Acute versus Chronic Pain

The International Association for the Study of Pain (IASP) defines pain as an unpleasant sensory and emotional experience associated with actual or potential tissue damage or described in terms of such damage. By this definition, pain does not HAVE to be associated with observable tissue damage or have a detectable underlying cause.

Pain is subjective.

If described by the patient – pain IS real.

Now, before you shoot the messenger here, let me explain the point of this blog series I am starting. An updated version of “Mechanisms and Management of Pain for the Physical Therapist” was recently released. As I was reading it I thought to myself “Are we using the proper vocabulary to explain chronic pain to our patients?” Why is this important, you ask. Because chronic pain works through a different mechanism than acute pain. And, the pain cycle we describe in the clinic tends to focus on acute pain. Which confuses people because they assume pain MUST be associated with tissue damage and we know that is false. So, it’s time to clear up the confusion!

Acute pain is a direct result of tissue damage and IS a symptom. When you sprain you ankle and the ligaments are overstretched, acute pain tells you to take it easy on the ankle and give it a chance to heal. This is a useful function of pain! Acute pain usually responds well and quickly to treatment including pain free movement, ice, and nonsteroidal anti-inflammatory drugs.

On the other hand, chronic pain is not protective and does not serve a biological purpose. Pain is defined as chronic if: 1) it outlasts normal tissue healing time, 2) the impairment is greater than would be expected from the physical findings or injury, and/or 3) pain occurs in the absence of identifiable tissue damage. In VERY general terms, chronic pain is pain that has lasted more than 3-6 months. However, you must take into consideration if the initial injury was properly diagnosed/treated in the first place, if the condition has been given enough time to heal, or if an athlete is constantly reinjuring the same tissues.

If YOU need help understanding YOUR pain, please feel free to contact us here at Physical Therapy for everyBODY at (425)658-4944 or amykonvalinpt@gmail.com.