Pain is an uncomfortable feeling that can take any form, either physical, mental, or emotional. Physical pain manifests as headaches, tiredness, aching muscles, swelling, and redness in your joints. 

Most physical pains go away after a few days but if a pain persists and stays longer than 3 months, it is referred to as chronic pain. 

Chronic pain may last for about 3 to 6 months, disrupt your routine activities, and result in lower productivity at work and home. 

Chronic pain not only takes a toll on your physical health but also on your emotional and mental health. Identifying the types, causes, symptoms, and treatment methods can help you beat chronic pain at the earliest. 

When chronic pain remains for a longer time even after an illness or a healed injury, it is known as chronic pain syndrome (CPS). It is characterized by pain that lasts longer than 6 months and is mostly associated with anger, anxiety, depression, loss of sexual desire, and disability. 

Most often, while chronic pain and CPS are used interchangeably and treated the same, they can be different in their forms and symptoms.

Who is More Likely to Suffer From Chronic Pain?

Anyone can suffer from chronic pain. However, it is more common among women and older adults. Athletes and sportsmen also suffer from chronic pain. 

The risk of this type of pain is sometimes higher in people who are obese/overweight (a disorder involving excessive body fat). Instances of chronic pain are observed less in children. 

Types and Causes of Chronic Pain

1. Lower back pain is a common disorder that involves the muscles, nerves, and bones in your back. It is generally a result of an injury in your spine, physical stress, wrong posture, or a sprain.

2. Arthritis pain is a combined result of joint pains and stiffness caused by the swelling and tenderness of one or more of your joints (a condition called arthritis). This pain can be a feeling of a dull ache or a burning sensation, which often worsens due to age. The most common types of arthritis are osteoarthritis and rheumatoid arthritis.

a) Osteoarthritis: It is a type of arthritis that affects the joints in your hands, knees, hips, and spine. Osteoarthritis occurs when cartilages degenerate gradually and progressively. 

  • Cartilage is a soft, flexible, rubbery substance that allows your joints to move easily against each other.

  • When the cartilages begin to disintegrate or degenerate, the bone surfaces become rough, resulting in pain and inflammation around the joints.

Symptoms include stiffness, loss of flexibility, swelling, and increased pain.

b) Rheumatoid arthritis (RA): An autoimmune inflammatory disease that affects the joints of your hands and legs. RA usually affects the joints on one side of your body and is a leading cause of chronic pain, especially in older people. 

  • Symptoms of RA are like those of osteoarthritis - swelling, tenderness of the joints, inflammation of the joints, redness, and pain.

  • RA is caused by external factors such as cigarette smoking, trauma or injury, or an infection that can trigger an autoimmune response.

3. Neuropathic pain occurs as a result of the abnormal functioning of your nervous system. Neuropathic or neurogenic pain is sharp and throbbing. It can start as a tingling sensation in your feet and arms and spread quickly to other parts of your body.

4. Psychogenic pain is a disorder that is caused by psychological factors such as fear, depression, anxiety, and any strong emotions in individuals. Headaches, muscle pain, back pain, and abdominal pain are some of the common types of psychogenic pains. 

As the pain occurs secondary to a psychological condition, the underlying disease should be treated for relief from the pain. 

5. Fibromyalgia is a long-term condition that causes pain throughout the body. Fibromyalgia is nothing but widespread muscle pain, accompanied by fatigue, poor sleep, and an irritable mood. 

Common Symptoms of Chronic Pain

Chronic pain can result in extreme weakness, chronic (persistent) fatigue, muscle cramps, muscle soreness, loss of a range of movements, sharp bouts of jolting pain, depression, anxiety, and recurrent fevers.

Treatment and Management of Chronic Pain

Medications, along with a combination of therapies and lifestyle changes work best in the treatment and management of chronic pain. 

  • Medications such as topical analgesics and over-the-counter (OTC) painkillers work mainly to reduce pain. Topical analgesics are applied to the body (on the skin) to treat all types of pain.

  • Therapies such as physical therapy (physiotherapy), occupational therapy, relaxation techniques (meditation, yoga, and breathing exercises), behavioural therapy, and surgery have been beneficial in some cases. Talk to your orthopaedician to know more about each of these treatment methods.

One interesting point to note is that the use of topical analgesics for the management of chronic pain is on the rise. The reasons for this are mainly easy availability, portable and handy nature, improved patient acceptance, and direct and immediate relief on the target site. 

Topical Analgesics for Chronic Pain Management

Topical analgesics are nonsteroidal, anti-inflammatory drugs (available in the form of gels, ointments, creams, foams, or lotions) used for managing chronic knee pain, osteoarthritis, and other chronic joint-related conditions. 

Topical analgesics were introduced in the first place to provide the same relief as oral analgesics (painkillers or tablets taken orally). It is considered a valuable therapy for chronic musculoskeletal pains and neuropathic pain disorders. 

The active ingredient in many topical analgesics is diclofenac. Diclofenac penetrates through your skin, reaches the site, provides relief from pain, and reduces inflammation. 

Why is GSK's Iodex Ultragel (IUG) Recommended for Chronic Pain?

Iodex Ultragel is an over-the-counter drug that does not require a doctor's prescription to purchase it. It is useful to relieve chronic backache, neck pain, shoulder pain, sprains, joint pain, and muscle pain. It is also used to reduce internal inflammation and provide relief from sprains and strains.

Iodex Ultragel contains diclofenac diethylamine (active ingredient), a nonsteroidal anti-inflammatory drug (NSAID) with Emulgel formulation. This gel penetrates deep into your skin and the tissues beneath up to a depth of 1 cm, to enhance the effect of diclofenac on the site of pain. 

Iodex Ultragel’s Emulgel formulation allows it to permeate the skin 7 times deeper, thus treating pain at its root and providing targeted relief. (5,6)

IUG is effective for different types of musculoskeletal and chronic pains like neck/shoulder pain, back pain, joint pain, and arthritis. A formulation designed for fast absorption, this gel is highly effective and widely accepted. (7,8)

For milder painful states, the pain usually resolves on its own or with the use of OTC topical analgesics. However, if the pain persists for long or if it gets worse, you must consult a doctor for evaluation of cause and appropriate management.

To know more about IUG as a topical analgesic, click here.


1. Department of Neurology. 2021. Chronic Pain Syndrome. [online] Available at: <> 

2. 2021. [online] Available at: <> 

3. Rudin, N.J. Topical Analgesics for Chronic Pain. Curr Phys Med Rehabil Rep 1, 315–321 (2013).

4. Nicholas Hall’s Global OTC Database, DBS 2018

5. Voltaren Global CSS, Pg. 27

6. Evidence comes from a double-blind, randomised trial in patients (n=72) with acute neck pain treated with either diclofenac diethylamine 1.16% gel (2 g, four times a day for 5 days) or placebo gel. (Predel HG, et al. BMC Musculoskeletal Discord 2013; 14:250)

7. Voltaren Global CSS Topical Gels p. 67

8. Voltaren Global CSS, Pg 20

Disclaimer: This article is written by Practo and sponsored by GlaxoSmithKline Pharmaceuticals Limited, as part of a collaboration activity. Information appearing in this material is for general awareness only. Nothing contained in this material constitutes medical advice. Please consult your physician for medical queries, if any, or any question or concern you may have regarding your condition. Practo and GlaxoSmithKline Pharmaceuticals Limited will not be responsible for any act or omission arising from the interpretation of the content present on this page. Issued in the public interest by GlaxoSmithKline Pharmaceuticals Limited. Dr. Annie Besant Road, Worli, Mumbai 400 030, India. <PM-IN-IDX-21-00037>