Chronic Pain Nursing Diagnosis & Care Plan – devshopsimplenursing

Chronic Pain Nursing Diagnosis & Care Plan

Amanda Thomas Headshot
By Amanda Thomas
Updated On May 2025
Medically Reviewed by:
Angela Slater FNP, RN
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Chronic pain is like a storm that never clears — not a thunderclap of acute pain, but a steady, exhausting drizzle that can wear patients down day after day. 

A nurses’ job is to be the umbrella: assess the situation, provide shelter, and create a care plan that brings relief.

A chronic pain nursing diagnosis helps nurses figure out where the storm is hitting hardest and what tools they and the patient will need to weather it.

What is Chronic Pain?

Pain is chronic when it persists beyond the normal healing time (typically lasting more than three to six months) and may not have an identifiable cause.

Chronic pain differs from acute pain, which is temporary and typically associated with a specific injury or condition. Chronic pain can be constant or intermittent, significantly affecting a patient’s physical, emotional, and psychological well-being.

Acute vs. Chronic Pain

Acute pain:

  • Short-term, resolves with healing
  • Typically due to injury, surgery, or illness
  • Responds well to pain relief interventions

Chronic pain:

  • Persists beyond expected healing time
  • Often linked to long-term conditions (arthritis, fibromyalgia, neuropathy)
  • May require multimodal treatment (medications, therapy, lifestyle changes)

Impact on Patient Health and Daily Life

  • Physical effects: Reduced mobility, muscle stiffness, sleep disturbances
  • Emotional effects: Anxiety, depression, frustration
  • Social effects: Impaired relationships, difficulty maintaining work and daily activities

Causes of Chronic Pain (Related To)

Before forming a nursing diagnosis related to chronic pain, it’s important to identify the underlying cause. 

Whether the pain stems from joint degeneration, nerve damage, or a chronic condition like diabetes, understanding the source helps guide effective interventions and improve patient outcomes.

Primary Causes

  • Musculoskeletal disorders (e.g., osteoarthritis, rheumatoid arthritis)
  • Fibromyalgia (widespread pain with unknown cause)
  • Chronic back pain (herniated discs, degenerative disc disease)

Secondary Causes

  • Neuropathic pain (e.g., diabetic neuropathy, sciatica, post-herpetic neuralgia)
  • Cancer-related pain (tumor pressure, nerve compression, treatment side effects)
  • Post-surgical pain (nerve damage, scar tissue formation)

Chronic Conditions Leading to Persistent Pain

  • Diabetes (peripheral neuropathy)
  • Neurological disorders (multiple sclerosis, stroke)
  • Autoimmune diseases (lupus, inflammatory bowel disease)

Signs and Symptoms of Chronic Pain (As Evidenced By)

Chronic pain goes beyond physical discomfort. 

It affects movement, mood, and daily functioning. Recognizing the key signs helps guide accurate assessment and effective care.

Pain Intensity and Frequency

  • Constant or intermittent pain lasting > 3-6 months
  • Descriptions: Dull, burning, stabbing, aching, throbbing
  • Exacerbated by movement, stress, or weather changes

Physical Manifestations

  • Muscle tension and spasms
  • Joint stiffness and reduced range of motion
  • Fatigue and sleep disturbances due to persistent discomfort

Psychological Effects

  • Depression and anxiety (there’s a connection between chronic pain and mood disorders)
  • Irritability, frustration, and social withdrawal
  • Cognitive impairment (“brain fog”) due to prolonged discomfort

Risk Factors for Chronic Pain

Several factors can increase a person’s likelihood of developing chronic pain.

Understanding these factors is key to early intervention and effective care. 

Genetic, Age, and Gender Factors

  • Older adults: More susceptible due to joint degeneration and chronic diseases.
  • Gender: Women are more likely to experience conditions like fibromyalgia and migraines.
  • Genetics: Some people may have a lower pain threshold due to hereditary factors.

Environmental and Lifestyle Factors

  • Obesity: Increased strain on joints and musculoskeletal system
  • Sedentary lifestyle: Leads to muscle deconditioning and stiffness
  • Stress and poor mental health: Amplify pain perception and emotional distress

Co-existing Conditions

  • Depression: Alters pain perception, making it harder to manage
  • Obesity: Adds physical stress to the body, exacerbating joint and back pain
  • Autoimmune disorders: Chronic inflammation contributes to persistent pain

Nursing Assessment for Chronic Pain

Subjective vs. Objective Data Collection

  • Subjective: Patient self-reports of pain (location, intensity, quality, duration)
  • Objective: Physical signs like guarding, muscle tension, reduced mobility

Pain Scales and Assessments

  • Numeric rating scale (NRS): 0 (no pain) to 10 (worst pain imaginable)
  • Visual analog scale (VAS): Uses a visual continuum for pain severity
  • McGill pain questionnaire (MPQ): Assesses pain quality and associated symptoms

Assessment of Pain Intensity, Quality, and Impact on Daily Living

  • Pain description: Is there sharp, dull, throbbing, burning, or stabbing pain?
  • Activity limitations: Does the patient have difficulty walking, dressing, or performing activities of daily living (ADLs)?
  • Psychosocial impact: Does pain interfere with work, relationships, or mental health?

Nursing Diagnosis for Chronic Pain

Chronic pain has a way of showing up everywhere — aching joints, restless nights, even in a patient’s ability to cope. 

A clear nursing diagnosis helps connect the dots between what the patient is feeling and what they need. Below are common examples that set the foundation for an effective care plan.

Examples of Chronic Pain Nursing Diagnoses

  1. Chronic pain related to musculoskeletal degeneration as evidenced by persistent joint pain, stiffness, and reduced mobility
  1. Impaired comfort related to persistent neuropathic pain as evidenced by burning pain, numbness, and difficulty sleeping
  1. Risk for ineffective coping related to long-term pain and disability.

Variations Based on Patient Conditions

  • Arthritis → Focus on mobility and inflammation management.
  • Neuropathic pain → Address nerve pain, sensory changes, and quality of life.
  • Cancer pain → Priority on palliative care and symptom relief.

Prioritizing Diagnoses in Clinical Practice

  • Address pain management first, as uncontrolled pain leads to worsened physical and emotional health.
  • Incorporate coping strategies to prevent depression and anxiety.

Expected Outcomes & Nursing Goals for Chronic Pain

With the right nursing interventions, patients can move from barely coping to actively managing their discomfort. 

The focus here? 

Lowering those pain scores and boosting comfort with strategies that work.

Alleviating Pain and Improving Comfort

  • Patient will report reduced pain levels (< 4/10) after interventions
  • Patient will demonstrate use of pain relief techniques (medications, relaxation)

Enhancing Mobility and Daily Function

  • Patient will engage in physical therapy and perform ADLs with minimal pain
  • Patient will participate in regular low-impact exercises to maintain joint health

Improving Emotional Well-being

  • Patient will demonstrate reduced anxiety and improved mood
  • Patient will express confidence in managing chronic pain

Nursing Interventions for Chronic Pain

Managing chronic pain takes more than just one tool. It takes a full toolbox. 

Nurses rely on a mix of strategies: 

  • Medications to ease physical discomfort
  • Non-pharmacological approaches like heat therapy or guided imagery
  • Psychological support to address the emotional toll

Knowing when and how to use each tool is key to delivering well-rounded, effective care. 

Pharmacological Interventions

  • Non-opioid analgesics: Acetaminophen, NSAIDs (ibuprofen, naproxen)
  • Opioid therapy (if necessary): Used cautiously for severe pain
  • Adjuvant medications:
  • Antidepressants (e.g., amitriptyline, duloxetine) for neuropathic pain
  • Anticonvulsants (e.g., gabapentin, pregabalin) for nerve pain

Non-Pharmacological Interventions

  • Physical therapy: Strengthens muscles, improves flexibility
  • Heat/cold therapy: Reduces inflammation and muscle spasms
  • Massage and acupuncture: Helps release endorphins and reduce pain perception

Psychological Interventions

  • Cognitive behavioral therapy (CBT): Helps patients manage thoughts and emotions related to pain
  • Mindfulness and relaxation techniques: Breathing exercises, meditation, and guided imagery
  • Patient education: Teaching about triggers, pain relief techniques, and lifestyle modifications

Chronic Pain Nursing Care Plan Examples

Nurses tailor care plans to meet each patient’s unique experience with chronic pain. 

From pinpointing the cause to managing daily discomfort, nurses play a key role in improving outcomes. Below are care plan examples that show how to turn assessment into action.

Care Plan #1: Chronic Pain in Osteoarthritis

Nursing Diagnosis

Chronic pain related to joint degeneration and inflammation, as evidenced by patient reports of persistent knee pain (6/10), stiffness in the morning, and difficulty walking long distances

Expected Outcomes

  • Patient will report pain reduction to ≤ 3/10 after pharmacologic and non-pharmacologic interventions
  • Patient will demonstrate improved mobility and ability to perform ADLs with minimal discomfort
  • Patient will demonstrate understanding of pain management strategies, including exercise, medication use, and joint protection techniques

Assessment

Subjective Data
  • Assess the severity, location, duration, and aggravating or alleviating factors of pain.
  • Ask about morning stiffness, limitations in movement, and impact on daily activities.
Objective Data
  • Observe for joint swelling, redness, deformities, and limited range of motion.
  • Assess gait, weight-bearing ability, and posture.
  • Use pain assessment tools, such as the NRS and VAS.

Interventions

Pharmacological Interventions
  • Consider topical analgesics, such as capsaicin cream or diclofenac gel, for localized pain relief.
  • If pain is severe, consult about intra-articular corticosteroid injections.
Non-Pharmacological Interventions
  • Encourage low-impact exercises, such as swimming, cycling, and tai chi, to maintain joint flexibility.
  • Educate the patient on joint protection techniques, such as using assistive devices like canes or braces.
  • Apply heat therapy (warm compresses) for stiffness and cold therapy for inflammation.
  • Provide weight management guidance, as reducing excess weight can relieve joint stress.
Psychosocial & Educational Support
  • Teach relaxation techniques, such as guided imagery and deep breathing, to help reduce stress-induced pain.
  • Educate the patient on the importance of maintaining activity despite discomfort to prevent muscle deconditioning.
  • Encourage participation in support groups to promote emotional well-being.

Care Plan #2: Chronic Pain in Diabetic Neuropathy

Nursing Diagnosis

Chronic pain related to peripheral nerve damage from prolonged hyperglycemia, as evidenced by burning pain, numbness, and tingling in the feet, difficulty sleeping, and reduced sensation to touch

Expected Outcomes

  • Patient will report reduced pain intensity (≤ 3/10) with appropriate interventions
  • Patient will demonstrate improved ability to perform ADLs without significant discomfort
  • Patient will verbalize understanding of diabetic foot care and neuropathy management strategies

Assessment

Subjective Data
  • Ask about pain description (burning, tingling, stabbing, or numbness).
  • Assess onset, duration, and exacerbating factors (e.g., prolonged standing or cold weather).
Objective Data:
  • Perform monofilament testing to assess sensory loss in the feet.
  • Check skin integrity for ulcers, redness, or wounds due to reduced sensation.
  • Assess blood glucose control, as poor control exacerbates neuropathy.

Interventions

Pharmacological Interventions
  • Administer anticonvulsants (e.g., gabapentin, pregabalin) to reduce nerve pain.
  • Consider antidepressants (e.g., duloxetine, amitriptyline) for neuropathic pain relief.
  • Ensure optimal blood glucose management with insulin or oral hypoglycemic agents.
Non-Pharmacological Interventions
  • Encourage daily foot care, including inspection, moisturizing, and wearing proper footwear.
  • Promote regular exercise, such as walking or gentle stretching, to improve circulation.
  • Use warm (not hot) water soaks to soothe aching feet.
Psychosocial & Educational Support
  • Educate the patient on how to manage blood sugar levels and their impact on nerve health.
  • Teach coping strategies such as mindfulness, distraction techniques, and breathing exercises.
  • Recommend support groups or counseling for managing chronic pain and diabetes-related stress.

Care Plan #3: Chronic Pain in Cancer Patients

Nursing Diagnosis

Chronic pain related to tumor invasion, nerve compression, or treatment side effects (e.g., chemotherapy, radiation) as evidenced by patient reports of persistent pain (7/10), grimacing, fatigue, and difficulty sleeping

Expected Outcomes

  • Patient will report a reduced pain, which is ≤ 3/10, with effective pain management strategies
  • Patient will demonstrate improved sleep quality and can perform daily activities with minimal discomfort
  • Patient will express a sense of control over pain and demonstrate the use of coping mechanisms
  • Patient’s vital signs (heart rate, blood pressure) will remain stable, indicating effective pain management

Assessment

Subjective Data:
  • Pain characteristics: What’s the location, intensity, quality (burning, aching, stabbing), and duration?
  • Triggers and relieving factors: What worsens or alleviates pain?
  • Impact on daily life: Does the patient experience sleep disturbances, changes in appetite, or mobility issues?
  • Psychosocial effects: Is the patient experiencing depression, anxiety, or emotional distress? 
Objective Data:
  • Vital signs: Monitor for hypertension, tachycardia, which may indicate poorly controlled pain.
  • Physical exam: Assess for tumor growth, pressure points, skin integrity (if on opioids, monitor for constipation).
Pain Assessment Tools:
  • NPS (0-10)
  • MPQ to characterize cancer pain
  • Brief pain inventory (BPI) to assess pain impact on daily life

Interventions

Pharmacological Interventions

Opioid analgesics:

  • First-line for moderate to severe cancer pain (e.g., morphine, fentanyl, oxycodone).
  • Use long-acting formulations for chronic pain and short-acting formulations for breakthrough pain.

Adjuvant pain medications:

  • Anticonvulsants (e.g., gabapentin, pregabalin) for nerve pain
  • Corticosteroids (e.g., dexamethasone) to reduce inflammation and tumor-related pain
  • Non-opioid analgesics (NSAIDs, acetaminophen) for mild pain or in combination with opioids
Non-Pharmacological Interventions
  • Palliative radiation therapy to shrink tumors causing pain
  • Physical therapy and gentle stretching to maintain mobility
  • Heat or cold therapy for localized pain relief
  • Acupuncture or massage therapy as complementary interventions
Psychosocial & Emotional Support
  • CBT for coping with chronic pain
  • Mindfulness, meditation, and guided imagery to reduce pain perception
  • Support groups or counseling for emotional well-being
  • Encourage family involvement in care and decision-making
End-of-Life Pain Management (If Applicable)
  • Palliative sedation for refractory pain.
  • Hospice care coordination to ensure comfort-focused care.

Patient Education & Discharge Planning

Patient education is essential in preventing pain flare-ups and reducing the long-term impact of chronic pain. 

Prevention and Management of Chronic Pain Complications

Nurses should ensure that patients:

  • Understand their condition: Teach patients about the causes, triggers, and expected progression of their chronic pain condition.
  • Adopt healthy lifestyle changes: Encourage regular low-impact exercises, such as yoga, swimming, and stretching, to maintain mobility and reduce stiffness.
  • Monitor their pain: Use a pain diary to track pain patterns, identify triggers, and assess the effectiveness of treatments.
  • Follow prescribed treatment regimens: Emphasize the importance of adhering to medication, physical therapy, and complementary therapies.
  • Avoid known triggers: For example, weather changes may worsen arthritis, prolonged sitting may increase back pain, and certain foods may trigger inflammatory pain.

Managing Comorbid Conditions That Worsen Chronic Pain

Many chronic conditions contribute to the intensity and frequency of pain. 

Here are some examples of management strategies for four chronic conditions.

1. Diabetes (Neuropathic Pain)

  • Monitor for symptoms of nerve damage, including burning pain, tingling, and numbness.

2. Depression & Anxiety

  • Encourage counseling, CBT, and mindfulness techniques.
  • Assess for sleep disturbances that can worsen pain perception.

3. Obesity & Sedentary Lifestyle

  • Recommend gradual weight loss and low-impact exercises (walking, swimming, cycling).
  • Address joint stress and inflammation associated with excess weight.

4. Autoimmune & Inflammatory Conditions (Arthritis, Lupus, Fibromyalgia)

  • Encourage an anti-inflammatory diet (Rich in omega-3 foods and low in processed foods).
  • Recommend physical therapy and heat therapy for symptom relief.

Effective Strategies for Long-Term Pain Management

  • Multimodal therapy approach: Combining medications, physical therapy, and non-pharmacologic treatments offers the best results.
  • Mind-body therapies: Meditation, guided imagery, and progressive muscle relaxation improve pain tolerance.
  • Regular physical activity: Encourage movement to prevent stiffness and deconditioning, which are crucial for managing arthritis and back pain.
  • Interdisciplinary pain management clinics: Referral to pain specialists, physiotherapists, and mental health counselors may provide better pain relief.

Educating Patients on Chronic Pain Management Strategies

  • Explain how pain medications work (opioids, NSAIDs, anticonvulsants for neuropathic pain).
  • Discuss the side effects and the importance of gradual tapering (for opioids or certain antidepressants).
  • Emphasize alternative therapies, including heat therapy, massage, acupuncture, and relaxation techniques.

Recognizing Signs of Worsening Pain and Seeking Timely Medical Intervention

Instruct the patient to seek medical attention if they experience:

  • Increased pain intensity (pain relief is ineffective)
  • New symptoms (e.g., burning pain in diabetes, joint swelling in arthritis)
  • Signs of opioid dependence or withdrawal (e.g., excessive sedation, confusion, nausea)
  • Severe side effects of medications (GI bleeding from NSAIDs, dizziness from antidepressants)

Recommended Resources for Chronic Pain Management

Staying current on chronic pain management means knowing where to find reliable, research-backed information. 

From clinical guidelines to patient support networks, the following resources offer practical tools and insights to enhance nursing care.

Links to helpful guides, research studies, and support organizations

Pain management resources for patients and health care providers:

Nursing Care Plan Resources

Simple Steps to Smarter Pain Care

Chronic pain is complex and often unpredictable, which makes informed, proactive nursing care essential. 

Using the right strategies and clinical insight, nurses can help patients feel seen, supported, and better equipped to manage their pain long term. Every small action — from assessment to education — adds up to lasting relief.

References and Sources

  1. American Society of Pain Management Nursing. (2022). Core curriculum for pain management nursing (4th ed.). Elsevier.
  1. D’Arcy, Y. (2011). Compact clinical guide to chronic pain management: An evidence-based approach for nurses. Springer Publishing Company.
  1. Wright, S. (2015). Pain management in nursing practice. SAGE Publications.
  1. Waldman, S. D. (2019). Atlas of interventional pain management (5th ed.). Elsevier.
  1. OpenStax. (2023). Fundamentals of nursing. OpenStax.