When we have an injury or problem causing inflammation in our bodies, we experience acute pain, which is a helpful warning sign that something is wrong. Pain is the main reason why people seek medical care, with three of the top 10 reasons being osteoarthritis, back pain and headaches.
Best practice guidelines in pain management encourage a multimodal approach to pain management. This should include self-care, physical therapy, exercise, sensible use of medicines, implementation of behavioural and psychological strategies as well as integrative treatments and occasionally procedures.
Acute Pain (short-term pain)
This acute pain usually eases when the problem or injury heals. Unfortunately sometimes the pain persists even after the injury has healed, which is no longer helpful. When pain has persisted for more than three months we consider it to be chronic pain, and we know from research into how nerves work that persistent pain is often the product of abnormal nerve signalling and no longer a indicator of ongoing damage. Chronic pain continues, even though the injury has healed.
Although there is no clear threshold of when acute pain becomes chronic, it is generally beyond the expected healing period or three months.
Chronic Pain (long-term pain)
To live with chronic pain is to live with daily challenges around simple tasks that others take for granted. It often means being disbelieved, stigmatised for not getting better, or judged as not coping. It might mean living with poor mental health and self-esteem, absenteeism from school or work, the breakdown of relationships, and socioeconomic disadvantage. For society, the costs are staggering: low back pain is the leading cause of years lost to disability and chronic pain costs billions of dollars through health system expenditures, productivity losses, reduced quality of life, and informal care.
Cancer pain management strategies follow similar guidelines. Important in cancer pain management is the addressing of existential issues such as uncertainty and prognosis. Many patients who have survived cancer continue to have chronic pain that may be related to the cancer or to treatment.
In summary, pain is a dynamic consequence of a host of biological, psychological and social factors. Guidelines recommend interdisciplinary treatment with a personalised approach and a shared-decision models between the patient and their pain management team.
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