Information & Resources

Find information and resources to help manage your pain.

Get Help & Support

Find the tools you need to
help you manage your pain.

Get Involved

Help make a real difference to people
in the UK living with chronic pain.

About Us

Find out about Pain Concern and how
we can help you.

New Classification for Chronic Pain

The World Health Orga­ni­za­tion (WHO) has updat­ed the Inter­na­tion­al Clas­si­fi­ca­tion of Dis­eases (ICD-11). For the first time, they have includ­ed chron­ic pain and pro­vid­ed spe­cif­ic pain diag­noses. Under the new sys­tem, chron­ic pain is clas­si­fied as either chron­ic pri­ma­ry pain or chron­ic sec­ondary pain.

Chron­ic pri­ma­ry pain is defined as pain that per­sists for longer than three months and is asso­ci­at­ed with sig­nif­i­cant emo­tion­al dis­tress or func­tion­al dis­abil­i­ty and that can­not be explained by anoth­er chron­ic con­di­tion. This new def­i­n­i­tion applies to chron­ic pain syn­dromes that are best con­ceived as health con­di­tions in their own right.  Exam­ples of chron­ic pri­ma­ry pain con­di­tions include fibromyal­gia, com­plex region­al pain syn­drome, chron­ic migraine, irri­ta­ble bow­el syn­drome and non-spe­cif­ic low-back pain.

Chron­ic sec­ondary pain syn­dromes are defined as pain that may ini­tial­ly be regard­ed as a symp­tom of oth­er dis­eases hav­ing said dis­ease being the under­ly­ing cause. How­ev­er, a diag­no­sis of chron­ic sec­ondary pain marks the stage when the chron­ic pain becomes a prob­lem in its own right. In many cas­es, the chron­ic pain may con­tin­ue beyond suc­cess­ful treat­ment of the ini­tial cause; in such cas­es, the pain diag­no­sis will remain, even after the diag­no­sis of the under­ly­ing dis­ease is no longer rel­e­vant. Exam­ples of chron­ic sec­ondary pain are chron­ic pain relat­ed to can­cer, surgery, injury, inter­nal dis­ease, dis­ease in the mus­cles, bones or joints, headaches or nerve damage.

More detail can be found in the online edi­tion of Pain: The Jour­nal of the Inter­na­tion­al Asso­ci­a­tion for the Study of Pain:


Very good infor­ma­tion and not just oh you will have to put up with that pa n espe­cial­ly after hav­ing such large surgeries

Good to final­ly take this sub­ject seri­ous­ly. I have no doubt about the link between neg­a­tive emo­tions as the cause of chron­ic phys­i­cal pain symp­toms. This deserves its own branch of diag­nos­tics, ther­a­pies, coun­sel­ing, and med­i­cine. So well done tak­ing this prob­lem that afflicts so many and bring­ing it into the light.., Peo­ple have the right to not be made to feel like they are nuts, being made to feel as if they should just go away, because this pain is a very real symp­tom of long term chron­ic emo­tion­al stress caus­ing phys­i­cal syn­dromes to man­i­fest, thus the new offi­cial catago­ry of “chron­ic pri­ma­ry pain” is much appre­ci­at­ed. Thank you.

I have been suf­fer­ing chron­ic pain for years I’ve also been to a pain clin­ic and a pain con­sul­tant. A few weeks ago I went to see my GP after hav­ing a major pain flare up in my ribs my waist and in my legs. The GP con­cerned said “you will have to live with the pain I’m not pre­scrib­ing painkillers” I nev­er even asked for painkillers. Then she said can I help you with any­thing else at which point I said no , thank you for see­ing me.
Some days I can bare­ly walk 🥺
I think some doc­tors need to be edu­cat­ed. It felt like I’ve been mocked by the doctor.

I have been in chron­ic pain since age 11 since I start­ed men­stru­a­tion I had to wait 28 yrs till 1999 for a diag­no­sis of Endometrio­sis & only got then due to ovar­i­an tor­sion due to cal­ci­fied endometri­omas. I got a diag­no­sis ear­li­er that year of CFS/FMS. In my expe­ri­ence all pain is sec­ondary. I haven’t had a pain in my life that I can’t attribute to a under­ly­ing issue either Endometrio­sis Arthri­tis, UTI’s, Fibroids. When peo­ple have to still wait an aver­age of 1o yrs for diag­no­sis for Endometrio­sis thats a long time to be labelled with­pri­ma­ry chron­ic pain.

This is a step in the right direc­tion. How­ev­er, with the lat­est guide­lines, GPs in par­tic­u­lar could feel dis­em­pow­ered with dwin­dling ther­a­peu­tic options avail­able for man­ag­ing chron­ic pain. Advise to refer to phys­i­cal and psy­cho­log­i­cal ser­vices is all well and good but these ser­vices are not always eas­i­ly available.
The def­i­n­i­tion of pri­ma­ry chron­ic pain “can­not be explained by anoth­er chron­ic con­di­tion” is use­ful BUT, not detract­ing from the psy­choso­cial aspect of chron­ic pain man­age­ment, as doc­tors we must con­tin­ue to be vig­i­lant. Aware­ness of the more unusu­al caus­es of chron­ic pain allows treat­ment options for patients who would oth­er­wise be bur­dened by their pain.

Comments are closed.