Persistent pain: understanding it and finding support
Pain that continues for more than three months is often described as persistent or chronic pain. It can affect sleep, work, relationships and confidence in movement. The pain is real, including when a scan or examination does not fully explain its intensity.
This guide is about the longer-term picture. For soreness after a recent treatment, read After your osteopathy appointment; for a short-term increase in back symptoms, use the back pain flare-up guide.
Start with an assessment, not an assumption
Persistent pain can accompany an identifiable condition, such as arthritis or nerve injury. This is sometimes called chronic secondary pain. Chronic primary pain is a diagnosis used when no underlying condition adequately accounts for the pain or its impact. Both can occur together.
These terms are not a judgement about how much pain you should feel. A clinician should consider the history, examination, relevant investigations and what has changed. New symptoms still deserve attention, even if you have lived with pain for years.
Why can pain continue?
Pain is influenced by more than the condition of one tissue. The nervous system can become more sensitive, and sleep, stress, previous experiences, illness and daily demands may affect how pain is experienced. The balance differs between people.
This does not mean the pain is imagined, that you caused it, or that every symptom is harmless. A useful explanation should make sense of your experience without dismissing symptoms or promising a single correction.
Build a plan around what matters to you
A helpful starting point is one activity you would like to make easier: a short walk, preparing a meal, returning to a hobby or getting through a working day. Agree how to judge progress in that activity, alongside changes in pain.
Find a manageable starting amount. This may be less than you can do on your best day.
Spread demanding tasks through the day or week and allow recovery. Pacing should help you participate, rather than become a rule to avoid all discomfort.
Change one demand at a time, such as duration, frequency or load, and see how you respond.
Review sleep, practical help and work adjustments as part of the plan.
Agree what a manageable flare looks like for you and which changes need medical review.
There is no single exercise dose for everyone. The Getting active guide offers ideas for walking, gardening and everyday movement that can be adapted to your situation.
What support may help?
Depending on the assessment, care may involve a GP, physiotherapist, pain service, rheumatology team or another specialist. NICE recommends appropriate exercise programmes for chronic primary pain and says pain-focused CBT or acceptance and commitment therapy may be considered with suitably trained professionals. Psychological support is a way to reduce the impact of pain, not a claim that it is imaginary.
Treatment recommendations differ between chronic primary pain and pain linked to another condition. Ask your prescriber about the purpose, benefit and risks of medicines. Do not stop or change prescribed medication abruptly because of something you read online.
Osteopathic assessment may help clarify whether a musculoskeletal approach is suitable. If hands-on treatment is considered, agree a practical goal and a review point. It should support your wider plan and ability to manage between visits; repeated treatment without useful progress is a reason to reconsider the approach.
Local NHS information
East Sussex MSK and East Sussex Healthcare NHS Trust provide information about understanding persistent pain and managing its impact. Ask your GP or existing treating team which local assessment or pain-management route fits your needs. Eligibility and referral arrangements can differ between services.
When to seek another assessment
Seek medical advice for new or worsening symptoms, unexplained swelling, fever or feeling unwell, or a substantial loss of function. A sudden change should not automatically be labelled another flare.
With back pain, new bladder or bowel disturbance, numbness around the genitals or anus, or symptoms affecting both legs can signal an emergency. Go to A&E immediately; do not drive yourself.
Sources and further information
Sources checked: 13 October 2026. This information supports individual assessment and an agreed care plan.