Chronic pain

About chronic pain, different options that may be available to help people manage their pain, and the Government of Canada’s role in supporting people living with pain.

About chronic pain

Pain is an unpleasant sensory and (or) emotional experience typically associated with physical damage to the body. Chronic pain is when the pain lasts longer than 3 months. Sometimes chronic pain can occur:

without a known cause
after an injury has healed
after a condition has been treated

The World Health Organization now recognizes chronic pain as a disease and not just a symptom of something else.

There are 2 types of chronic pain:

Chronic primary pain

Chronic primary pain occurs when:

pain persists after the body has completely healed
the pain has no identifiable cause, such as:
- fibromyalgia
- pelvic pain
- musculoskeletal pain
- lower back pain

Chronic secondary pain

Chronic secondary pain occurs together with underlying diseases or issues, such as

cancer treatment
post-surgical pain
rheumatoid arthritis

Acute Pain

Acute pain lasts less than 3 months and usually decreases as a person heals. Acute pain warns you that something has caused or may cause damage to your body.

Living with chronic pain

Nearly 8 million Canadians live with chronic pain. People who experience chronic pain face a wide range of physical, emotional and social challenges.

Pain is a unique and personal experience that can vary widely from person to person. Your experience of pain is influenced by:

biology
psychology
spiritual factors
social factors
emotional factors

Social barriers

Since pain is an invisible condition, other people:

may not understand the pain
may not believe the pain is real

People who experience pain can often feel isolated. This can lead to:

trouble accessing health services
a lack of treatment and support
them not seeking support

Chronic pain can have major impacts on a person's:

physical health
mental and emotional health
finances and job security
social interactions
sense of self and spirituality
ability to take part in everyday activities

Treatments and therapies

Talk to your health care provider to find out what treatment options may be available and best for you and your situation.

Treatment options are most effective as part of a pain management plan that could involve different types of therapies and treatments to help manage your pain. Treatment goals may include a reduction in pain and (or) improvements in:

cognitive health
psychological health
social function
physical function
all of the above

People with chronic pain should choose and use treatments based on their own needs. Examples of treatment options include:

Pharmaceuticals

Medications and substances that have an effect on the body, such as:

nonsteroidal anti-inflammatory drugs
acetaminophen
opioids
cannabinoids
anticonvulsants
antidepressants
muscle relaxants

Psychological interventions

Interventions that aim to change thoughts, emotions, or behaviours, such as:

cognitive behavioural therapy
acceptance and commitment therapy
support groups
education sessions
individual and group psychotherapy
mindfulness-based interventions
problem adaptation therapy for pain (PATH)

Physical and rehabilitation interventions

A process that enables people to reach or maintain optimal physical function, such as:

exercise, movement, and physical activity
activity modification
Yoga and Tai Chi
graded motor imagery
graded activity participation and exposure

Medical devices or interventional pain procedures

Procedures or applications of medical devices that can treat or manage pain, such as:

dental splint
low-level laser therapy
shock wave therapy
deep brain stimulation
spinal cord stimulation
transcutaneous electrical nerve stimulation (TENS)
nerve blocks, steroid injections, trigger point injections, or prolotherapy

Practitioner administered or manual therapy

Therapeutic activities administered by a health professional, such as:

acupuncture
massage therapy
physical therapies
spinal mobilization
spinal manipulation
osteopathic treatments

Self-management

Individual-led strategies focused on coping mechanisms or cognitive and behavioural factors, such as:

meditation
support groups
dietary practices
pain neuroscience education
relaxation and breathing exercises
life skills and self-efficacy programs

Programs and services in my area

Alberta

British Columbia

Manitoba

Provincial health services

New Brunswick

Provincial health services

Newfoundland and Labrador

Provincial health services

Northwest Territories

Territorial health services

Nova Scotia

Nunavut

Territorial health services

Ontario

Prince Edward Island

Provincial health services

Quebec

Provincial health services
Association Québécoise de la douleur chronique (In French only)
Quebec Pain Research Network
Quebec Pain Society (In French only)

Saskatchewan

Yukon

Territorial health services

Chronic pain and opioids

Opioids are medications that are sometimes prescribed to treat pain. As with all medications, opioids have benefits and risks, and sometimes potentially serious side effects. The opioid overdose crisis is very complex, and untreated pain is a contributing factor. Health Canada firmly believes the medical needs of patients, including which prescription medications they should be taking, are best determined through shared decision-making between the patient and their health provider based on the unique needs of the individual.

Information on talking to your doctor about prescribed opioids.

Health Canada's Statement on Opioids and Pain Management (November 2022)

Canadian Pain Task Force and the Government of Canada's role

The Government of Canada recognizes the impacts and challenges faced by Canadians with chronic pain. In March 2019, Health Canada established the Canadian Pain Task Force to provide advice and guidance on how to prevent and manage chronic pain. The Task Force concluded on December 31, 2021, and delivered 3 reports to Health Canada over its mandate:

Chronic Pain in Canada: Laying a Foundation for Action (June 2019)
This report summarizes the state of chronic pain in Canada.
Working Together to Better Understand, Prevent, and Manage Chronic Pain: What We Heard (October 2020)
This report summarizes
- consultations about chronic pain
- gaps and challenges in current care
- best pain management practices
- ways to improve Canada's approach to preventing and managing chronic pain in Canada
The consultations occurred in-person, written, and online.
An Action Plan for Pain in Canada (March 2021)
This report provides recommendations on priority actions, so that:
- people with pain are recognized and supported
- pain is understood, prevented, and effectively treated throughout Canada
- Canada can better meet the needs of people living with chronic pain in the future

In April 2022, Health Canada established the Chronic Pain Policy Team to pursue engagement with pain stakeholders and coordinate the federal response to the Canadian Pain Task Force recommendations. The Chronic Pain Policy Team can be reached at: ChronicPain-Douleurchronique@hc-sc.gc.ca.

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