One of the most common feelings associated with persistent pain is fatigue, and this fatigue can become extreme. Chronic pain sufferers may experience a lack of energy and motivation to engage with others or the world around them.

One of the most common feelings associated with persistent pain is fatigue, and this fatigue can become extreme. People with chronic pain may lack the energy and motivation to engage with others or the world around them. A study of people with long-term health problems in the UK found that pain and fatigue were two of the biggest barriers to leading an active and meaningful life. But why is chronic pain so exhausting? One clue is the nature of pain and its powerful effect on our thoughts and behaviours.

Modern ways of thinking about pain emphasize its positive effects. Because in this way it attracts your attention and forces you to change your behavior to protect a part of the body. Try this. Pinch your skin. As you increase the pressure, you will feel the feelings change until at a point it becomes painful. It is the pain that prevents you from pressing too hard, isn't it? In this way, pain protects us. When we are injured, our pain system becomes more sensitive due to tissue damage or inflammation. This pain prevents us from mechanically applying pressure to the damaged tissue while it is healing. For example, the pain of a broken leg or a cut on the bottom of our foot prevents us from walking on it. The concept that 'pain protects us and promotes healing' is one of the most important things.

People with chronic pain told us they had learned this that helped them recover. But long-term pain can make you overly sensitive. In the short term pain is very helpful in protecting us and the more our pain system is activated, the more protective it becomes. But persistent pain can make us overly vigilant and prevent us from recovering. Think of it as your pain system being on 'red alert' and this is where exhaustion comes in. When pain becomes a daily experience, triggered or modified by a wide range of activities, contexts and cues, it becomes a constant burden on a person's resources. Living with pain requires substantial and ongoing effort and it exhausts us. About 80 per cent of us are lucky enough not to know what it's like to live with pain day after day, for months or years. But imagine for a moment what that would be like.

Imagine having to struggle, muster strength and use distraction techniques to even go about your daily activities, let alone carry out work, care or other duties. Whenever you are in pain, you have a choice about whether and how you act on it. Constantly making these choices requires thought, effort and strategy. It is also exhausting and difficult to mention your pain or how it affects your daily activities, tasks or activities. It is also painful when no one else sees or feels your pain. For those who do hear, it can be boring, tiring or worrying. It is no wonder it is exhausting. Chronic pain is not just a 'warning' for the pain system. Increased inflammation throughout the body (alert to the immune system), disrupted production of the hormone cortisol (alert to the endocrine system), and rigid and cautious movements (alert to the motor system) also occur simultaneously with chronic pain. Each of these contributes to fatigue. So learning how to manage and resolve chronic pain often involves learning how to best manage the overactivity of these systems. Sleep deprivation is a cause of both fatigue and pain. Pain causes sleep disruption and sleep deprivation causes pain.

What really works?

People with chronic pain are often misjudged, ignored and misunderstood, which can lead to them not receiving the care they need. Persistent pain prevents people from working, limits their social interactions and impacts their relationships. This can lead to a cycle of social, personal and economic harm. That's why we need high quality education for people with chronic pain, as well as better access to evidence-based care. However, the good news is that modern care for chronic pain is based on first gaining a modern understanding of the underlying biology of chronic pain.

The best treatments we have for chronic pain require effort, patience, persistence, courage, and often a good coach. All of this is daunting advice for an already exhausted person. So, if you are among the 80