --- # Chronic Pain Chronic pain is pain that persists beyond normal tissue healing. You will learn how the nervous system produces and amplifies pain, what the evidence shows for exercise, psychological therapies and medication, and how to manage long-term pain. ## Available Resources 1 Videos • 1 Books • 2 Websites • 4 Papers ## Papers ### 1. CDC Clinical Practice Guideline for Prescribing Opioids for Pain — United States, 2022 **Author:** Deborah Dowell, Kathleen R. Ragan, Christopher M. Jones, Grant T. Baldwin, Roger Chou US federal guideline from November 2022 with 12 recommendations on whether to start opioids, choosing doses, prescription duration and follow-up, and assessing harms, set alongside the evidence for non-opioid and non-drug treatments for chronic pain. Covers the medication side of the topic note in more depth than NICE, especially long-term opioid use and tapering. **Difficulty:** Advanced | **Language:** English | **Price:** Free **Link:** https://www.cdc.gov/mmwr/volumes/71/rr/rr7103a1.htm **Tags:** opioids, clinical guideline, pain management, prescribing, tapering ### 2. The revised International Association for the Study of Pain definition of pain: concepts, challenges, and compromises **Author:** Srinivasa N. Raja, Daniel B. Carr, Milton Cohen, et al. 2020 IASP task force paper in Pain presenting the first revision of the definition of pain since 1979, with six notes separating pain from nociception, stressing biopsychosocial influences, and explaining the reasoning behind each wording choice. **Difficulty:** Advanced | **Language:** English | **Price:** Free **Link:** https://pmc.ncbi.nlm.nih.gov/articles/PMC7680716/ **Tags:** pain definition, iasp, nociception, biopsychosocial model ### 3. Psychological therapies for the management of chronic pain (excluding headache) in adults **Author:** Amanda C. de C. Williams, Emma Fisher, Leslie Hearn, Christopher Eccleston 2020 Cochrane systematic review of randomised trials comparing cognitive behavioural therapy, behavioural therapy and acceptance and commitment therapy with usual care or active controls for chronic pain, reporting effects on pain, disability and distress. Its measured conclusion (small but real CBT benefits, uncertain evidence for BT and ACT) is the calibrated view learners need when evaluating newer psychological pain programmes. **Difficulty:** Advanced | **Language:** English | **Price:** Free **Link:** https://pmc.ncbi.nlm.nih.gov/articles/PMC7437545/ **Tags:** cognitive behavioural therapy, acceptance and commitment therapy, systematic review, psychological therapy, chronic pain ### 4. Physical activity and exercise for chronic pain in adults: an overview of Cochrane Reviews **Author:** Louise J. Geneen, R. Andrew Moore, Clare Clarke, Denis Martin, Lesley A. Colvin, Blair H. Smith 2017 Cochrane overview synthesising 21 reviews across conditions including osteoarthritis, fibromyalgia, low back pain and neck disorders, assessing whether exercise reduces pain severity and improves function, and whether it causes harm. Free full text. **Difficulty:** Advanced | **Language:** English | **Price:** Free **Link:** https://pmc.ncbi.nlm.nih.gov/articles/PMC5461882/ **Tags:** exercise therapy, physical activity, systematic review, fibromyalgia, low back pain ## Websites ### 1. Chronic pain (primary and secondary) in over 16s: assessment of all chronic pain and management of chronic primary pain (NICE NG193) **Author:** National Institute for Health and Care Excellence The clearest authoritative statement of what works and what does not for chronic primary pain, with notable 'do not offer' recommendations on common drugs. Essential counterweight in a fad-prone field. UK national clinical guideline published April 2021 covering assessment of all chronic pain and management of chronic primary pain: which treatments to offer (exercise, psychological therapy, acupuncture, some antidepressants) and which drugs not to start, including opioids and gabapentinoids. **Difficulty:** Intermediate | **Language:** English | **Price:** Free **Link:** https://www.nice.org.uk/guidance/ng193 **Tags:** clinical guideline, chronic primary pain, nice, pain management, gabapentinoids ### 2. painHEALTH Free self-management site for persistent musculoskeletal pain with written and video modules on neuroplasticity, pacing and goal setting, movement, sleep, mindfulness, medicines and procedures, plus condition pages, self-check questionnaires and patient stories. Moves the learner from understanding pain to managing it day to day, organised as structured modules that follow current evidence. Government and university backed. **Difficulty:** Beginner | **Language:** English | **Price:** Free **Link:** https://painhealth.com.au/ **Tags:** self-management, musculoskeletal pain, pacing, pain education ## Books ### 1. Explain Pain (2nd Edition) **Author:** David S. Butler, G. Lorimer Moseley Illustrated 2013 book explaining how the brain constructs pain, how immune, autonomic and motor responses contribute, and why pain can outlast tissue healing. Written in plain language for people in pain, their families and clinicians. Recommended by Tame the Beast and pain physiotherapists as the entry text for both patients and clinicians. **Difficulty:** Beginner | **Language:** English | **Price:** Paid **Link:** https://www.amazon.com/dp/0987342665?tag=edmonddante07-20 **Tags:** pain neuroscience education, pain science, central sensitisation, persistent pain ## Videos ### 1. Tame the Beast: It's Time to Rethink Persistent Pain **Author:** Lorimer Moseley, Dave Moen, Sam Chisholm Five-minute animated explainer with full transcript showing why persistent pain reflects an overprotective nervous system rather than ongoing tissue damage, and how movement and graded exposure retrain it. Includes a vetted list of further reading. **Difficulty:** Beginner | **Language:** English | **Price:** Free **Link:** https://www.tamethebeast.org/ **Tags:** pain neuroscience education, persistent pain, graded exposure, nervous system --- *This content is part of Dantes.io - Your Treasure Map to Knowledge* *Curated by humans at Dantes.io. Personal study use welcome; republishing this curation requires permission (team@dantes.io).* View this page online: https://dantes.io/subject/chronic-pain