Understanding acute and persistent chronic pain

Sometimes words get bandied about and we may not be entirely sure we know what they mean. This can be especially so when it comes to medical terms and their meaning. Here we’re concentrating on understanding what acute and persistent chronic pain is.

Persistent pain is annoying and feels like it’s going to last forever (persistent is the clue!). It’s also called chronic pain, but chronic just means that it’s been going on for a long time rather than the intensity of the pain to you. Because here’s another thing, pain is subjective, so what might be excruciating to you is just a little annoyance to someone else. And that can make it challenging for treatment. And it’s not helped by the fact that often we can’t describe how our pain feels to give it the intensity we feel that it deserves.

So, let’s look at persistent or chronic versus acute pain. Persistent and chronic can be used interchangeably as they both represent the same thing.

Persistent or chronic pain is pain that has lasted for longer than 12 weeks. That is pain you have experienced for 3 months or longer, a quarter of the year. I want to really drive home that this is long term pain. I had sciatica some years ago which lasted for eighteen months. I know the trigger for it; training for a charity bike ride, along with having had some back issues since my teenage years. I made various changes to my bike, but the impact of all the leaning towards the handlebars didn’t help. It was very distracting on a day-to-day basis, especially as I was teaching lots of fitness classes at the time! And at the time, I struggled to see a point in the future when the pain would stop being there, but thankfully it did. Long term pain impacts all aspects of our life and often those around us.

But, before we get to the persistent or chronic pain, we have to experience the event/injury. This is known as the acute phase. This is the part where you injure yourself or however the pain begins for you. The acute phase of an injury is said to last for up to twelve weeks (it all depends on you and the presenting issue).

The acute phase is the bit that tells us and our body that we’re done something to ourselves. We’ll commonly have inflammation with it (redness) and some pain (to stop us doing it again or something that will add to our injury). This (should) make us take steps to reduce the pain and inflammation such as applying RICES (Rest, Ice, Compression, Elevation, Support) and or take painkillers to help (depending on medical advice).

We know we instinctively move to protect ourselves when pain strikes, such as holding the sore bit, rubbing it, running it under cold water etc. As we recover, the inflammation and redness reduce and disappears and full movement returns.

Typically, pain goes before the end of twelve weeks, but we may take longer to heal depending on what the problem is. We don’t need to keep the pain for the full duration of our recovery. It is just there as an alarm in the first place. Once the injury has been dealt with the pain is not needed as a constant reminder.

However, if the pain does continue past twelve weeks, it becomes known as persistent or chronic pain. So, my previously mentioned sciatica that lasted for 18 months (it was a joy! Not)! was very definitely in the chronic pain category. But not all long-term pain is created equally; maybe you’re pregnant and are having pain and discomfort throughout your pregnancy. So, there is also a logical cause for the discomfort, you’re growing a human and in nine months that human will be born and you will recover.

Sometimes, there is a reason for the pain remaining, maybe there is ongoing issues or treatment that keeps prolonging it. But often times we don’t need the pain to remind us that we have an issue. We’re very clever us humans, we know (well most of us know) what our limitations are. We don’t require the constant pain on top of that to remind us.

For instance, arthritis. Some of you may have it in various joints, it often causes stiffness, inflammation and pain. You know you have arthritis; you know what your limitations are, you know what triggers it. So why do you need the pain to remind you? Unless you are a person who is prone to ignoring your own abilities and pushing on regardless, but that is a whole other issue!

Start understanding your persistent chronic pain with this handy Investigating Your Pain Guide here and keep an eye open for part 2 next weeks about becoming your own investigator.