In short
The best-supported way to manage chronic pain combines several things: understanding pain, gradually increasing activity, pacing, sleep, and psychological approaches, alongside treatment of any underlying condition. Medicines help some people but are rarely enough on their own.
On this page
The goal of chronic pain management
For most chronic pain, there isn’t one treatment that switches it off. The aim is to reduce pain where possible, and just as importantly, to help you do more of what matters to you, sleep better and feel more in control. Most people do best with a plan that combines several approaches.
What works
Movement and exercise
A large overview of Cochrane reviews found that physical activity and exercise can improve pain and physical function across many chronic pain conditions, with few side effects. The type matters less than doing it regularly. Start low and build up slowly.
Pacing
Many people with chronic pain fall into a boom-and-bust cycle: doing a lot on good days, then paying for it for days afterwards. Pacing means breaking activities into smaller chunks, taking planned breaks before pain flares, and gradually increasing what you do over weeks.
Psychological therapies
Cognitive behavioural therapy (CBT), acceptance and commitment therapy (ACT) and similar approaches help people manage the impact of pain on mood, sleep and daily life. A 2020 Cochrane review found CBT had small benefits for pain, disability and distress. These therapies work alongside physical treatment, not instead of it.
Understanding pain
Pain education, sometimes called pain neuroscience education, explains how the nervous system produces pain. It can reduce fear and catastrophising and make it easier to move.
Sleep
Poor sleep makes pain worse, and improving sleep can reduce pain. See chronic pain and sleep.
Pain management programmes
Multidisciplinary programmes bring together doctors, physiotherapists, psychologists and other health professionals. They’re run through many public hospital pain services in Australia, as well as privately.
Living with pain that hasn’t settled?
Talk it through with an Australian doctor online. No referral needed.
Where do medicines fit?
Medicines can help some people with some types of pain, particularly when they make it possible to sleep, move and take part in other treatment. But for many chronic pain conditions the benefit of medicines is modest, and some carry real risks with long-term use, including dependence. A good plan is reviewed regularly, and medicines are reduced or stopped if they aren’t helping.
Practical steps you can start now
- Pick one activity you want to get back to and set a small weekly goal
- Walk or move a little every day, even on bad days
- Keep a regular wake-up time
- Write a flare-up plan: what you’ll do, what you’ll ease off, and when you’ll get help
- Tell people close to you what helps
How a GP can help
A GP can review your diagnosis and current treatment, check for anything that needs further tests, and coordinate care. People with chronic conditions may be eligible for some Medicare-subsidised allied health sessions, and a mental health treatment plan can give access to subsidised psychology sessions for eligible people.
Next step: talk to a doctor
Answer a few quick questions and you’ll get an email about your eligibility. A consultation doesn’t guarantee any particular treatment.
References
- Cohen SP, Vase L, Hooten WM. Chronic pain: an update on burden, best practices, and new advances. Lancet. 2021;397(10289):2082-2097.
- Geneen LJ, Moore RA, Clarke C, et al. Physical activity and exercise for chronic pain in adults: an overview of Cochrane Reviews. Cochrane Database Syst Rev. 2017;4(4):CD011279.
- Williams ACC, Fisher E, Hearn L, et al. Psychological therapies for the management of chronic pain (excluding headache) in adults. Cochrane Database Syst Rev. 2020;8(8):CD007407.
- Louw A, Zimney K, Puentedura EJ, et al. The efficacy of pain neuroscience education on musculoskeletal pain: A systematic review of the literature. Physiother Theory Pract. 2016;32(5):332-55.
- Finan PH, Goodin BR, Smith MT. The association of sleep and pain: an update and a path forward. J Pain. 2013;14(12):1539-52.
- Painaustralia. Painaustralia.
This guide is general information, not medical advice. It doesn’t replace a consultation with a doctor who knows your history. In an emergency, call 000.