Pain Management | Living with Persistent Pain
Care Plan Library
Introduction
This page is part of the Care Plan Building Library used by GeneralPracticeTraining.com.au.
It is designed to support clinicians and practice teams in understanding, assessing, and managing persistent (chronic) pain in general practice.
Condition Overview
This snippet focuses on persistent pain, sometimes called chronic pain, which is pain lasting longer than three months.
Around one in five Australians live with persistent pain. Pain can affect people physically, mentally, emotionally, and socially. A coordinated, team-based approach with the person at the centre offers the best outcomes.
Care Plan Snippet – Persistent Pain Management (Table Format)
Care Plan Details
Item: Chronic pain and long-term condition care
(May be incorporated into GP Chronic Condition Management Plan – Medicare item 965 where relevant)
Date: [Insert date]
Patient Details
Patient: [Patient name], [DOB], [Contact details]
GP Details
GP: [Doctor name], [Clinic name]
GP Management Plan – Problems / Goals / Treatments / Arrangements
| Area | Patient problem / risk | SMART goal | Key actions and advice | Arrangements and follow-up |
|---|---|---|---|---|
| Persistent pain | Ongoing pain >3 months | Improve function and coping within 3–6 months | Educate about pain mechanisms. Validate experience. Set realistic goals focused on function. | GP review. Ongoing monitoring. |
| Reduced activity | Fear of movement and deconditioning | Increase safe activity levels | Encourage graded activity and pacing. Address fear-avoidance behaviours. | Physiotherapy or exercise physiology referral. |
| Central sensitisation | Heightened pain sensitivity | Reduce pain amplification | Explain nervous system changes. Use education and reassurance. | Multidisciplinary input if needed. |
| Impact on mood | Anxiety, low mood, frustration | Improve emotional wellbeing | Screen for anxiety and depression. Teach relaxation and coping strategies. | Psychology referral if appropriate. |
| Sleep disturbance | Poor sleep worsening pain | Improve sleep quality | Address sleep hygiene. Review medications affecting sleep. | Follow-up review. |
| Medication use | Limited benefit or side effects | Optimise medication safety | Review current medications. Avoid over-reliance on opioids. | Pharmacist input. Regular medication review. |
What Is Pain?
Pain is the body’s alarm system.
Specialised nerve endings (nociceptors) detect potential danger and send signals to the brain. The brain evaluates these signals and may produce pain to protect the body from harm.
This process is essential for survival. However, in persistent pain, this system can become overprotective.
Acute and Persistent Pain
Acute pain
- Starts suddenly
- Usually linked to injury, inflammation, or infection
- Resolves as healing occurs
Persistent pain
- Lasts longer than three months
- May continue after tissues have healed
- Often involves changes in the nervous system
What Causes Persistent Pain?
Persistent pain is complex and may:
- Occur alongside conditions such as arthritis, diabetes, or fibromyalgia
- Follow injury or trauma
- Occur without a clear ongoing tissue cause
Changes in the nervous system can lead to central sensitisation, where the brain becomes more sensitive to pain signals. Normal movements or light touch may then cause pain.
The Impact of Persistent Pain
Persistent pain can affect:
- Strength and fitness
- Ability to work or carry out daily tasks
- Mental health and mood
- Sleep and concentration
- Social relationships and intimacy
Fear of pain can reduce movement, leading to deconditioning and further pain.
Diagnosing Persistent Pain
Assessment focuses on understanding the pain experience and its impact. This may include:
- Detailed pain history and pattern recognition
- Review of triggers and relieving factors
- Physical examination
- Selective use of scans or tests when appropriate
Not all pain requires imaging. Some scans can show “abnormalities” in people without pain and may not explain symptoms.
Treating Persistent Pain
The most effective approach is multidisciplinary, with the person at the centre. Management may include:
- Education about pain
- Physical activity and exercise
- Psychological strategies
- Medication where appropriate
- Relaxation and pacing techniques
The goal is often better function and quality of life, rather than complete pain elimination.
When Pain Gets Overwhelming
Living with persistent pain can be exhausting and frustrating.
Emotional distress is common and understandable. Support, education, and timely review help people regain confidence and direction.
Moving Forward with Persistent Pain
Recovery looks different for each person.
Even when pain persists, people can often improve what they can do and how they feel.
Clear goals, regular review, and willingness to adjust strategies support progress. A second opinion may help if progress stalls.
You can use our Care Plan Building Tool.
You can also explore our free online courses, completed by thousands of health professionals worldwide, covering allergy management, asthma care, and preventive health.