September Is Pain Awareness Month: Understanding Chronic Pain and Ways to Manage It

Disclaimer: This content is provided for general educational and informational purposes only and is not medical advice, diagnosis, or treatment. It is intended to help you learn about chronic pain and various management options so you can discuss them with your primary care physician (PCP), orthopedic specialist, rheumatologist, pain-management provider, physical or occupational therapist, pharmacist, or another qualified healthcare professional. Always speak with your healthcare provider before starting, stopping, or changing medications, supplements, exercise programs, or treatments.

September is Pain Awareness Month, an opportunity to bring greater attention to chronic pain, the conditions that cause it, and the many ways people can work with their healthcare teams to manage it.

Chronic pain is more than simply “hurting.” It can affect mobility, sleep, work, independence, relationships, mental well-being, and the ability to participate in everyday activities.

It also doesn’t have one single cause. Chronic pain can develop from arthritis, osteoarthritis, avascular necrosis (AVN), nerve disorders, spinal conditions, injuries, surgeries, inflammatory diseases, and many other conditions.

Understanding why you are hurting is an important part of determining what can be done about it.

Arthritis and Chronic Pain

Arthritis isn’t a single disease. The term describes numerous conditions affecting joints and surrounding tissues.

Depending on the type of arthritis, a person may experience:

• Joint pain and tenderness
• Swelling
• Stiffness
• Reduced range of motion
• Difficulty walking or using the affected joint
• Pain during or after activity
• Periods of worsening symptoms

Some forms of arthritis are primarily inflammatory, while others involve degenerative changes within the joint.

That distinction matters because managing the symptoms of arthritis and treating the underlying disease aren’t always the same thing.

Osteoarthritis: A Common Cause of Chronic Joint Pain

Osteoarthritis (OA) is a degenerative joint disease involving changes in cartilage, bone, and other tissues within and around a joint.

It commonly affects the hips and knees, but it can also occur in the hands, spine, shoulders, ankles, and other joints.

As osteoarthritis progresses, people may experience increasing pain, stiffness, decreased range of motion, difficulty with weight-bearing activities, and limitations in everyday life.

Treatment may involve a combination of movement, strengthening, physical or occupational therapy, weight management when appropriate, topical treatments, medications, injections, assistive devices, and, for some people with advanced disease, joint-replacement surgery.

Avascular Necrosis (AVN): Bone Damage That Can Lead to Osteoarthritis

Avascular necrosis (AVN), also called osteonecrosis, is different from osteoarthritis—but AVN can eventually lead to secondary degenerative osteoarthritis.

AVN develops when the blood supply to an area of bone becomes inadequate, causing bone tissue to die.

Although AVN is frequently discussed in connection with the hip, AVN is not exclusively a hip condition. Osteonecrosis can affect bones around the:

Hips, knees, shoulders, ankles, elbows, wrists, and other joints.

In its earlier stages, the structure of the affected bone may remain intact. As AVN progresses, however, weakened bone can begin to collapse.

When AVN affects bone near a joint, collapse can alter the shape and mechanics of that joint. The joint surface and cartilage can subsequently become damaged.

That damage can eventually result in secondary degenerative osteoarthritis.

At that point, a person may be dealing with both the consequences of osteonecrosis and degenerative changes within the joint, potentially contributing to additional pain, stiffness, reduced mobility, and loss of function.

This relationship is important because managing AVN pain does not necessarily mean the underlying AVN has stopped progressing.

Someone living with AVN should talk with an orthopedic specialist about the stage and location of the disease, whether there are signs of collapse, whether degenerative osteoarthritis has developed, and whether joint-preserving treatment is still an option.

Other Types of Chronic Pain

Chronic pain can come from many different conditions.

Some people live with rheumatoid or other inflammatory arthritis, fibromyalgia, neuropathy, chronic back or neck pain, degenerative spine conditions, migraines, tendon or soft-tissue disorders, previous injuries, postsurgical pain, or nerve damage.

Others may have several painful conditions at the same time.

Two people can even have the same diagnosis and experience very different levels and types of pain.

That is one reason chronic pain management needs to be individualized.

Building a Chronic Pain Management Toolbox

For many people, chronic pain management isn’t about discovering one treatment that eliminates every symptom.

It can involve building a toolbox of strategies that work together to reduce pain, protect function, maintain mobility, and improve everyday quality of life.

Here are several options to discuss with your healthcare team.

Diet and Nutrition

Food isn’t a cure for chronic pain, AVN, arthritis, or osteoarthritis, but good nutrition can support overall health.

A balanced eating pattern may include:

• Vegetables and fruits
• Whole grains
• Legumes
• Nuts and seeds
• Appropriate sources of protein
• Foods containing healthy unsaturated fats
• Adequate hydration

For some people, maintaining a weight appropriate for their individual health circumstances can also decrease mechanical stress on weight-bearing joints.

Be cautious with supplements or restrictive diets advertised as being able to “cure” arthritis, reverse AVN, or completely regenerate a damaged joint.

Supplements can also interact with medications. Talk with your doctor, pharmacist, or registered dietitian before making major dietary changes or adding supplements.

Movement: Motion Can Still Matter

Chronic pain can make movement difficult, and there are days when simply getting through normal activities can be challenging.

But movement doesn’t have to mean intense exercise.

Depending on your condition, options might include:

Walking, gentle stretching, range-of-motion exercises, aquatic exercise, strengthening, stationary cycling, chair exercises, or other low-impact activities.

The right amount and type of movement depends on the individual.

This is particularly important for someone with AVN or another condition where weight-bearing may need to be limited. An orthopedic specialist may recommend crutches, a walker, reduced weight-bearing, or other activity modifications depending on the location and stage of the disease.

Don’t assume that “pushing through the pain” is always beneficial.

Ask your healthcare team what types of movement are safe for your particular condition.

Physical Therapy (PT)

Physical therapy can be an important part of chronic pain management.

A physical therapist can evaluate how you move and develop an individualized program that may address:

• Strength
• Flexibility
• Range of motion
• Balance
• Walking and gait
• Joint stability
• Conditioning
• Safe use of assistive devices

Physical therapy isn’t simply about exercising harder. It can help identify ways to move more efficiently while working within the limitations created by your condition.

Occupational Therapy (OT)

Occupational therapy can help people continue performing the activities that make up everyday life.

An occupational therapist may help with:

• Dressing and bathing
• Cooking
• Household activities
• Work tasks
• Energy conservation
• Joint-protection techniques
• Adaptive equipment
• Home modifications
• Mobility strategies
• Finding less painful ways to perform everyday activities

Sometimes managing chronic pain isn’t about giving up an activity.

It’s about discovering another way to do it.

Topical Pain Relief

Topical treatments are applied directly to a painful area and may be appropriate for certain types of musculoskeletal or nerve-related pain.

Depending on the condition, options may include products containing ingredients such as diclofenac, lidocaine, capsaicin, menthol, or other topical preparations.

“Topical” doesn’t automatically mean risk-free.

Some products can cause skin reactions, have dosing limitations, or may not be appropriate with certain medications or medical conditions. Ask your doctor or pharmacist which options are appropriate for you and how they should be used.

Medications

Medication can also be one part of chronic pain management.

Depending on the underlying condition and an individual’s health history, healthcare professionals may consider options including:

Acetaminophen, nonsteroidal anti-inflammatory drugs (NSAIDs), certain medications used for nerve pain, medications directed at inflammatory disease, and other prescription treatments.

The appropriate medication depends on what is causing the pain, not simply how severe the pain feels.

Medications also have risks and potential interactions. NSAIDs, for example, may not be appropriate for everyone, particularly people with certain kidney, gastrointestinal, cardiovascular, or medication-related concerns.

Talk with your healthcare provider or pharmacist about what is appropriate for you.

Pain Management and Disease Treatment Aren’t Always the Same Thing

This distinction deserves special attention.

Reducing pain doesn’t necessarily mean the condition causing the pain has been treated.

A topical medication might make an arthritic knee feel better.

Medication may help someone function with chronic back pain.

Physical therapy may help improve mobility.

Someone with AVN may find ways to reduce pain while the underlying osteonecrosis still requires monitoring or treatment.

This is why chronic pain management should include conversations about both questions:

“How can we help control my pain?”

and

“What are we doing about the condition causing my pain?”

Both matter.

Pain Is More Than a Number

People with chronic pain are frequently asked:

“On a scale from 0 to 10, how bad is your pain?”

That number provides information, but it doesn’t tell the entire story.

Tell your healthcare provider what the pain is actually doing to your life.

Can you sleep?

Can you walk through the grocery store?

Can you prepare a meal?

Can you work?

Can you drive?

Can you climb stairs?

Can you shower and get dressed?

Can you exercise?

Can you play with your children or grandchildren?

Can you participate in activities you enjoy?

Sometimes what pain prevents you from doing communicates its impact better than a number ever could.

This September, Talk About Chronic Pain

Pain Awareness Month is about making chronic pain visible and encouraging better conversations about how it affects people’s lives.

Whether your pain comes from arthritis, osteoarthritis, AVN, nerve damage, spinal disease, an injury, surgery, an inflammatory condition, or another chronic illness, you deserve the opportunity to understand your condition and discuss available options.

Ask your healthcare team about diet and nutrition.

Ask about safe movement.

Ask whether physical therapy or occupational therapy could help.

Ask about topical treatments and medications.

Ask whether you need additional imaging or evaluation.

And ask whether controlling your pain is enough—or whether the underlying condition also needs additional treatment.

There may not be one solution for chronic pain. For many people, progress comes from combining several approaches and adjusting them as their condition and needs change.

The goal isn’t simply to put a number on your pain. It’s to find ways to manage it, protect your function, and help you participate as fully as possible in your life.