Acute Versus Chronic Pain
September 25, 2024Chronic vs persistent pain
I hate the term ‘chronic pain.’ Why? Because it implies that pain will never go away. ‘Persistent pain’ is a better term. It is softer and it is more descriptive. Not to mention, that we now know that we can heal from this. The people who are in ‘persistent pain’ are not who you think.
Who are the people in persistent pain?
I have had multiple bouts of ‘persistent pain’ in my lifetime. These episodes have lasted as long as 14 years and as short as 4-6 months. Did you know this about me? Chances are you know someone who is living with persistent pain. They are your mother, father, husband, best friend, neighbor, even child. There are many different diagnoses that fall under this general umbrella of pain. Some are the most common that you think of—someone with fibromyalgia, chronic fatigue syndrome, complex regional pain syndrome. But did you know that this also includes someone with chronic headaches/ migraines, low back pain, neck pain, whiplash syndrome, joint pain (any joint). We used to diagnose this based on time that you are having symptoms (longer than it takes for tissue to heal which is about 3-6 months). But that is only a piece of the puzzle.
Tissue injury vs NOT
30% of people who are living with pain have not had an injury…did you know this? So what is the cause of musculoskeletal pain when there isn’t an injury. The short answer is that it is usually related (in some part) to a significant emotional stressor. Usually the stressor is big and prolonged (a death in the family, car accident, work changes, some other trauma). Why would an emotional stressor cause musculoskeletal pain? Because the brain doesn’t know the difference between physical and emotion pain/ injury. And because pain is produced by the brain in response to a perceived threat, it doesn’t matter if the threat is physical (I just stepped on a nail) or emotional (I just lost a loved one). To the brain it is enough that there is a threat and as part of how your alarm system functions, pain is a wonderful alarm that will make you sit up and take notice.
How do I know if I have persistent pain?
Ask yourself a few questions.
- How long have I had pain?
- Has it been constant, or does it ebb and flow?
- Does it get worse when the weather changes?
- Does it get worse when my stress levels are high?
- Does it cover a large area (for example is it “my whole back”)?
- Does it move? (sometimes it is one knee then other times it is the other)
- Are you limiting activities because you are concerned it might cause or increase your pain?
- Does your spouse caution you to not do certain activities because it might ‘hurt you’?
Maybe these aren’t the questions you need to ask yourself but are asking about a friend or a loved one. If a few of these questions are getting ‘yes’ answers then ‘persistent pain’ is probably a safe diagnosis.
What do I do?
The short answer is learn more about the nervous system. There are lots of resources that exist to help educate the public on persistent pain (www.retrainpain.org, Curable app, www.noigroup.com, www.ispinstitute.com, or the Pain Reframed podcast). The research is really convincing—the more you learn about pain—the better you will begin to feel. But it is not enough. Newer research now shows that education needs to be combined with movement. Take a gentle yoga class, go for a short but brisk walk, try a pilates class. Some of you may be saying—been there, done that. If that is the case, then you need a more one-on-one approach. That is when you come in to see us. At Lake Burien Physical Therapy, this is what we specialize in. Our job is to help you return to full function. We will give you the tools to do this.