Manage Chronic Pain
by: Amanda Chua, TCM Physician, Regis Wellness
Last updated: November 29, 2025
Chronic pain affects approximately 20.4% of all adults, making it an extremely common condition, with prevalence increasing with age. 7.4% of adults had chronic pain so severe that it limited their ability to work as well as their quality of life.
Chronic Pain in Singapore
In 2009, the prevalence of chronic pain in Singapore was reported to be 8.7%. Considering our ageing population as well as global trends, it is likely that this number has risen significantly in today’s Singapore.
Furthermore, with the recent COVID-19 pandemic related lockdowns alongside the rise in popularity of work from home or hybrid work arrangements, more Singaporeans have found themselves experiencing chronic pain due to prolonged periods of sitting and physical inactivity.
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What is Chronic Pain?
Chronic pain is defined as pain that persists over a period that is longer than three months. The pain can come and go or be there all the time, in any parts of your body. Chronic pains can appear anywhere in the body and exist in many different forms. It is a very common problem and is one of the most common reasons for patients to seek medical care.
Chronic pains could be caused by chronic illnesses or underlying health conditions, or in some cases, could be unrelated to any injuries or physical illnesses. These types of chronic pains are sometimes referred to as psychogenic pain or psychosomatic pain. These pains are caused by psychological factors such as stress, anxiety and depression.
Types of Chronic Pain
As mentioned earlier, chronic pains can come in many forms. These can include:
- Joint pain
- Back pain
- Neck pain
- Cancer pain
- Headaches
- Testicular pain
- Muscle pain
- Neurogenic pain
It is important to know what type of chronic pain you have in order to treat and manage it effectively. For some patients, it is possible to have more than one type of chronic pain.
Symptoms of Chronic Pain
Symptoms of chronic pain can differ amongst individuals, depending on the cause of their pain.
Symptoms can include:
- Joint pain
- Muscle aches
- Burning pain
- Fatigue
- Loss of sleep, decrease in sleep quantity or quality
- Loss of stamina and flexibility, due to decreased physical activity
- Psychological problems, including depression, anxiety, and irritability
Risk Factors of Chronic Pain
Some groups of people are more likely to develop chronic pain. Risk factors of chronic pain include:
- Chronic conditions. Chronic conditions such as arthritis have chronic pain as one of its symptoms.
- Depression. While it is unclear why, experts suggest that depression alters how your brain receives and interprets messages from your nervous system.
- Smoking. While the reason for the link is unclear, smoking has been heavily associated with chronic pain disorders.
- Obesity. Obesity has been heavily associated with chronic pain.
- Sex. Women are naturally more sensitive to pain.
- Age. Those above 65 are at greater risk of developing chronic pain due to their susceptibility to health conditions that can cause chronic pain.
Common causes of chronic pain
Chronic pain can be caused by many different reasons but is typically the symptom of other health conditions that you may be suffering from. Chronic conditions, in particular, tend to cause chronic pain in patients. Common chronic conditions that can result in chronic pain include:
- Arthritis. Arthritis can cause chronic joint pain. Approximately half of adults with arthritis experience chronic joint pain.
- Migraine. Chronic migraines can cause chronic headaches. In severe cases, the pain can radiate to your neck and shoulders.
- Slipped disc. A slipped disc can put pressure on your nerves, causing chronic back pain.
- Gout. Chronic gout can cause damage to your joints, resulting in chronic pain.
- Sciatica. Sciatica pain can be chronic, persisting for more than 8 weeks and is unresponsive to self-management.
Complications of Chronic Pain
Complications of chronic pain can be rather severe as chronic pain can worsen quickly if left untreated. It can also be very difficult to treat and manage. Complications may include:
- A loss in quality of life - Chronic pain undeniably affects your quality of life because it inhibits your ability to carry out everyday tasks. Even activities that you used to enjoy can become extremely painful to go through if you are suffering from chronic pain.
- Depression - Chronic pain can be very stressful to deal with, affecting your sleep cycles and causing your body to be more sensitive to pain. This can lead to depression if not handled well.
- Anxiety - Chronic pain can cause you to be constantly tensed and stressed, being easily irritated. This can lead to anxiety if not managed well.
- Substance abuse - Chronic pain may be so severe that you seek alternative options that can distract you from the pain. This includes abusing substances which can lead to very severe health consequences.
Preventing Carpal Tunnel Syndrome
While there are no known prevention methods for carpal tunnel syndrome, there are ways in which you can minimise stress on your hands and wrists while you carry out your daily activities.
These include:
- Reducing your force and relaxing your grip
- Adopt good form and posture
- Use a mouse that is comfortable for your wrist
- Keeping your hands warm
Treatment Methods for Chronic Pain
Due to the multitude of reasons behind chronic pain, the treatment methods for chronic pain will differ greatly depending on your type of pain and will as the severity of your condition.
NSAIDs (nonsteroidal anti-inflammatory drugs)
NSAIDs are the most common type of pain-relieving drugs. Examples of NSAIDs include aspirin, ibuprofen, and naproxen. These drugs help to relieve pain caused by muscle aches and stiffness. It also reduces inflammation in the body. These can be consumed orally.
Topical Pain-relieving Creams
Topical painkillers, or analgesics can be sprayed on, applied on, or put on as patches onto the skin over the affected muscles or joints. This can be used for pain caused by arthritis.
Muscle Relaxants
Muscle relaxants can be prescribed by a doctor if the usual over-the-counter drugs are unable to relieve your pain.
Trigger Point Injections
Trigger points, commonly referred to as muscle knots, cause pain as the affected muscles are unable to relax. A local anaesthetic which sometimes can include a steroid is injected into the trigger point, forcing it to relax and therefore alleviate pain.
Botox
OnabotulinumtoxinA (Botox) blocks signals from the nerves to the brain. While it is more commonly known as part of a cosmetic procedure that prevents wrinkles, Botox injections can also be used to alleviate pain for a period of up to three months. However, it is only used when traditional pain treatment methods have been ineffective.
Dry Needling
Dry needling is a form of therapy that uses thin, sterile needles to penetrate the skin, targeting trigger points in your muscle and tissue. In doing so, the trigger points are released, relieving muscle tension, pain and muscle spasms.
Deep Tissue Massage
A deep tissue massage is a form of massage therapy that targets the deeper layers of your muscle to relieve and treat muscle and tendon pain, stiffness and injuries. Deep tissue massage also stimulates blood circulation and promotes your body’s recovery process.
Extracorporeal Shockwave Therapy (ESWT)
ESWT is a non-invasive, non-surgical, and risk-free treatment that uses shockwaves to target your damaged muscle, tendons, ligaments, or joints to relieve pain, reduce inflammation, and stimulate recovery.
Magnetic Resonance Therapy
Magnetic resonance therapy is a non-invasive, non-surgical, and risk-free treatment that uses three different electromagnetic fields that transfer energy into your damaged cells to stimulate your cell regeneration process. In doing so, cartilage and ligament regeneration is stimulated and reactivated, alleviating chronic pain and discomfort.
Psychological Treatment
Some patients may experience chronic pain that is triggered by stress or certain feelings such as anger, anxiety or sadness. Psychological problems such as anxiety and depression, or a lack of sleep, can all contribute to aggravating symptoms of pain.
Physiotherapy for Chronic Pain Management
Physiotherapy plays a central role in managing chronic pain by reducing discomfort, improving mobility, and strengthening the body to better tolerate daily activities.
While many individuals instinctively choose rest when in pain, excessive rest can actually worsen stiffness, weaken muscles, and intensify symptoms. A targeted physiotherapy program helps break this cycle by restoring movement, retraining muscles, and addressing the underlying contributors to persistent pain.
Through a combination of hands-on therapy, corrective exercises, and pain-relief modalities, physiotherapists design personalised treatment plans that reduce flare-ups, improve function, and enhance long-term quality of life.
Chronic pain physiotherapy typically progresses through the following treatment focuses:
- Pain Reduction & Symptom Relief Phase
- Hot and Cold Therapy to reduce inflammation, ease stiffness, and provide immediate relief during flare-ups
- Ultrasound Therapy to promote tissue healing and reduce deep-seated inflammation
- TENS Therapy to block pain signals and stimulate endorphin release for natural pain relief
- Manual therapy techniques including massage, joint mobilisation, myofascial release, and soft-tissue therapy to reduce muscle tension and improve circulation
- Gentle range of motion exercises to prevent joint stiffness and maintain mobility
- Corrective Movement & Strengthening Phase
- Strengthening exercises tailored to stabilise affected areas and reduce strain on overworked muscles
- Posture correction to alleviate stress on the spine, neck, shoulders, or other pain-sensitive regions
- Flexibility training to lengthen tight muscles and improve balanced movement
- Core and functional strengthening to support everyday tasks and reduce the risk of flare-ups
- Gait and movement retraining when pain is related to poor biomechanics or compensatory patterns
- Long-Term Management, Conditioning & Prevention
- Personalised strength and conditioning programs to build resilience and improve overall physical capacity
- Education on pain management strategies, including pacing, load management, and activity modification
- Home exercise programs designed to maintain improvements between sessions
- Guidance on ergonomics and daily movement habits to minimise stress on vulnerable joints and muscles
- Ongoing monitoring and adjustment of treatment plans based on progress and symptom patterns
By combining targeted exercises, hands-on treatments, and personalised guidance, physiotherapy empowers individuals to manage chronic pain more effectively, improve movement, and reduce the likelihood of future flare-ups.
TCM for Chronic Pain Management
Traditional Chinese Medicine (TCM) offers a holistic and natural approach to chronic pain by addressing not only the symptoms but also the underlying imbalances that contribute to long-term discomfort. In TCM, chronic pain is often linked to stagnation of Qi and blood, blockages along the meridians, or deficiencies that weaken the body’s ability to recover.
TCM treatments aim to restore smooth energy flow, reduce inflammation, support tissue healing, and strengthen the body’s resilience. Treatment duration may vary depending on the chronicity and severity of symptoms, but many patients experience improved comfort, mobility, and overall wellbeing through a personalised program.
TCM chronic pain treatment typically includes the following focuses:
- Pain Relief, Circulation & Qi Regulation
- Acupuncture helps regulate Qi and blood flow, reduce inflammation, and relieve pain by targeting specific meridian points associated with the painful region.
- Electro-acupuncture may be used when appropriate to enhance stimulation, support nerve function, and provide stronger pain-relieving effects.
- Cupping therapy increases circulation, reduces muscle tension, and helps clear stagnation that commonly contributes to chronic pain.
- Internal Healing, Strengthening & Balance Restoration
- TCM herbal medicine is prescribed based on individual diagnosis to nourish deficiencies, reduce inflammation, calm nerve irritation, and strengthen Qi and blood. Herbal formulas may support conditions such as joint pain, muscular tightness, nerve-related discomfort, or fatigue-linked pain.
- Certain herbs or topical applications may be used to warm the channels, promote healing, and relieve persistent tension in affected areas.
- Dietary adjustments based on TCM principles may be recommended to support internal balance, reduce inflammation, and nourish the body’s healing systems.
- Ongoing Maintenance & Prevention of Flare-Ups
- Maintenance acupuncture sessions may be recommended at spaced intervals to prevent recurrence and maintain smoother Qi flow.
- Our TCM practitioner may suggest lifestyle and self-care practices, such as gentle movement, stress reduction techniques, and habits that reduce strain or trigger pain cycles.
- For chronic conditions, combining TCM with physiotherapy or functional strengthening can support long-term pain control and improved quality of life.
By working on both the physical and internal imbalances associated with chronic pain, TCM provides a comprehensive and natural pathway toward long-term relief, improved mobility, and enhanced overall wellbeing.
Manage Chronic Pain with Regis Wellness
Reviewed by Doctor xxx and Physiotherapist xxx
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