When acute pain becomes chronic pain
It is critical for a doctor and a patient to have
an understanding of the difference between acute pain
and chronic pain. With acute pain, the pain is a symptom
of injured or diseased tissue. When the injury has
finished healing, the correlating pain will subside.
For example, with a herniated disc, once the pressure
on the nerve is alleviated the acute pain stops. For
this reason, medical treatment for acute pain focuses
on healing the underlying cause of the pain.
Additionally, with acute pain the severity
of pain directly correlates to the level of tissue
damage. This provides us with a protective reflex,
such as to stop an activity when it causes pain. However,
chronic pain does not serve a protective or other biological
function. Treatments will be different depending on
the underlying cause of the pain.
Chronic pain
development
Not all pain that persists will turn
into chronic pain. Different people experience chronic
pain very differently. Likewise, the effectiveness
of a particular treatment for chronic pain will often
differ from person to person. For example, a particular
medication or injection for a herniated disc may
provide effective pain relief for some people but
not for others.
One problem is that not all patients with similar
conditions develop chronic pain, and it is not understood
why some people will develop chronic pain. Also, a
condition that appears relatively minor can lead to
severe chronic pain, and a serious condition can be
barely painful at all.
As pain moves from the acute phase to the chronic
stage, influences of factors other than tissue damage
and injury come more into play and influences other than
tissue input become more important as the pain becomes
more chronic.
Pain medicine and pain management as a medical specialty
is relatively new. However, now that
chronic
pain is becoming
recognized as a primary problem, rather than always
being a symptom of a disease, the specialty of pain
management is starting to grow.
By:
William W. Deardorff, PhD, ABPP
January 22, 2003
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