What is Chronic Pain?
“Those who do not feel pain, seldom think that it is felt” – Dr Samuel Johnson.
Pain is often considered a warning system, as our body’s attempt to draw attention to a body part that has been injured or that is in danger. It warns of physical harm so that we can protect ourselves. We can understand this type of pain as it has a straightforward message of actual or potential tissue injury. Of course it is unpleasant, but thankfully it is usually brief and resolves when the injury heals. This is called acute pain and should last for less than three months.
Unfortunately sometimes pain continues beyond this initial warning system stage, even after an injury has healed, and acute pain becomes persistent or chronic pain. In some situations the problem that caused the acute pain, such as arthritis, continues and this explains the ongoing nature of the pain. However, there are also times when pain can persist despite resolution of the initiating event. Scientific research into how pain works in the body has led to recent advances in our understanding of why this happens. We know that pain has persisted for more than three months is no longer a straightforward warning system of physical harm, but involves complex changes in the nervous system and brain. Unfortunately this type of pain is not uncommon, with 1 in 5 Australians experiencing chronic pain.
Although pain is often described in terms of its duration, acute pain having lasted less than three months, and chronic or persistent pain having lasted longer, this obviously doesn’t tell the full story of why a person has pain and doctors will attempt to further define an individual’s pain by describing its source.
- Musculoskeletal pain has originated in the joints (eg. hip or spine arthritis), bones (eg. fractures), ligaments / tendons (eg. ankle sprains, tendonitis) or muscles of your body.
- Visceral pain refers to pain perceived from organs in the body, eg. chronic angina, abdominal/pelvic pain, or headache.
- Neuropathic pain occurs when the problem itself is within the nervous system, either because of nerve damage in the periphery, or due to problems in the spinal cord or brain. This is a particularly difficult problem because the mind may perceive pain in a part of the body that has no injury at all, or only a minor injury, because nerves are sending the wrong message to the brain. Sometimes people have severe pain in their foot, despite having had that foot removed at the time of a leg amputation. This is due to neuropathic pain.
People who live with pain know that it challenges many aspects of your life and can affect your whole person. Pain is by definition an unpleasant experience that evokes an emotional response and persistent pain can lead to feelings of frustration, depression and isolation, especially when a person with pain feels misunderstood and perhaps even not believed. Our doctors and health professionals can share their knowledge, and are aware of the biological, psychological and social impacts of pain on a person. Only after listening to each individual’s pain story can they then help to develop a personalised pain management plan, addressing the biological, psychological and social aspects of that person’s pain journey.