Acute pain is the normal pain that we feel when we experience an injury. Acute pain is useful – it tells us not to put weight on a broken leg, and to take our hand off a hot plate so we don’t get burnt. It doesn’t last too long – generally less than 3 months – after which things will have healed up.
Chronic pain is pain that lasts a long time. Although it can be associated with ongoing injury or disease, most of the pain that clinicians treat is
pain that continues long after healing has occurred or when there has been no obvious injury.
In many instances of chronic pain, the usual clinical examinations and investigations cannot adequately explain why there is on-going pain. It is quite usual for scans such as MRIs and x-rays to be reported as normal, despite the fact you feel a lot of pain.
Sometimes pain symptoms are described as being down to wear and tear, arthritis or degeneration, and scans will often give the result of
degenerative changes that may account for the symptoms. However, wear and tear is a normal part of the ageing process and does not produce pain in itself. Many people with significant wear and tear (degeneration) have little or no symptoms.
Many studies have shown that there is a poor relationship between the pain that people feel and what is identified on a scan. So, how can we explain chronic pain when examination and investigations are normal?
Over the last 50 years, pain science has begun to discover how chronic pain may be
related to alterations in your nervous system itself. Signals from your muscles, joints
and bones can be amplified and interpreted as pain by an over sensitive nervous
system.
The best way of understanding this is think about a car alarm. Just like
your car alarm should only go off when somebody tries to break in, your pain system should only be activated when there is injury or disease. However, we’ve all probably lived on a street with an alarm that goes off
with a change in the wind or a dog barking. Similarly, we believe that as a result of a sudden incident or slowly over time, our nervous system can become hypersensitive to normal or mildly painful stimuli like an
amplifier that has been turned up to 10.
So What can be done?
We don’t know as yet how to turn down the dial on
the nervous system. But we do know that many things
contribute to it being hypersensitive. There are many tools we now have which can help you to manage your pain, and reduce its intensity. These include:
• gentle movement;
• managing your overall mental and physical health;
• relaxation;
• understanding what’s behind your pain and having a clear plan to deal with it;
• not allowing pain to dictate what your life is about