Living With Chronic Pain: How to Manage Symptoms and Improve Quality of Life

8-13-2025

By Dr. Howard Friedman MD | Veteran | U.S. Army Medical Corps | Internal Medicine | HHOM LLC

Chronic pain isn’t just a symptom—it’s a daily battle. Understanding it is the first step toward reclaiming your life.

Pain’s first cry is sharp and brief,

A warning flare, a call for relief.

But when the siren will not fade,

Life’s bright colors turn to shade.

It steals the night, it blunts the day,

And will not let its prisoner stray.

---Dr. Howard Friedman MD

Pain – More Than a Word

We all know the word pain—each of us attaching our own memories, fears, and associations to it. Medically, pain is an unpleasant sensory or emotional experience associated with actual or potential tissue damage. That sterile definition does little to capture the depth of its impact. Entire books have been written on the subject.

For the sake of this discussion, let’s divide pain into two main categories: acute and chronic.

Acute pain is the body’s alarm system—an urgent signal to stop harmful behavior or seek help. It is self-limited, typically lasting less than three months, and it resolves once the injury heals. That is all we will cover here, because this blog is about the other kind—the one that overstays its welcome.

Chronic pain lasts beyond three months. It is no longer part of the body’s protective alarm system. Instead, it becomes a destructive presence—robbing us of health, happiness, and quality of life. Chronic pain damages nerves, blood vessels, and organs. It fuels inflammation and suppresses the immune system. It affects more than 166 million Americans—more than the number of people living with cancer, diabetes, and heart disease combined.

Why Managing Pain Matters

The toll of chronic pain is overwhelming. It disrupts sleep, work, appetite, and focus. It strains relationships—both social and intimate—and can erode independence, making daily living tasks difficult or impossible. The physical burden is compounded by emotional suffering: depression, anxiety, fear, and anger. Over time, it can chip away at self-esteem, break down relationships, and even dissolve marriages.

How Chronic Pain Changes the Brain

Chronic pain is not just a symptom—it becomes part of the nervous system. Pain is processed in brain regions tied to memory, emotion, and behavior. Over time, it can create lasting changes in the central nervous system. It is also associated with higher rates of alcohol and drug misuse, divorce, and suicide. While some substances may temporarily dull pain, they also dull function, delay healing, and risk dependence. Suppression is not the same as recovery.

Evaluation

Successful treatment starts with evaluating the whole person, aiming to both reduce pain and restore function.

One useful system is LOCATES:

• Location of the pain

• Other associated symptoms

• Character of the pain

• Aggravating or alleviating factors

• Timing of the pain

• Environment in which it occurs

• Severity of the pain

Treatment Approaches

Physical & Rehabilitation Therapies

• Modulation, exercise, hydrotherapy, heat/cold therapy

• Myofascial release, casts/splints

• TENS (transcutaneous electrical nerve stimulation) units

  
  

Mind-Body & Psychosocial Therapies

• Relaxation techniques, mindfulness, biofeedback

• Behavioral modification, hypnotherapy

• Acupuncture, meditation, breathing exercises

• Tai chi, yoga

  
  

Additional OptionsWhile not a full list, there are also medical interventions such as trigger point injections, spinal cord stimulators, and more—each to be considered based on the patient’s needs and goals.

Conclusion

Pain begins as a messenger—an alarm to protect us. But when that alarm is rewired into an endless signal, it becomes an illness in its own right. The good news is that treatment is not limited to one path. Healing may require a combination of physical, emotional, and interventional approaches.

At Howard’s House, we are here to help you find your starting point. If you have questions, Ask Dr. Howard.

Once, you spoke to guard my flesh,

But now your voice will not refresh.

I will not bow, I will not bend,

This is not where my story ends.

With patient steps, I’ll seek release—

Till I reclaim my rightful peace.

—Dr. Howard Friedman MD

Board-Certified | Internal Medicine | Veteran | U.S. Army Medical Corps

Founder of Howard’s House of Medicine (HHOM LLC)

https://www.hhomllc.com

Frequently Asked Questions:

Q: What is the difference between acute pain and chronic pain?

A: Acute pain is your body’s warning system—it signals that something is wrong and usually fades once the injury heals, often within three months. Chronic pain persists beyond that point, becoming a condition in its own right. It can damage nerves, disrupt sleep, fuel inflammation, and diminish overall quality of life.

Q: Can chronic pain really change the brain?

A: Yes. Chronic pain affects brain areas linked to memory, emotion, and behavior. Over time, it can rewire the nervous system, making pain more persistent and harder to treat. This can also increase the risk of depression, anxiety, and substance misuse.

Q: What are some effective ways to manage chronic pain?

A: Management is often most effective when it combines multiple approaches—physical therapies like exercise and heat/cold treatment, mind-body practices such as mindfulness and yoga, and medical interventions like trigger point injections or TENS units. The goal is to both reduce pain and restore function, tailoring treatment to the individual’s needs.