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Matt Davies & Catherine Addison-Swan

NHS lists the 20 most painful health conditions including migraines, arthritis and gout

Many of us will sadly have suffered from a painful health condition at some point in our lives, with some people affected every day by problems that may well be invisible to the rest of us.

While there are countless conditions that can affect our daily lives, some are more debilitating than others, and the NHS has shared a list of what are believed to be the twenty most painful. While there are several things on the list that you'd expect to see, such as heart attacks, broken bones or a slipped disc, some are much lesser known.

For example, many people may not have heard of cluster headaches - a rare and painful condition that takes the top spot - as well as things like complex regional pain syndrome, trigeminal neuralgia, and fibromyalgia. Here is the full list of the 20 'most painful' conditions, what causes them and their most common symptoms according to the NHS, InYourArea reports.

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1. Cluster headaches

Cluster headaches are a rare condition that cause excruciating attacks of pain in one side of the head, often felt around the eye. Anyone can get them, but they're more common in men and tend to start when a person is in their 30s or 40s.

Cluster headaches begin quickly and without warning. The pain is very severe and is often described as a sharp, burning or piercing sensation on one side of the head - it's often felt around the eye, temple and sometimes face, and tends to affect the same side for each attack.

They usually happen between one and eight times a day, generally lasting between 15 minutes and three hours, in bouts lasting several weeks or months at a time (typically four to 12 weeks), before they subside. A symptom-free period (remission) will often follow, which sometimes lasts months or years before the headaches start again.

You should see a GP as soon as possible the first time you experience what you think may be a cluster headache. They'll ask you about your symptoms and may refer you for tests - a brain scan is sometimes needed to exclude other conditions that can have similar symptoms to cluster headaches.

2. Shingles

Shingles is an infection that causes a painful rash on one side of your body - it usually appears on your chest and tummy, but you can get it anywhere on your body. The first signs can be a tingling of painful feeling in an area of skin, a headache, or generally feeling on well.

Shingles is caused by the chickenpox virus, which means people who haven't had chickenpox before could catch it from you, although shingles itself cannot be spread to others. It can take up to four weeks for the rash to heal and your skin can be painful for weeks after the rash has gone, but it usually gets better over time.

3. Frozen shoulder

Frozen shoulder is when your shoulder is painful and stiff for months, or sometimes years. The painful condition happens when the tissue around your shoulder joint becomes inflamed; the tissue then gets tighter and shrinks, which causes pain.

It's often not clear why people get a frozen shoulder, but it can happen because you've had an injury or surgery that keeps you from moving your arm normally. Frozen shoulder can be treated with shoulder exercises and painkillers, and while the pain and stiffness usually go away eventually, it can take at least 18 months to three years to get better.

4. Broken bones

A fractured ankle, hip, arm or nose is one of the most painful things you can experience. Broken bones can happen after an accident like a fall, or by being hit by an object, and the most common signs are pain, swelling or a deformity.

If you think you've broken a bone, you will need to seek medical help as soon as possible as the break must be properly aligned and held in place, often with a plaster cast, so it heals in the correct position. If you do not receive the correct treatment, you could develop a serious infection or a permanent deformity, and you may also have long-term problems with your joints.

5. Complex regional pain syndrome (CRPS)

Complex regional pain syndrome (CRPS) is a poorly understood condition where a person experiences persistent severe and debilitating pain, according to the NHS. Although most cases of CRPS are triggered by an injury, the resulting pain is much more severe and long-lasting than normal.

The skin of the affected body part can become so sensitive that a slight touch, bump or even a change in temperature can cause intense pain. The pain usually only affects one limb, but it can sometimes spread to other parts of the body, and some people with CRPS experience pain for many years.

A common heart attack symptom is severe chest pain that can feel like a pressure or tightness (iStockphoto)

6. Heart attack

A heart attack, known medically as a myocardial infarction, is a serious medical emergency in which the supply of blood to the heart is suddenly blocked, usually by a blood clot. A lack of blood to the heart may seriously damage the heart muscle and can be life threatening.

Symptoms of a heart attack can include chest pain that is often severe, such as a feeling of pressure, heaviness, tightness or squeezing across your chest, as well as pain in other parts of the body, most commonly the left arm. People can also feel light-headed or dizzy, or experience shortness of breath, wheezing, nausea, or an overwhelming feeling of anxiety.

You must call 999 immediately if you think someone might be having a heart attack. A lack of blood to the heart may seriously damage the heart muscle and can be life threatening - the faster you act, the better their chances.

7. Slipped disc

A slipped disc is when a soft cushion of tissue between the bones in your spine pushes out, and if it presses on nerves it can be extremely painful. It usually gets better slowly with rest, gentle exercise and painkillers.

Also called a prolapsed or herniated disc, it can be caused by lifting heavy objects the wrong way, exercising too hard, ageing, or being inactive or overweight. While not all slipped discs cause symptoms, it can lead to lower back pain, neck pain, numbness or tingling in your shoulders or limbs, problems bending or straightening your back, or muscle weakness.

8. Sickle cell disease

Sickle cell disease is the name for a group of inherited health conditions that affect the red blood cells, and is a serious and lifelong health condition. The most serious type is called sickle cell anaemia.

Sickle cell disease is particularly common in people with an African or Caribbean family background. People with sickle cell disease produce unusually shaped red blood cells that can cause problems because they do not live as long as healthy blood cells and can block blood vessels.

The main symptoms of sickle cell disease are painful episodes called sickle cell crises, which can be very severe and last for days or weeks, an increased risk of serious infections, and anaemia, which can cause tiredness and shortness of breath. It usually requires lifelong treatment by a team of healthcare professionals.

9. Arthritis

Arthritis is a common condition that causes pain and inflammation in a joint and it affects people of all ages, including children. In the UK, millions of people have arthritis or other, similar conditions that affect the joints, with the two most common types of arthritis being osteoarthritis and rheumatoid arthritis.

Osteoarthritis initially affects the smooth cartilage lining of the joint, which makes movement more difficult than usual, leading to pain and stiffness. In rheumatoid arthritis, the body's immune system targets affected joints, which leads to pain and swelling.

Migraines are common and often last for between two hours and three days (Getty Images/iStockphoto)

10. Migraine

Migraines are a common condition that usually manifest as a very bad headache with a throbbing pain on one side of the head. You may also get other symptoms just beforehand, such as tiredness, a stiff neck or mood changes., and some people also get 'warning signs' like sight problems, dizziness or pins and needles.

Migraines usually last between two hours and three days, with some symptoms starting up to two days before the head pain starts and finishing after the headache stops, and some people can have them several times a week. Treatments can include painkillers or medicines called triptans.

11. Sciatica

Sciatica is where the sciatic nerve, which runs from your lower back to your feet, is irritated or compressed. It usually gets better in four to six weeks, but can last longer.

If you have sciatica, your bottom, the back or your leg, or your foot and toes may feel painful, tingling, numb or weak, and symptoms may be worse when moving, sneezing or coughing. A GP may suggest exercise and stretches and prescribe painkillers to help relieve your pain and speed up recovery.

12. Kidney stones

Kidney stones are a common condition affecting more than one in 10 people, most often those aged 30 to 60, and can develop in one or both kidneys. They can be extremely painful, and can lead to kidney infections or the kidney not working properly if left untreated.

Kidney stones are caused by waste products in the blood forming crystals that collect over time to form a hard stone-like lump, which is more likely in people with certain medical conditions, who are on certain types of medication, or who do not drink enough fluids. Larger kidney stones can cause several symptoms including severe pain in your abdomen that comes and goes, feeling sick or vomiting.

13. Appendicitis

Appendicitis is a painful swelling of the appendix - a small, thin organ connected to the large intestine. It typically starts with a pain in the middle of your tummy that may come and go, and within hours the pain travels to the lower right-hand side and becomes constant and severe.

It's not clear what causes appendicitis, but if you have it, it's likely your appendix will need to be removed as soon as possible. Removal of the appendix, known as an appendicectomy or appendectomy, is one of the most common operations in the UK and is usually carried out as keyhole surgery.

14. Trigeminal neuralgia

Trigeminal neuralgia is sudden, severe facial pain that happens in short, unpredictable attacks. It's often described as a sharp shooting pain or like having an electric shock in the jaw, teeth or gums, and can last anywhere from a few seconds to about two minutes.

People with trigeminal neuralgia may experience attacks of pain regularly for days, weeks or months at a time. In severe cases attacks may happen hundreds of times a day, and living with the condition can be very difficult, having a significant impact on a person's quality of life.

Endometriosis affects around one in 10 women and can cause very heavy periods as well as severe pain (Getty Images/iStockphoto)

15. Endometriosis

Endometriosis is a condition where tissue similar to the lining of the womb grows in other places, such as the ovaries and fallopian tubes. Endometriosis can affect women of any age, including teenagers. and it's a long-term condition that can have a significant impact on your life.

Symptoms of endometriosis can vary, but common signs include pain in your lower tummy or back, debilitating period pain and abnormally heavy periods. There's currently no cure for endometriosis, but there are treatments that can help ease the symptoms, including painkillers, hormone medicines, and surgery to cut away patches of endometriosis tissue.

16. Gout

Gout is a type of arthritis that causes sudden, severe joint pain and hot, swollen skin, usually in your big toe. An attack of gout usually lasts five to seven days, and can affect other joints in your feet, hands, wrists, elbows or knees.

Attacks of gout are usually treated with a non-steroidal anti-inflammatory (NSAID) like ibuprofen. If the pain and swelling does not improve, you may be given steroids as tablets or an injection.

17. Acute pancreatitis

The pancreas is a small organ located behind the stomach that helps with digestion, and acute pancreatitis is a condition where the pancreas becomes inflamed over a short period of time. While most people with the condition start to feel better within about a week and have no further problems, some can go on to develop serious complications.

Symptoms of acute pancreatitis include severe and sudden pain in the centre of your tummy, feeling or being sick, and a high temperature. The condition is most often linked to gallstones or drinking too much alcohol, but the exact cause is not known - you should always see a GP or call 111 immediately if you suddenly develop severe abdominal pain.

18. Stomach ulcer

Stomach ulcers are sores that develop on the lining of the stomach, and the most common symptom is a burning or gnawing pain in the centre of the abdomen. Some people may experience other symptoms, such as indigestion, heartburn and acid reflux and feeling sick.

Stomach ulcers happen when there’s damage to the layer that protects the stomach lining from the acids in your stomach, and is usually a result of an infection or taking anti-inflammatory medicines such as ibuprofen or aspirin. Stomach ulcers can affect anyone but are more common in people aged 60 or over - you should visit your GP if you think you may have one, the NHS advises.

19. Fibromyalgia

Fibromyalgia, also called fibromyalgia syndrome (FMS), is a long-term condition that causes pain all over the body. The exact cause of fibromyalgia is unknown, but it's thought to be related to abnormal levels of certain chemicals in the brain and changes in the way the central nervous system processes pain messages carried around the body.

As well as widespread pain, symptoms of fibromyalgia include increased sensitivity to pain, muscle stiffness, difficulty sleeping, problems with mental processes, headaches and irritable bowel syndrome (IBS). Although there's currently no cure for fibromyalgia, there are treatments to help relieve some of the symptoms and make the condition easier to live with.

20. Pain after surgery

It's common to have some pain after surgery, though the intensity of the pain will vary according to the type of operation. But too much pain after surgery is not a good thing, the NHS website said, and you should never feel you have to 'tough it out'.

You should only do as much as you feel able to in the days after your operation. But it's important to try to move around as soon as possible and follow your doctor's advice on getting active again, the health service advised.

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