Chronic Pain Types The 6 Most Common Chronic Pain Conditions Millions of Americans live with chronic pain By Adrienne Dellwo linkedin Adrienne Dellwo is an experienced journalist who was diagnosed with fibromyalgia and has written extensively on the topic. Learn about our editorial process Adrienne Dellwo Published on January 01, 2021 Print Chronic pain is considered an epidemic in America. Not only are millions of people living with it, if you add up the cost of treatment and lost productivity, it comes to an estimated economic impact of $635 billion each year. Many of the most common chronic pain conditions are well known, but some of them have gone unrecognized and underdiagnosed for decades—leaving untold numbers of people without proper treatment. The most common chronic pain conditions in the U.S. are: MigraineIrritable bowel syndrome (IBS)Osteoarthritis (OA)VulvodyniaTemporomandibular joint disorder (TMJ)Fibromyalgia Together, those six conditions affect more than 150 million Americans. Defining Chronic Pain Conditions Chronic pain is defined as lasting for three months or longer, causing either significant emotional distress or functional disability, and not being explained by another chronic condition. Migraine, IBS, vulvodynia, and fibromyalgia are defined as chronic primary pain conditions, meaning they involve pain not due to other conditions. OA and TMJ are considered chronic secondary musculoskeletal pain, which means pain from a musculoskeletal problem (inflammation, joint damage) is a problem in its own right. They were included due to their huge impact, because their major symptom is pain, and because primary treatments are aimed at relieving pain. Some major causes of chronic pain are cancer, low back pain, and neuropathy (pain from nerve damage). They weren’t included in this list because the pain is a consequence of another condition or because pain isn’t their main symptom. 1 Migraine AsiaVision / Getty Images U.S. prevalence: 39 million people; 12% of the population Worldwide, migraine is the third most prevalent illness. It's a neurological condition that causes intense headaches and other symptoms called “aura.” More than 15 migraine attacks a month is considered chronic migraine. Symptoms Migraines often come in four phases, each of which has its own set of symptoms. Prodrome: Food cravings, constipation or diarrhea, mood changes, stiff muscles, fatigue, nauseaAura: Visual phenomenon like flashing lights, seeing spots, or partial vision loss; vertigo, confusion, tingling or numbness, smelling odors that aren’t there, hearing things that aren’t there, partial paralysisHeadache: Throbbing, pulsating, or pounding pain, usually on one side of the head; sensitivity to light and sound, nausea and vomiting, hot and cold spells, dizziness, sadness or anxietyPostdrome: Fatigue, mood changes, muscle aches, dizziness, difficulty concentrating Understanding Migraine Symptoms Causes and Triggers Migraines are believed to be caused by genetic factors and several types of dysfunction in the brain, including pain pathways and neurotransmitters (chemical messengers). Several exacerbating factors are believed to trigger the migraines themselves, such as: StressHormonal changes in womenNot eatingWeather changesSleep schedule irregularitiesFragrance sensitivityCaffeine, alcohol, MSG, chocolate, and other foodsDehydrationBright or flickering light What Causes Migraines? Diagnosis No test can conclusively diagnose migraines, so your doctor will consider your symptoms, family history, and test to rule out other possible causes of symptoms. You may be given several blood and imaging tests to check for stroke, multiple sclerosis, seizures, thyroid disease, swelling of the optic nerve, and a host of other conditions. How Migraine is Diagnosed Treatment Treatment for migraines may include: Prescription or over-the-counter medicationsInjections of anesthetic, muscle relaxants, or steroidsIntravenous infusions of anestheticsTranscranial magnetic stimulation, which involves a device placed at the back of your headGinger supplementsAromatherapy with lavender oil You may also be able to learn how to prevent your migraines. Medications and Home Remedies for Migraine 2 Irritable Bowel Syndrome Grace Cary / Getty Images U.S. prevalence: 39 million people; 12% of the population Irritable bowel syndrome (IBS) is classified as a functional gastrointestinal disorder. Abdominal pain is a major symptom, with severity ranging from annoying to debilitating. Symptoms The predominant symptoms of IBS include: Abdominal painAcid refluxBloatingDecreased appetiteDiarrhea and/or constipationExcessive belchingGassiness/flatulenceHeartburnIndigestionLump in the throat (globus)Nausea Different types of IBS include diarrhea-predominant (IBS-D), constipation-predominant (IBS-C), or alternating-type (IBS-A) with alternating episodes of diarrhea and constipation. IBS Signs, Symptoms, and Complications Causes The causes of IBS aren’t clear, but it’s believed to be a combination of: GeneticsGut motility problemsPain sensitivityInflammationDisordered communication between the brain and gutStress or trauma early in lifeDepression or anxietyDigestive tract infectionsBacterial overgrowth in the small intestineFood intolerances or sensitivities IBS Causes and Risk Factors Diagnosis No test can diagnose IBS, so doctors run blood tests, check for blood in the stool, and sometimes use imaging tests like colonoscopy to rule out other possible causes of symptoms. Diagnostic criteria include: Symptoms present at least one day a week for at least a monthRecurrent abdominal pain or discomfort In addition, you must have at least two of the following: Pain relieved by bowel movementOnset of pain is related to a change in frequency of bowel movementsOnset of pain is related to a change in the appearance of stool How IBS is Diagnosed Treatment IBS treatment plans should be tailored to your specific symptoms and triggers. A typical plan includes: Dietary changes, such as the low-FODMAP dietOver-the-counter laxatives or anti-diarrheal medicationsProbiotic supplementsPrescription IBS drugsPrescription antispasmodics, antibiotics, or antidepressantsCognitive behavioral therapy (CBT)Enteric-coated peppermint oil supplements IBS Treatment Options 3 Osteoarthritis SMC Images / Getty Images U.S. prevalence: 32.5-million people; 10% of the population The most common form of arthritis, osteoarthritis involves the breakdown of cartilage, which is a flexible tissue inside joints that enables your bones to glide over each other. Symptoms The symptoms of OA are caused by the loss of cartilage in the joints and degeneration of the joints themselves. Primary OA symptoms include: Joint pain and stiffnessLimited range of motionInflammation The most common joints affected are the neck, low back, knees, hips, shoulders, or fingers. Signs, Symptoms and Complications of OA Causes and Risk Factors OA is often called “wear-and-tear” arthritis and used to be considered an inevitable part of aging. However, experts now know that a combination of many factors combine to cause degradation of the cartilage and joints. While the exact role of these as causes of OA isn’t yet clear, experts have identified several risk factors. Age: It’s more common over 40, and especially over 65.Sex: It’s more prevalent in men until age 45, after which it’s more prevalent in women.Injury: About 12% of all OA diagnoses are considered post-traumatic arthritisGenetics: Having a parent or a sibling with OA means you’re more likely to get it.Lifestyle factors: Being overweight or having a job that puts extra stress on your joints increases the likelihood that you’ll develop OA. Causes of Osteoarthritis Diagnosis If you have symptoms that suggest OA, your doctor will likely perform a physical exam, order blood tests for inflammatory markers and to rule out other causes, and possibly send you for imaging tests such as X-rays or magnetic resonance imaging (MRI). The specific diagnostic criteria differ depending on which joint(s) you’re having trouble with. How Is Osteoarthritis Diagnosed? Treatment OA treatment may include: Prescription and/or over-the-counter medications aimed at reducing pain and inflammationSupplements that improve joint healthTopical pain relieversJoint injectionsPhysical therapyAcupunctureJoint surgeries and other procedures Drugs and Other Treatments for OA 4 Vulvodynia U.S. prevalence: An estimated 26 million people, or 8% of the population, with many cases undiagnosed. Vulvodynia is chronic pain in the vulva, which is the exterior portion of the female genitalia. It can impact the labia, clitoris, or the opening of the vagina, and makes sexual intercourse painful. Symptoms Symptoms vary, but the pain of vulvodynia can be constant or come and go. It’s often described as burning, stinging, itching, throbbing, or rawness. Most cases fall into one of two subgroups: generalized vulvodynia and localized vulvodynia. The localized form is more common. Symptoms of generalized vulvodynia include: Pain throughout the vulvar region, sometimes spreading to the perineum, mons pubis, or inner thighPain may or may not be triggered by pressure or touchWhile most cases don’t involve visible findings, the vulvar tissue appears inflamed in some people Symptoms of localized vulvodynia include: Pain only at one sitePain triggered by intercourse, gynecologic exam, tampon insertion, tight clothing, riding a bicycle, motorcycle, or horseHigher likelihood of red, inflamed tissue Causes of Pain During Sex Causes Researchers haven’t yet uncovered the cause of vulvodynia but several possible causes have been identified, including: Allergic response to irritantsExcess oxalate crystals in the urineHypersensitivity to yeastIrritation of pelvic floor musclesNerve damage Vulvodynia is especially common in people with fibromyalgia, suggesting a possible common underlying mechanism. Vulvodynia is not believed to be related to any kind of infection, including sexually transmitted infections. The Female Reproductive System Diagnosis Vulvodynia is diagnosed based on symptoms and ruling out other conditions with similar symptoms, including skin disorders and sexually transmitted infections. Your doctor may use a cotton swab to apply pressure to multiple areas of your vulva to see where and how much it hurts. Depending on the appearance of the skin, they may perform a biopsy. A colposcopy, which uses a specialized instrument to examine the vulva, may also be ordered. Treatment Treatments for vulvodynia are aimed at alleviating symptoms and may include: Avoiding irritantsPain medicationsTopic pain relievers (hormone cream, topical anesthetics)Muscle therapy for the pelvic floorNeurostimulationBiofeedbackNerve-block injectionsSurgery Vulvodynia in Fibromyalgia Many people with chronic pain have more than one condition. For example, it's not unusual for someone with fibromyalgia to have TMJ, vulvodynia, and/or IBS. 5 Temporomandibular Joint Disorder stockdevil / Getty Images U.S. prevalence: 10 million people; 3% of the population Temporomandibular joint disorder (TMJ) is chronic jaw pain from the temporomandibular joint or surrounding muscles. The temporomandibular joint connects your lower jaw to your skull. TMJ is the name of the joint but is often used as the name of the condition, which is alternatively called TMD, for temporomandibular disorder. Symptoms Symptoms of TMJ include: Radiating pain in the jaw, face, or neckJaw stiffnessImpaired range of motion in the jawPainful popping or clicking with jaw movementChange in bite alignment Causes TMJ is believed to be caused, in some cases, by trauma to the jaw. However, the cause of most cases is never known. The condition is more common in women, so researchers are investigating a possible connection with female hormones. TMJ may also be linked to: Teeth grinding (bruxism)Anxiety, stress, or depressionStructural abnormalities in the jaw Things to Stop Doing With TMJ Diagnosis TMJ is diagnosed based on symptoms, including severity, location, and quality of the pain. Your doctor may ask questions or order tests to rule out other possible causes of your symptoms, including dental problems, migraine, and trigeminal neuralgia. Your doctor may also assess the range of motion in your jaw and check surrounding muscles for tenderness. In some cases, they may order imaging tests. Treatment TMJ treatment usually starts conservatively and progresses if symptoms aren’t alleviated. The first step is self-care, including: Resting your jawEating soft foodsApplying heat to the jawStretching exercisesRelaxation techniquesAvoiding triggering behaviors such as jaw clenching or chewing gum Your doctor may recommend massage therapy, physical therapy, or a dental device to help you stop clenching or grinding, especially while you sleep. The next step is medication, which ranges from over-the-counter anti-inflammatory drugs (ibuprofen, naproxen) to prescription muscle relaxants and tricyclic antidepressants, which are commonly prescribed for several pain conditions. Severe TMJ that doesn’t respond well to these treatments may require surgery, but this is rare and controversial. When Surgery Is Used for TMJ 6 Fibromyalgia U.S. prevalence: An estimated 10 million people; 3% of the population; most cases remain undiagnosed Fibromyalgia is a condition of “central sensitization,” meaning the pain originates from a central nervous system that’s become hypersensitive to pain signals. Symptoms Fibromyalgia can involve more than 60 symptoms, with each person experiencing a unique mix. Primary symptoms include: Widespread pain that may be aching, stabbing, burning, or shootingPain from stimuli that shouldn’t cause pain (temperature, pressure)Abnormal nerve sensations such as itching, tingling, or “zings” (paresthesias)Pain that moves around the bodyCognitive dysfunction (“fibro fog”)Unrefreshing sleepFatigueSensitivity to light, noise, or fragrancesDizziness and fainting Symptoms may be constant or they may have remissions (when symptoms are light or absent) and flares (when symptoms are more severe). The Big List of Fibromyalgia Symptoms Causes The causes of fibromyalgia aren’t yet understood. Possible causes include a combination of: Genetic predisposition: The condition clusters in families.Sex hormones: Women appear to be more susceptible, especially during times of hormonal fluctuations (pregnancy, menopause).Age: While anyone can develop fibromyalgia, it’s most often diagnosed during the childbearing years.Stress levels: The onset of some cases is during or after periods of heightened stress. Other chronic pain conditions may be a cause of fibromyalgia. Research suggests the constant bombardment of pain signals may change the way the brain processes them and lead to central sensitization. Who Gets Fibromyalgia? Diagnosis No blood or imaging test can diagnose fibromyalgia. Doctors diagnose it one of two ways. Tender-point exam: Pressure is placed on 18 points around the body to gauge widespread pain and heightened pain response.Widespread pain index and symptom severity scale: Two questionnaires assess the level and nature of pain and other symptoms. (This is the newer and preferred method.) Your doctor will also likely order blood tests and possibly imaging tests to rule out other conditions. How Fibromyalgia Is Diagnosed Treatment Fibromyalgia treatment should be tailored to your specific symptoms and their severity as well as known symptom triggers. A typical treatment regimen involves: Prescription medications (antidepressants, anticonvulsants, painkillers)Topical pain relieversCognitive behavioral therapyModerate, gradually increased exerciseComplementary treatments (acupuncture, cupping, myofascial release)Mindfulness meditationSupplements (Omega-3, vitamin D, SAM-e, 5-HTP)Medical marijuana and cannabidiol (CBD)Physical and occupational therapyLifestyle changes (diet, weight loss, not smoking ) Finding Relief From Fibromyalgia Other Major Chronic Pain Conditions Many chronic pain conditions are better known than the ones above. In some cases (rheumatoid arthritis, multiple sclerosis), that’s because they’re more disabling. In other cases, it’s due to how long they’ve been recognized or the successful efforts of advocacy groups. Other major chronic pain conditions include: Myofascial pain syndrome: A connective tissue disease often confused with fibromyalgiaGout: An intensely painful type of arthritisEndometriosis: Tissues from the uterus grow in other placesInterstitial cystitis: Also called painful bladder syndromeCentral pain syndrome: Results from nervous-system damage, such as a strokeDegenerative disc disease: Involves the discs between vertebrae in your spineLupus: An autoimmune disease that comes in many formsPsoriatic arthritis: A type of arthritis that affects the skinRheumatoid arthritis: The most disabling form of arthritisMultiple sclerosis: Involves damage to the nerves Those conditions, combined, impact an estimated 40 million or more people. The 6 Best Chronic Pain Support Groups Was this page helpful? Thanks for your feedback! Sign up for our Health Tip of the Day newsletter, and receive daily tips that will help you live your healthiest life. Sign Up You're in! Thank you, {{form.email}}, for signing up. There was an error. Please try again. What are your concerns? Other Inaccurate Hard to Understand Submit Article Sources Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy. Harvard Medical School, Harvard Health Publishing. The chronic pain epidemic: What's to be done? Updated November 10, 2016. Treede RD, Rief W, Barke A, et al. Chronic pain as a symptom or a disease: the IASP Classification of Chronic Pain for the International Classification of Diseases (ICD-11). Pain. 2019;160(1):19-27. doi:10.1097/j.pain.0000000000001384 Perrot S, Cohen M, Barke A, et al. The IASP classification of chronic pain for ICD-11: chronic secondary musculoskeletal pain. Pain. 2019;160(1):77-82. doi:10.1097/j.pain.0000000000001389 Migraine Research Foundation. Migraine facts. American Migraine Foundation. The timeline of a migraine attack. Updated January 18, 2018. American Migraine Foundation. The American Migraine Foundation’s guide to triggers & how to manage them. Updated July 27, 2017. Lan L, Zhang X, Li X, Rong X, Peng Y. The efficacy of transcranial magnetic stimulation on migraine: a meta-analysis of randomized controlled trails. J Headache Pain. 2017;18(1):86. doi:10.1186/s10194-017-0792-4 Sasannejad P, Saeedi M, Shoeibi A, Gorji A, Abbasi M, Foroughipour M. Lavender essential oil in the treatment of migraine headache: a placebo-controlled clinical trial. Eur Neurol. 2012;67(5):288-91. doi:10.1159/000335249 National Institutes of Health, National Institute of Diabetes and Digestive and Kidney Diseases. Definition & facts for irritable bowel syndrome. Updated November 2017. Foley A, Burgell R, Barrett JS, Gibson PR. Management strategies for abdominal bloating and distension. Gastroenterol Hepatol (N Y). 2014;10(9):561-71. National Instititues of Health, National Institute of Diabetes and Digestive and Kidney Diseases. Symptoms & causes of irritable bowel syndrome. Updated November 2017. Böhn L, Störsrud S, Liljebo T, et al. Diet low in FODMAPs reduces symptoms of irritable bowel syndrome as well as traditional dietary advice: a randomized controlled trial. Gastroenterology. 2015;149(6):1399-1407.e2. doi:10.1053/j.gastro.2015.07.054 Kinsinger SW. Cognitive-behavioral therapy for patients with irritable bowel syndrome: current insights. Psychol Res Behav Manag. 2017;10:231-237. doi:10.2147/PRBM.S120817 Camilleri M, Ford AC. Pharmacotherapy for irritable bowel syndrome. J Clin Med. 2017;6(11):101. doi:10.3390/jcm6110101 Centers for Disease Control and Prevention. What is osteoarthritis (OA)? Updated July 27, 2020. Loeser RF. The role of aging in the development of osteoarthritis. Trans Am Clin Climatol Assoc. 2017;128:44-54. National Institutes of Health, National Institute on Aging. Osteoarthritis. Updated May 1, 2017. Punzi L, Galoozi R, Luisetto R, et al. Post-traumatic arthritis: overview on pathogenic mechanisms and role of inflammation. RMD Open. 2016;2(2):e000279. doi:10.1136/rmdopen-2016-000279 Reed BD, Harlow SD, Sen A, et al. Prevalence and demographic characteristics of vulvodynia in a population-based sample. Am J Obstet Gynecol. 2012;206(2):170.e1-170.e1709. doi:10.1016/j.ajog.2011.08.012 Sadownik LA. Etiology, diagnosis, and clinical management of vulvodynia. Int J Womens Health. 2014;6:437-49. doi:10.2147/IJWH.S37660 National Vulvodynia Association. What is vulvodynia? Reed BD, Harlow SD, Sen A, Edwards RM, Chen D, Haefner HK. Relationship between vulvodynia and chronic comorbid pain conditions. Obstet Gynecol. 2012;120(1):145-151. doi:10.1097/AOG.0b013e31825957cf National Vulvodynia Association. Diagnosis. National Vulvodynia Association. Vulvodynia treatments. U.S. Department of Health and Human Services, National Institutes of Health. TMJ disorders. Published September 2017. National Institutes of Health, National Institute of Dental and Craniofacial Research. TMJ (temporomandibular joint & muscle disorders). Updated July 2018. National Fibromyalgia & Chronic Pain Association. Prevalence of fibromyalgia. Sumpton JE, Moulin DE. Fibromyalgia. Handb Clin Neurol. 2014;119:513-527. doi:10.1016/B978-0-7020-4086-3.00033-3 Balbaloglu O, Tanik N, Alpayci M, Ak H, Karaahmet E, Inan LE. Paresthesia frequency in fibromyalgia and its effects on personality traits. Int J Rheum Dis. 2018;21(7):1343-1349. doi:10.1111/1756-185X.13336 U.S. Department of Health & Human Services, Office on Women’s Health. Fibromyalgia. Updated April 1, 2019. Russek L, Gardner S, Maguire K, et al. A cross-sectional survey assessing sources of movement-related fear among people with fibromyalgia syndrome. Clin Rheumatol. 2015;34(6):1109-19. doi:10.1007/s10067-014-2494-5 Centers for Disease Control and Prevention. Fibromyalgia. Updated October 11, 2017. Ji RR, Nackley A, Huh Y, Terrando N, Maixner W. Neuroinflammation and central sensitization in chronic and widespread pain. Anesthesiology. 2018;129(2):343-366. doi:10.1097/ALN.0000000000002130 Theadom A, Cropley M, Smith HE, Feigin VL, Mcpherson K. Mind and body therapy for fibromyalgia. Cochrane Database Syst Rev. 2015;(4):CD001980. doi:10.1002/14651858.CD001980.pub3 Habib, G. and Artul, S. Medical cannabis for the treatment of fibromyalgia. J Clin Rheumatol. 2018. [Epublished ahead of print.] doi:10.1097/RHU.0000000000000702 Okifuji A, Donaldson GW, Barck L, Fine PG. Relationship between fibromyalgia and obesity in pain, function, mood, and sleep. J Pain. 2010;11(12):1329-37. doi:10.1016/j.jpain.2010.03.006 Goesling J, Brummett CM, Meraj TS, Moser SE, Hassett AL, Ditre JW. Associations between pain, current tobacco smoking, depression, and fibromyalgia status among treatment-seeking chronic pain patients. Pain Med. 2015;16(7):1433-1442. doi:10.1111/pme.12747