What the difference between acute and chronic pain?
How is pain defined?
Pain is an uncomfortable feeling and/or an unpleasant
sensation in the body. The presence of pain often is an
indication that something is wrong. Pain can appear suddenly
or can come about slowly.
Each individual is the best judge of his or her own pain.
Feelings of pain can range from mild and occasional to
severe and constant. Pain can be classified as acute pain or
What is chronic pain?
Tens of millions of Americans suffer from
chronic pain -- pain that lasts longer than six months. Chronic pain can be mild or
excruciating, episodic or continuous, merely inconvenient or
chronic pain, signals of pain remain active in the nervous system for weeks, months,
or even years. This can take both a physical and emotional
toll on a person. Physical effects include tense muscles,
limited mobility, a lack of energy, and changes in appetite.
Emotional effects include
anxiety, and fear of re-injury. Such a fear might hinder a personís ability to
return to normal work or leisure activities.
Common chronic pain complaints include:
Chronic pain might have originated with an initial
trauma/injury or infection, or there might be an ongoing
cause of pain. However, some people suffer chronic pain in
the absence of any past injury or evidence of body damage.
What Are the Symptoms
of Chronic Pain?
The symptoms of chronic pain include:
Mild to severe pain that does not go away
Pain that may be described as shooting, burning, aching, or
Feeling of discomfort, soreness, tightness, or stiffness
Pain is not a symptom that exists alone. Other problems
associated with pain include:
Withdrawal from activity and increased need to rest
Weakened immune system
Changes in mood including hopelessness, fear,
anxiety, and stress
Chronic Pain - Treatment Overview
Treating chronic pain can be challenging. Often the reason
for the pain is not clear. And it may take several types or
before you find relief. When treatment is started, some
people may have increased pain because their chronic pain
has caused them to be inactive and they have lost strength
and flexibility. But over time treatment should reduce the
pain and increase your ability to function. You may learn
new ways of doing ordinary tasks to reduce pain. Often
chronic pain cannot be cured, but it can be managed well
enough to significantly improve the quality of your life.
Be sure to seek treatment if your pain lasts longer than 2
to 3 months. Early treatment may prevent the pain from
The goals of treatment are to reduce
and increase your ability to function. This includes
and coping skills and reducing
so you can return to your regular activities. Initial
treatment depends on what kind of pain you have and how
severe it is, as well as whether your pain is related to an
illness, injury, or an unknown cause. Often, the best
approach is a combination of therapies.
You may be able to control your pain at home by:
(such as walking or
a routine part of your life.
This includes getting enough vitamins such as vitamin B
Talk to your doctor or a
about a healthy diet for you.
Getting enough sleep.
non-steroidal anti-inflammatory drugs
(NSAIDs), such as
(Advil, for example) or
Always take these medicines exactly as prescribed or
according to the label. Do not take a nonprescription
NSAID for longer than 10 days without talking to your
mental health counselor,
can help with your emotional well-being while you are
dealing with chronic pain. It is common to respond to
chronic pain with feelings of frustration,
fear, and even anger. These feelings can make it tough to
conquer chronic pain, especially if you use alcohol or
to manage your symptoms. Pain affects both your physical and
emotional well-being. Untreated depression or
can make your pain worse. A counselor may use treatments
to help you cope with your pain.
It is important to build a clear treatment plan for chronic
pain with your doctor. Part of this plan includes
identifying ways for you to manage your pain. Only you know
severity of your pain
and how it affects your life. Be sure to ask your doctor if
you are not clear about what steps you can take when pain
occurs or gets worse.
Medicines or a combination of medicines and other therapies
may be used to relieve pain, inflammation,
and sleeping problems that are linked to chronic pain.
If you continue to experience chronic pain, you may be:
Referred to one or more doctors who specialize in rehabilitation and
pain management (such as an anesthesiologist, a
neurologist, or a physiatrist)
Offered electrical stimulation therapies (such as TENS), which seem
to decrease the feeling of pain for some people.
(such as corticosteroids), which can sometimes reduce
or pain and inflammation.
For some people, complementary therapies can help reduce
chronic pain. The best approach is usually a combination of
treatments. If one treatment has stopped working, another
treatment or combination of treatments may help reduce your
pain. Try to stay ahead of the pain: don't wait until your
pain is severe to begin treatment.
Treatment if the
condition gets worse
If your chronic pain is not relieved after you have tried
numerous treatments, you may want to think about going to a
pain management clinic. Treatment is provided by a team of
doctors who work together to address all the factors that
may cause your chronic pain.
Treatments that are commonly used for prolonged chronic pain
Physical therapy, which may include using hot and cold therapy to
relieve painful areas of the body, and exercises to
maintain strength, flexibility, and mobility.
Transcutaneous electrical nerve stimulation (TENS), which uses a
wire in a skin patch to apply brief pulses of
electricity to nerve endings in the skin to relieve
Professional counseling, such as cognitive-behavioral therapy.
Stress and depression may contribute to or occur as a
result of chronic pain. It is important to be healthy
emotionally as well as physically to recover from
You may also wish to consider surgical options for relieving
Your chronic pain may improve more if you have a combination
of treatments at the same time.
It is important to find a doctor with whom you feel
comfortable, and to keep in regular contact with this
doctor. If your doctor is unable to provide effective
treatment to reduce your pain, ask about a referral to a
pain management clinic. There, a team of doctors can help
you set realistic expectations and identify treatment
Chronic Pain - Surgery
Surgery is not often used to treat chronic pain. The
decision to have surgery depends on your condition and the
cause of your pain. Surgery is usually considered only after
other treatments have failed or if it is considered
Surgery may provide pain relief, but it also may permanently
damage your ability to perceive other sensations, such as
light touch and temperature changes. It can also cause a
different pain to occur.
The most common, effective implanted pain control systems
Intrathecal drug delivery. An intrathecal pain pump is a small tube
inserted in the spinal canal where the pain signals go
to the brain. This tube is connected to a small
reservoir of medicine inserted under the skin of your
belly. The medicine is regularly delivered to the area
of pain through the tube.
Spinal cord stimulation. Spinal cord stimulation (SCS) is a
procedure that uses an electrical current to treat
chronic pain. An electrical generator is put under the
skin. This generator sends electrical pulses to a
certain area of the spinal cord through electrodes
placed in the spinal cord by a specialist.
(also called radiofrequency lesioning) is a procedure
that can disrupt the flow of pain signals. First, you
will need to have a test that uses a
which numbs specific nerves, to help your doctor find
the nerves that are causing your pain. Then the doctor
places an instrument under your skin through which
electrical stimulation heats the surrounding tissue. The
heat "stuns" your nerves, blocking them from sending
pain signals to your brain.
Chemical sympathectomy. Sympathectomy prevents the flow of pain
signals. In chemical sympathectomy, the malfunctioning
nerve or nerves are destroyed with chemicals, usually
stopping or reducing the pain. This procedure, though,
may also destroy other sensations besides pain or create
other sensations such as burning or numbness. This
treatment may be used for a type of chronic pain called
reflex sympathetic dystrophy, which is a condition that
affects the nervous system. This procedure is not
commonly done, because it can cause side effects that
include new pain and sweating. Your doctor may want to
try a sympathetic nerve block first, in which local
anesthetic is injected into the nerve to relieve pain.
is another type of surgery used for nerve pain, such as
from trigeminal neuralgia. The doctor makes an incision,
and then tries to move away blood vessels or other body
structures that are pressing on nerves and causing pain.
Surgically implanted devices are not commonly used to treat
chronic pain. They may not always control chronic pain in
the long term and can lead to other problems that can
complicate chronic pain or sometimes make it worse.