Pain Basics
Pain is one of the most common reasons people consult a physician, yet frequently it is inadequately assessed and under treated, leading to enormous social costs in the form of needless suffering, lost productivity, and excessive healthcare expenditures. Much progress has recently been made in understanding the origin and progression of pain, yet many health care professionals are untrained in pain management.
| “an unpleasant sensory and emotional experience associated with actual or potential tissue damage.” |
Pain can be divided into two basic types of pain, acute and chronic.
Acute Pain
Acute pain is defined by a recent onset and transient nature. Acute pain begins suddenly and is usually sharp in quality. It serves as a warning of disease or a threat to the body. Acute pain may be caused by many events or circumstances, including:
- Surgery
- Broken bones
- Dental work
- Burns or cuts
- Labor and childbirth
Acute pain may be mild and last just a moment, or it may be severe and last for weeks or months. In most cases, acute pain does not last longer than six months and it disappears when the underlying cause of pain has been treated or has healed. Unrelieved acute pain, however, may lead to chronic pain.
Chronic Pain
Chronic pain persists despite the fact that an injury has healed. Pain signals remain active in the nervous system for weeks, months, or years. Physical effects include tense muscles, limited mobility, a lack of energy, and changes in appetite. Emotional effects include depression, anger, anxiety, and fear of re-injury. Such a fear may hinder a person's ability to return to normal work or leisure activities. Common chronic pain complaints include:
- Headache
- Low back pain
- Cancer pain
- Arthritis pain
- Neurogenic pain (pain resulting from damage to nerves)
- Psychogenic pain (pain not due to past disease or injury or any visible sign of damage inside)
Chronic pain may have originated with an initial trauma/injury or infection, or there may be an ongoing cause of pain. However, some people suffer chronic pain in the absence of any past injury or evidence of body damage. In short, chronic pain is not a single entity but may have a myriad of causes and perpetuating factors. Therefore, chronic can be much more difficult to manage than acute pain, requiring a multidisciplinary approach and customized treatment protocols to meet the specific needs of each patient.
Transitory exacerbations of severe pain over a baseline of moderate pain or less may be described as “breakthrough pain.” Breakthrough pain is common in both acute and chronic pain states.
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