Chronic Pain: The 20 Most Painful Conditions

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Pain is an uncomfortable feeling that tells you something is wrong. People feel pain from time to time, but chronic pain is different. It’s a type of pain that is ongoing and typically lasts longer than six months.

What is chronic pain?

Pain is a signal from the nervous system to let the individual know that something is wrong in the body. Pain may be dull or sharp. Pain can take many forms, and be localized to a part of the body or appear to come from all over. Pain involves a complex interaction between specialized nerves, the brain, and the spinal cord.

Both acute and chronic pain are known. Acute pain lasts less than 3 to 6 months. Usually, it’s directly related to soft tissue damage like a  cut, a wound, or a sprained ankle. Acute pain is characterized by its severe or sharp quality. On the other hand, chronic pain lasts more than 6 months. It’s usually associated with an underlying condition, such as arthritis, and is typically less intense, though flare-ups are very common.

Chronic pain can be debilitating and affects a person’s ability to perform activities of daily living. The following includes some of the most painful conditions.

Image Credit: Monika Wisniewska / Shutterstock
Image Credit: Monika Wisniewska / Shutterstock

20 most painful conditions

Cluster headaches

A cluster headache is a rare type of headache, known for its extreme intensity and a pattern of occurring in “clusters”. Autonomic symptoms such as agitation and restlessness accompany the headache. The pain is so severe that it can affect a person’s ability to perform daily activities. The pain is often preceded by a migraine-like aura and followed by severe pain located quite often at one side of the head. The pain peaks over the next 5 to 10 minutes and intensifies for the next three hours or so. It goes away but may come back up to eight times a day.

Herpes zoster or shingles

Herpes zoster or shingles is a viral disease that affects the nerves. It leads to sharp, shooting, and burning pain, accompanied by itching, tingling, rash, and fluid-filled blisters. The varicella-zoster virus (VZV), the same virus that causes chicken pox, can continue to live in the nerve cells after an attack of chickenpox. It may be reactivated on occasion, to cause shingles in some people. It is among the most painful conditions known. Age and weakened immunity predispose to activation.

Raised red bumps and blisters caused by shingles on skin - Image Credit: Adtapon Duangnim / Shutterstock
Raised red bumps and blisters caused by shingles on skin - Image Credit: Adtapon Duangnim / Shutterstock

Frozen Shoulder

A frozen shoulder (adhesive capsulitis) is a condition that causes stiffness and pain on the shoulder joint. The signs and symptoms include severe pain, limited range of motion, and stiff shoulder joint. The symptoms begin gradually and worsen over time. It typically resolves within one to three years.

X-ray film of primary frozen shoulder or adhesive capsulitis of Asian female patient. Image Credit: PK289 / Shutterstock
X-ray film of primary frozen shoulder or adhesive capsulitis of Asian female patient. Image Credit: PK289 / Shutterstock

Bone fracture

A fractured bone pertains to a crack or a break in the bone. It can occur in any bone in the body and causes severe pain and inflammation. The severity of a fracture depends on the force that caused the break. Hence, there are many types of fractures – stable, open, transverse, oblique, and comminuted. The pain associated with a fracture is severe and may lead to limitation of movement of the affected area.

Complex regional pain syndrome (CRPS)

Complex regional pain syndrome (CRPS) is a chronic pain condition that affects one limb (foot, hand, leg or arm) after an injury. It usually stems from damage or malfunction of the peripheral and central nervous system. The pain is described as burning, “pins and needles” or squeezing sensation. Aside from the severe pain, other symptoms include changes in skin color, temperature, or swelling of the affected limb.

Heart attack

Heart attack or myocardial infarction (MI) is a potentially fatal condition in which a part of the heart loses its blood supply. It is one of the leading causes of death across the globe. The prevalence of MI approaches three million people worldwide with more than one million deaths in the United States each year. When the blood flow to the heart muscles become blocked, the heart is starved of oxygen and the cells die. The pain of a heart attack is described as crushing chest pain, a feeling of pressure or tightness in the chest, or aching in the chest that spreads to the arms, neck, and jaw.

Slipped disc

Pelvic intervertebral disc prolapse or slipped disc is a condition in which the soft cushion of tissue present between adjacent spinal bones pushes out. A slipped disc can irritate nearby nerves, resulting in pain and numbness or weakness in an arm or leg. The pain worsens after sitting or standing, walking short distances, and with certain movements. The pain is more severe at night, and is    accompanied by burning, tingling, and aching sensations on the affected area.

Slipped disc illustration. Image Credit: corbac40 / Shutterstock
Slipped disc illustration. Image Credit: corbac40 / Shutterstock

Sickle cell disease

Sickle cell disease is a group of blood disorders that affects the structure of hemoglobin, the oxygen-carrying component of the blood. People with this disease have an abnormal form of hemoglobin called hemoglobin S, which alters the shape of red blood cells into a sickle or crescent. A major symptom of sickle cell disease is periodic episodes of pain, called crises. The pain ensues when the sickle-shaped RBCs gather together inside the small blood vessels in the abdomen, joints, and chest, and block the blood flow. In some cases, bone pain can also occur.


Arthritis is a condition characterized by inflammation of one or more of the joints in the body. The main symptoms include pain and stiffness, which affect mobility and worsen with age. The most common types of arthritis include osteoarthritis, rheumatoid arthritis, and gouty arthritis. Arthritis pain, called arthralgia, can feel like a dull ache or a burning sensation.

Migraine headache

Migraine is a recurring type of headache that causes moderate to severe pain of a pulsing or throbbing character. Typically the pain occurs on one side of the head and is accompanied by nausea, vomiting, and extreme sensitivity to sound and light. The pain can last for hours or even days, with pain described as so severe it can be debilitating.


Sciatica refers to the pain that radiates along the path of the sciatic nerve. The sciatic nerve is the longest nerve in the body, running from the hips to the feet. When the nerve is pressed or irritated, it can lead to pain. The pain radiates from the lower lumbar spine to the buttock and down the back of the leg. The pain can be moderate to severe, accompanied by tingling, weakness, and numbness on the affected leg. Severe sciatica can be debilitating, preventing movement.

Sciatica diagram with vertebrae, disks and nerves - Image Credit: Designua / Shutterstock
Sciatica diagram with vertebrae, disks and nerves - Image Credit: Designua / Shutterstock

Kidney stones

Kidney stones form when there is a decrease in urine volume or an excess of stone-forming components in the urine. A kidney stone may not cause any symptoms unless it moves around within the kidney and passes down in the ureter. Severe pain may then occur in the side and back, below the ribs, and can radiate to the lower abdomen and groin area.

Human Kidney stones medical illustration. Image Credit: Lightspring / Shutterstock
Human Kidney stones medical illustration. Image Credit: Lightspring / Shutterstock


Appendicitis refers to the inflammation of the appendix, a small and thin pouch connected to the colon. It can become inflamed and lead to severe pain. In severe cases, an inflamed appendix may rupture, leading to peritonitis, a serious infection of the inner lining of the abdomen. The most common symptom of appendicitis is pain that begins near the umbilical area and moves down into the right side of the lower abdomen. It gets worse in a matter of hours, but twinges of sharp pain even before that, when moving around or taking deep breaths.

Acute appendicitis, 3D illustration showing inflammed appendix on the cecum. Image Credit: Kateryna Kon / Shutterstock
Acute appendicitis, 3D illustration showing inflammed appendix on the cecum. Image Credit: Kateryna Kon / Shutterstock

Trigeminal neuralgia

Trigeminal neuralgia or tic douloureux is a chronic pain condition that affects the trigeminal or fifth cranial nerve. It is one of the most painful conditions known. It causes extreme, sporadic and sudden burning pain or electric shock sensation in the face, including the eyes, lips, scalp, nose, upper jaw, forehead, and lower jaw.


Endometriosis is a painful condition wherein the tissue that normally lines the endometrium grows outside the uterus. It can grow in the fallopian tubes, ovaries, and the tissue lining the pelvis. The pain occurs before, during, or after menstruation. Some women may feel disabling severe pain. It can also happen during or after sexual intercourse, urination, or bowel movements.

Endometriosis. Schematic drawing of various types of endometriosis disease. Image Credit: Designua / Shutterstock
Endometriosis. Schematic drawing of various types of endometriosis disease. Image Credit: Designua / Shutterstock


Gout is a form of arthritis that develops in some people with high levels of uric acid in the blood. It causes intense pain, stiffness, and swelling in a joint, usually the joint in the big toe. The pain is described as if the foot is on fire.

Acute pancreatitis

Acute pancreatitis is the sudden inflammation of the pancreas, which can be mild or potentially fatal. The main causes of acute pancreatitis are gallstones and alcohol abuse. The predominant symptom is severe abdominal pain. The symptoms may include upper abdominal pain that radiates to the back and becomes worse after eating, accompanied by fever, nausea, vomiting, rapid pulse, and tenderness of the abdomen.

Stomach or peptic ulcer

Peptic ulcers are open sores that form in the lining inside the stomach. Stomach pain is the most common symptom. It may occur anywhere from the belly button to the breastbone. The pain may last briefly or can last for hours, which typically occurs when the stomach is empty or right after eating.


Fibromyalgia is a condition that causes pain all over the body (widespread musculoskeletal pain). It may be accompanied by fatigue, sleep problems, and emotional or mental distress. Patients with the condition may be more sensitive to pain than others. Studies have linked fibromyalgia to how the body amplifies painful sensations due to the brain’s ability to process pain signals. Usually, fibromyalgia occurs after physical trauma, infection, psychological stress or surgery.

Post-surgical pain

Pain occurs after surgery due to impaired skin integrity. But, the severity and characteristic of pain depend on the type of surgery performed.


Further Reading

Last Updated: Jun 14, 2019

Angela Betsaida B. Laguipo

Written by

Angela Betsaida B. Laguipo

Angela is a nurse by profession and a writer by heart. She graduated with honors (Cum Laude) for her Bachelor of Nursing degree at the University of Baguio, Philippines. She is currently completing her Master's Degree where she specialized in Maternal and Child Nursing and worked as a clinical instructor and educator in the School of Nursing at the University of Baguio.


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  1. Hum
    Helen Richardson Helen Richardson Australia says:

    What about central pain syndrome? Man I have several of the conditions list but nothing hurts like central pain syndrome... 24 /7 electric shock and pain felt instead of various sensations such as sunlight on skin and even vibrations cause pain. This is on a background pain scoring 10+ out of 10.
    Former nurse and science writer now a very experienced pain patient

  2. Deb Dopson Deb Dopson Australia says:

    Dercums Disease is in the top 10 most rare and painful diseases. But due to being so rare, you don't often see it in any list. There is hardly any awareness for it. It is like having cancer, lupus, fibromyalgia and some, all at once. But instead of killing you quickly you have an incredibly slow and painful death, could take 40 years, until you die of heart failure. And drs tell you sorry I can't help you, you just have to deal with it. One specialist in the world for it. A one in a million disease. Any awareness could be life changing for us. Love n light oxo

    • Lisa Gallahar Lisa Gallahar United States says:

      Hi Deb:  you’re right Deb, if it’s rare, it doesn’t seem to make the cut.  I have Interstitial Cystitis (Painful Bladder Disease). Four years to finally get a diagnosis. It is high on the list of suicidal diseases.  But hey, two of my others are on the list; kidney stones (another rare disease Medullary Sponge Kidney) and sciatica.

    • Lisa Gallahar Lisa Gallahar United States says:

      I don’t know how I could forget this, I also had a heart attack in 2010.

    • Robert Davis Robert Davis United States says:

      I have Dercums Disease, it is a far worse pain than many on this list. I have Fibromyalgia, it is a walk in the park compared to DD. I would rather have a kidney stones in both kidneys at the same time than have DD. Like you said very rare condition, only 1 out of 200,000 have it.

    • Carmen Garcia Carmen Garcia United States says:

      I have Dercum’s, fibromyalgia, and I’ve also had trigeminal nerve attacks in my face. For years, I thought my main problem was Dercum’s. Unfortunately, it’s not. I have a condition called him MCTD multi connective tissue disorder. MCTD is what caused my bladder to quit suddenly, and my hands just start dropping things which are clear signs of MS. I have arthritis, lupus symptoms and tested positive for RA twice and suffered with leg pain for 25 years until finally diagnosed with MCTD. If you have Dercums, Fibro, etc. I would highly suggest you go to rheumatologist and have them test you for MCTD. It will save you a lot of heartache and pain that I went through for 25 years. There’s a test your GP can use, but I would recommend going to the rheumatologist. My MCTD test with my GP was negative. The one my rheumatologist did which isn’t just a straight up test, but involves them looking at levels etc. on a case by case basis, is the one you need to take. My leg pain that haa been constant for two decades (which led me to have three unnecessary back surgeries that ruined my back to the point I was given disability at 49 years oldj) turned out to be Myleoitis, which is one of the big branches of MCTD. I’m not commenting here on the article. I think it’s a terrific selection, although I do believe that the over arching condition of Durcums and Fibro are varying levels of MCTD.

  3. Rees Andrew Rees Andrew United States says:

    Vigorous Achalasia w/ Dysphagia and Nutcracker Esophagus has to be in the top 5 most brutal and painful diseases.  Imagine a heart attack times four.  Esophageal Spasm pain is on a different level of misery as it can last for hours.  You also can’t swallow, and if you do it’s extremely painful.  But it’s a “rare disease”, so no one cares except for the people that have to live with evil disease that rarely gets better with surgery, balloon dilation, Botox injections, meds, etc.

    • Leah Mazdra Leah Mazdra United States says:

      100% agree with this. I underwent a Heller Myotomy in 2018, and since have had 3 dilations of my esophagus, all of them failing. This disease was made by the devil himself. The feeling of everything being stuck in your chest all the time, its debilitating. Constantly feels like choking, which causes my mouth to salivate, which I then have to swallow, and the saliva subsequently gets stuck halfway down my esophagus, and the process repeats. I'm currently looking at my second Heller Myotomy at 21, and had my first done at 18. This disease.... it robs you of your life. Slowly becoming a skeleton because you don't want to eat anything because you know it'll take at least 15 min for a single bite to go down. So many impairments with cognition because of lack of nutrients, its embarrassing to eat in public, being constantly hungry... the list goes on. The worst though is having an insane amount of pressure in your chest from the food, but you literally cannot do anything to get it down, except swallow liquids, which only works half the time. It is brutal and more people need to know about how intensely it can impact someone's life.

      Also, I am so sorry for the long message, today has been a really bad day for my achalasia and its been causing me a lot of frustration. Along with the fact that I may need surgery in the upcoming future... it's really hard.

      • Carmen Garcia Carmen Garcia United States says:

        I had forgotten about esophageal spasms! I’ve never had one because on top of my other pain I think it was just flat out kill me and I don’t think I have much care. But I have a friend that suffers with that and her heart quit because her pain level was so high. she coded and the second she regained consciousness, the first thing she did was try to hit the dr with a lunch tray. She was that pissed at being alive. I kid you not… I still laugh about that to this day. She is gone now, but damned if she had didn’t do whatever single one of us has wanted to do to a doctor every now and then.

  4. Katherine Linde Katherine Linde United States says:

    As someone who fights this beast everyday, you should really try and educate people better than a shoddy overview. What about movement diseases that go with it like Dystonia can be added to the already unrelenting pain. It interferes with the hypocampus, making short term memory very patchy. It causes neuropathy, autoimmune disorders, failure to properly regulate temperature and far more than what was represented. Honestly, I feel offended by the very brief ‘synopsis.’ It’s higher in the pain scale than everything placed above it. I had birth naturally and I’d rather that everyday than this. I hope you do more thorough research next time. Articles like this minimize the disease, when what we need is more awareness.

  5. Britt N Britt N United States says:

    Where did you obtain the information about endometriosis? It is not the lining of the uterus (endometrium) but instead is a tissue similar to it. It has been found and can grow anywhere throughout the body.

    • Brittney Purdon Brittney Purdon Canada says:

      I was just thinking the same thing. I expected better accurate information about what endometriosis is but it just goes to show how little factual information is available.

      No it's not a period disease. No it's not just during your cycle. And no it's not only on reproductive parts.

      We really need to seperate periods from endometriosis. Self creating estrogen lesions don't just stay in one area.

  6. bejdn clofh bejdn clofh Australia says:

    The sources are just info on each disease. What kind of studies were done to mention how painful each disease is to decide on these being the top 20?

  7. Melanie Sayles-Hawkins Melanie Sayles-Hawkins United States says:

    I have so many of these☹️ CRPS, Fibromylgia, Sciatica and fusion left me with numb lower legs. Trigeminal neuralgia, Immune mediated, inflammatory, dymyleinating neuropathy confirmed with biopsy and labs. Fibro, Endometriosis. radicuopathy, chronic appendicitis.. yes chronic. Took 12 years to figure it out. Didn’t take me serious until I said I was gonna jump off a bridge…  I’m only 47. Most started at 20. And now I lay here with Covid and feel like I’m dying. Being sick flares all that up. And I work full time (from home thank god) as a RN.

The opinions expressed here are the views of the writer and do not necessarily reflect the views and opinions of News Medical.
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