Sign up for free to ask questions and discover great content.
What causes chronic pain to be different from acute pain?
Neurologically what is happening in chronic pain that makes it persist?
6 Answers
Russell Jurney, Applied Technology Historian
12 votes by Paul Shapiro, Sam Rash, Anon User, (more)Loading...
Acute pain is useful. Chronic pain is a motherfucker.
To be more specific: acute pain is a symptom of an acute injury that
requires medical attention, rest, and healing. Chronic pain is a disease. It is pain
that is not necessarily associated with a detectable underlying
malady.
Some notable differences between acute and moderate/severe chronic pain, that come from the Stanford Pain Management Center's outpatient pain class, as I remember them:
I'm not a doctor, just some guy.
To be more specific: acute pain is a symptom of an acute injury that
requires medical attention, rest, and healing. Chronic pain is a disease. It is pain
that is not necessarily associated with a detectable underlying
malady.
Some notable differences between acute and moderate/severe chronic pain, that come from the Stanford Pain Management Center's outpatient pain class, as I remember them:
- Everyone understands acute pain, as it is experienced by all people. Few people understand serious chronic pain, as it is relatively rare.
- You can 'walk off' acute pain. You can tough it out. You cannot 'walk off' chronic pain. If you don't learn to manage it, it will break the strongest person. See: http://en.wikipedia.org/w
iki/Acu... - You can take opiate pain medications for acute pain without serious risk of addiction or side effects. Long-term use of opiate medications for chronic pain is associated with tolerance, dependence and addiction, increased pain sensitivity, reduced testosterone, and other problems.
- There is no stigma to acute pain. Sympathy abounds. There is a stigma with chronic pain. People may think it is 'all in your head.' (Ever seen that scene in the movie The Beach where they drag the shark bite victims out into the jungle to die because they're tired of the wailing?) Actually, it's all in your peripheral nervous system ('your spinal nerve roots'), not the central nervous system ('your head').
- Acute pain is the normal, expected response to the activation of nociceptors during injury. Chronic pain is an endless loop in the peripheral nervous system where pain is amplified as it travels from nociceptors to your spinal chord, and then on to your brain.
- Acute pain has a cure: healing. Chronic pain is rarely cured. You must learn to live with it.
- Resting a lot helps acute pain, by allowing the injury to heal. Resting a lot inflames chronic pain. Keeping active reduces chronic pain.
- Everyone knows when they start to experience acute pain. Nobody knows they are experiencing the onset of chronic pain. You know that something is wrong with you, you are hurting and you keep expecting it to get better. Just like always. But it doesn't. It begins to affect your whole life. Unmanaged, it destroys lives.
- Acute pain can be treated with analgesics or corrective action of the underlying problem. Chronic pain requires a complete lifestyle change to manage the disease long-term. Analgesics are a small part of treatment.
- You may be blamed for your chronic pain. You may blame yourself. We don't know why chronic pain happens, we only know certain risk factors. Because chronic pain is so disruptive to family, work and lifestyle, and because there is no clear cause... there is every opportunity to assign blame to the patient.
- You may be criminalized for your chronic pain. There are severe penalties for becoming addicted to addictive medications, which many chronic pain patients require long-term. If you need such medications, you are under the scrutiny of your doctor, pharmacist, law enforcement and others. Your prescribing doctor is under the scrutiny of the Drug Enforcement Agency.
I'm not a doctor, just some guy.
Denis Bédard, Palliative care physician
3 votes by Hong Chen, Anon User, and Russell Jurney
Acute pain is a very useful phenomenon. It tells you to take your hand of that burning stove, that your appendix is about to burst or that your leg is broken so you should not walk on it.
After a while, if pain remains untreated, the brain acts as if it had learned to feel that pain : this is known as wind-up phenomenon. Of course, that type of pain is no longer useful and by far more difficult to treat. You can find more information on in it by searching "pain wind-up" in wikipedia.
After a while, if pain remains untreated, the brain acts as if it had learned to feel that pain : this is known as wind-up phenomenon. Of course, that type of pain is no longer useful and by far more difficult to treat. You can find more information on in it by searching "pain wind-up" in wikipedia.
Anon User
1 vote by Russell Jurney
I'm sorry, but several of the answers given are simply wrong.
"Acute" anything in medicine means it is sudden in onset. It says nothing about how long it lasts.
"Chronic" means something that lasts a long time. A long time can be defined in different ways, but Chris Taylor's definition of "greater than 6 months" is as good as any for pain.
"Acute" anything in medicine means it is sudden in onset. It says nothing about how long it lasts.
"Chronic" means something that lasts a long time. A long time can be defined in different ways, but Chris Taylor's definition of "greater than 6 months" is as good as any for pain.
Christopher Taylor, Physiatrist (Non-Cervical Lumbar and ...
2 votes by Hong Chen and Russell Jurney
The definition of chronic pain is pain (an unpleasant sense of discomfort) that persists for greater than six months. Chronic pain usually arises from actual or potential tissue damage, but it will persist, or get worse even after the tissue has healed. Acute pain is pain that arises from actual or potential tissue damage that improves as the tissue damage heals. We don't know the exact reason why chronic pain occurs, but we be believe that when pain receptors in the body and brain receive a prolonged painful stimulus, there is modulation of the receptor causing it to be more sensitive to any stimulus, painful or not. The modulated receptor will allow a non-painful stimulus to be perceived as painful. Of course chronic pain will be present if the injury never heals, which is the case with some medical conditions.
Paul Shapiro, iOS & full-stack web, Design, Product
1 vote by Russell Jurney
By definitions, acute either means that the problem which causes the pain is temporary (e.g. trauma), or if not recognized properly, it can be caused by a problem that manifests in different places at different times.
Chronic pain is pain that repeatedly presents due to a problem which is not changed (problems that chronically present neurologically include slipped disc, stenosis, herniation, disease, foods which cause or help cause inflammation, etc).
Chronic pain is pain that repeatedly presents due to a problem which is not changed (problems that chronically present neurologically include slipped disc, stenosis, herniation, disease, foods which cause or help cause inflammation, etc).
Chet Collins, Diplomate in Pain Management
Acute pain is generated in response to pain generators such as tissue damage, muscle spasm, inflammation, etc. Acute pain can be reproduced over and over again for any length of time, but is decreased when the stimulus is removed. The tissues heal, the muscle stops spasming, the inflammatory response decreases. An example would be degenerative arthritis of a joint, where increased use causes increased pain, and decreased use reduces or eliminates the pain. This cycle can go on indefinitely, but it is still acute pain.
Chronic pain begins with changes to the central nervous system. The nerves that carry pain information become sensitized to the degree, that normal sensations of movement, pressure, temperature, light touch, are percieved as painful in the brain. This then causes the brain to respond just as if a damaging insult to the body, or an inflammation process is occurring. Muscles tighten to protect the area, blood vessel dialation can lead to chronic swelling, the person begins to react to their environment as if they are continually being injured. Chronic pain has an effect on the entire body, and mind of the person, even when the pain is perceived in only a single area. The cycle, once entered is very difficult to reverse. For this reason acute pain has become more important to control early on, and take directed measures to correct and relieve it, rather than the historical idea of just letting time take its course. For clinical guideline purposes, 6 months of pain duration is used, but the change to chronic pain can occur before that time.
Chronic pain begins with changes to the central nervous system. The nerves that carry pain information become sensitized to the degree, that normal sensations of movement, pressure, temperature, light touch, are percieved as painful in the brain. This then causes the brain to respond just as if a damaging insult to the body, or an inflammation process is occurring. Muscles tighten to protect the area, blood vessel dialation can lead to chronic swelling, the person begins to react to their environment as if they are continually being injured. Chronic pain has an effect on the entire body, and mind of the person, even when the pain is perceived in only a single area. The cycle, once entered is very difficult to reverse. For this reason acute pain has become more important to control early on, and take directed measures to correct and relieve it, rather than the historical idea of just letting time take its course. For clinical guideline purposes, 6 months of pain duration is used, but the change to chronic pain can occur before that time.
⌘⌘⌘
Sent from my Mac
Keine Kommentare:
Kommentar veröffentlichen