What is Pain?
The International Association for the study of pain defines pain as “an unpleasant sensory or emotional experience associated with actual or potential tissue damage”.
Chronic or persistent pain is pain that lasts for more than three months, or in many cases, beyond normal healing time. It doesn’t obey the same rules as acute pain. It can be seen as somewhat of a mystery.
Acute pain is generally defined as pain of sudden onset usually associated with an injury, procedure or operation which is expected to improve and lasts for less than 12 weeks. Acute pain begins suddenly and is usually sharp in quality. It serves as a warning of disease or threat to the body and can be caused by many things including:
- Broken bones
- Knocks and accidents
- Dental work
- Burns or cuts
- Labour and childbirth
Acute pain might be mild and last for a short period of time such the flashing pain of “brain freeze” when eating ice-cream or when you prick yourself with something sharp. It may last longer such as after sustaining a broken bone or after surgery but usually subsides as the healing process takes place. Acute pain disappears when the underlying cause of the pain is treated or has been healed. Unrelieved acute pain may lead to chronic pain.
Chronic or persistent pain is generally defined as continuous long term pain with duration of more than 12 weeks or after the time that healing could have been expected to occur. Chronic pain is quite common with 1 in 5 people in Australia experiencing chronic pain. This statistic rises to 1 in 3 people over the age of 65 years.
Common Causes of Chronic Pain
Some causes of chronic pain can be traced back to an injury, an infection (such as shingles) or a surgical procedure. Sometimes a prior injury or tissue damage cannot be identified. Most causes of chronic pain are related to the conditions listed below:
- Arthritic conditions such as osteoarthritis or rheumatoid arthritis
- Lower (lumbar) back pain
- Headaches, migraines and neck pain
- Upper (thoracic) back pain
- Failed back surgery syndrome (FBSS)
- Nerve damage (neuropathic pain)
- Multiple Sclerosis
- Diabetic Neuropathy
- Cancer pain
Unlike acute pain, chronic pain does not always indicate ongoing tissue damage; pain researchers now know that in some people the nervous system can become over-sensitive as a response to an initial injury. This is also known as central sensitisation but no further tissue damage is occurring within the body. See diagram below for how this can become a vicious cycle.
What is the difference between Acute and Chronic Pain?
With chronic pain there may be no known cure for the disease or problem causing the pain such as arthritis or phantom limb pain. The cause of chronic pain may not be obvious, be difficult to diagnose or be poorly understood.
Living with Chronic Pain
A Team Approach
To effectively treat and manage your chronic pain requires a team approach. You are the most important member of this team and it is very important that you understand the information about your chronic pain and proposed treatment options as communicated to you by health professionals.
Health professionals likely to be involved or who may be available to help you are your local Doctor, Pain Specialist, Neurologist, Orthopaedic or other Surgeon, Physician, Rheumatologist, Nurses, Exercise Physiologist, Physiotherapist, Occupational Therapist, Dietitian, Social Worker, Psychologist and any other Specialists who deal with your particular chronic pain issues.
It is very important that you ask questions when you may not understand information until you have a clear understanding. It may be helpful to write out a list of questions to take with you to your appointments to help you to remember to ask them in a systematic manner. You may choose to take a family member or friend with you to your appointments for support.
The more you know about Chronic Pain and your treatment, the more control you have over your condition and the lifestyle choices which are available to assist you to optimise your health.
Living Better with Chronic Pain
It is important to find a good balance between work, activity and rest. Many people find living with chronic pain very tiring. It can be difficult to juggle the many demands of everyday life such as work, family and home duties so it is essential that you listen to your body, rest when you are tired and avoid forcing yourself to work or exercise through pain.
Endeavour to make activities easier. Good planning and body mechanics allow you to safely use your body to lift, bend, reach and transfer. Attend to your daily activities with the least amount of strain to your muscles and joints.
You may need to rethink how to adjust the environment around you to optimise your health outcomes. You can request a review of your work space by an Occupational Therapist or ask for a home review by an Occupational Therapist. This will help you to ensure that you have appropriate aids and assistive devices in place to help you carry out everyday chores and activities, enhance your safety and minimise the risk of exacerbating your pain.
HSS run a Health Coaching Program for people living with Chronic Pain. Contact our Chronic Disease Management team to discuss your eligibility for entering this program.