Acute pain occurs due to an injury, like a broken bone or cut, or a surgical procedure. Once the wound heals, the pain should go away. But what happens when it doesn’t?
When pain persists for longer than three to six months, it becomes chronic. Chronic pain is one of the most common reasons why people seek medical attention, affecting about one out of every five people in the U.S.
There are a variety of reasons that persistent pain can occur. Sometimes, it’s caused by an underlying injury or condition, while other times, there is no clear reason for the pain, making chronic pain the cause itself.
Before elaborating on chronic pain, it may be helpful to understand the human pain experience.
Dimensions to the Human Pain Experience
There are three dimensions to the human pain experience:
- Sensory-discriminative, which is responsible for the detection, location, and intensity of pain.
- Affective-motivational, which is involved in the emotional processing of pain.
- Cognitive-evaluative, which is the conscious interpretation of the pain signal.
These dimensions are balanced in acute pain.
However, with chronic pain, the sensory-discriminative dimension diminishes while the affective-motivational dimension becomes dominant. As a result, pain is less localized, and the risk for psychological consequences increases.
What’s more, pain and emotion are inversely related, meaning that while being in pain can lead to a negative emotional state, being in a negative emotional state can also worsen feelings of pain.
The same principle applies to the cognitive-evaluative dimension, which includes attention and memory. Both can affect the way a person experiences pain.
Traditionally, pain was defined as “an unpleasant sensory and emotional experience associated with actual or potential tissue damage or described in terms of such damage.”
In 2020, The International Association for the Study of Pain updated the definition of pain to better communicate the nuances and complexities associated with pain. The new definition is “an unpleasant sensory and emotional experience associated with, or resembling that associated with, actual or potential tissue damage.”
The updated version also includes six notes to further expand on the meaning of chronic pain.
Although these changes seem minor, this new definition does a much better job at capturing pain for what it really is: a subjective experience that cannot always be put into words.
This scenario is often the case when people are experiencing chronic pain.
Treatments for Chronic Pain
When treating chronic pain, health care providers will usually start by trying to identify the underlying cause. As mentioned, sometimes, the chronic pain itself is the condition. Next, the provider may recommend one of the following treatments to help provide relief.
- Cognitive Behavioral Therapy (CBT) is a type of therapy that helps you think differently about pain, enabling you to develop improved coping skills.
- Physical therapy combines stretching and activity to help strengthen the muscle.
- Occupational therapy teaches you how to reduce your pain or avoid reinjury.
- Behavioral therapy, which helps patients relax and relieve stress.
For the treatment of persistent pain, a provider may recommend over-the-counter (OTC) medications, such as Tylenol, Advil, or Aleve, which a person can buy without a prescription. Prescription medications, including opioids, are also common for pain management. The type of recommended medication will largely depend on the kind of pain the person is experiencing.
Complimentary or Alternative Medicine for Chronic Pain
Complimentary or alternative medicines (CAM), such as acupuncture, chiropractic, massage, and meditation, are another possible treatment option. These are increasing in popularity due to the dangers associated with opioids.
If you are experiencing chronic pain, please consult with your doctor to find a pain management strategy that works for your unique needs.