What is Chronic Pain?

In my last blog entry, we took some time to explore the phenomenon of pain. We covered what pain is, and why we experience pain in the body. We concluded that, in most cases, pain is not a bad thing. It acts subject to an “alarm system”; alerting us of the presence of harmful stimuli and it prepares us to deal with the situation as a whole. We also noted that after sustaining a painful injury, our body will typically work through the healing process, and the pain that we feel will eventually go away completely.

In essence, our last blog covered the phenomenon of “Acute Pain”; sudden, usually sharp pain related to tissue damage in the body. In most cases, acute pain leads to short term distress, and will go away completely when its underlying cause has been treated or healed. Now this left us with the following questions: “What if the pain doesn’t stop?” and “What if we are experiencing pain long after our injuries have healed?”

This is where the term “Chronic Pain” comes into the equation. Chronic pain can be described as ongoing or persistent pain that lasts beyond the usual course of an injury healing. Typically, this means that the pain has lasted for more than 3-6 months and has come to the point where it adversely affects an individual’s life. The chronic pain eventually becomes a major focus of disability or dysfunction and can take a serious toll on one’s physical AND emotional well-being. This multi-dimensional nature of chronic pain is very important to note.

Remember our definition of pain from last month’s blog: “an unpleasant sensory and emotional experience associated with actual or potential tissue damage.” As such, the definition recognizes the importance of psychology in the experience of pain. Long term pain not only inhibits our abilities to be physically active, but can also evoke emotions like fear, depression, and hopelessness. You may experience heightened levels of anger, anxiety, and stress. Because of this complex interplay of emotions and physical factors, effective treatment of chronic pain requires a multi-disciplinary approach. We need to focus not only on the physical symptoms of pain, but also on one’s feelings, beliefs, and coping skills.

Another, more simplistic way we could define chronic pain, is “pain that continues, when it should not”. In other words, your pain “alarm” is going off, even when there is no real damage or threat of damage to the body. Now, this naturally leaves us questioning why exactly chronic pain exists. Why do we feel pain when it is not serving its protectionary purpose? Why am I feeling pain, when I’ve been told by doctors that all of my injuries have healed and no real issues can be found in tests or diagnostic imaging?

In short, it’s all in your head! No, this does not mean that you are “faking it” or that you are “imagining” pain that is actually not there. When looking at chronic pain, one could say that the brain most likely plays the biggest role in why and how we experience pain as individuals. Future blogs will hone in on the brain’s role in pain perception. We will also explore factors that influence how much pain we feel and will take time to cover effective pain management strategies that, with time and effort, can lead to improvements in one’s overall activity levels and affect.