Pain is best described as a sense – much like smell, touch, or sight, our sense of pain helps us interpret and navigate the world around us and respond to both potential and real threats via our brain’s processing of information. Pain is a preservation tool our nervous system employs to warn us of certain stimuli, ranging from the uncomfortable to the deadly. But while pain is always meant to serve a purpose, there are times when it does not.
How and Why Does Pain Occur?
Pain begins in the central nervous system. While the stimuli that leads us to feel pain is usually (though not always) external, the actual feeling of pain stems from our brain. Pain usually begins with nociception, or the encoding of stimuli received and transmitted via our nociceptors, or pain nerves. The result of this information is the feeling of pain, the experience and understanding that something is deeply unpleasant and should be avoided.
Our pain receptors are spread throughout the body, especially in our skin and internal organs. Pain is not always concurrent with nociception. The two concepts exist separately. You can feel pain for a limb that is not there. You can fail to feel pain even when the nociceptive process has occurred, due to a chemical disruption. You can even feel pain when there is no real danger to the body, as is often the case with inflammation and depression.
As a whole, we are still learning about the experience of pain, and exactly how it is triggered and modulated in the mind. That being said, we do know a few things about how pain works, and how it can be treated – as well as when it should be treated. Most pain can be categorized as either acute (pain felt concisely, in relation to an injury or disease) or chronic (recurring over the course of months, often not immediately related to the original cause or trigger). The nature and importance of pain in medicine and survival is inherently contradictory, and lines are often blurred.
Pain is important and good – it helps us avoid danger. But at a certain point, and given certain circumstances, pain can be bad, only serving to cause suffering in a patient who otherwise does not need to feel any pain to heal. This dichotomy is more obvious in the difference between acute vs chronic pain – one is a warning mechanism (acute pain), and the other is sometimes considered a disease (chronic pain). Differentiating between the two is important – as is knowing when and how to treat pain.
What Is Acute Pain?
Acute pain serves a critical function as a means for us to detect and react to dangers in the environment. For example: we learn from a painful experience that we shouldn’t touch the stove – and the acute pain felt in the burn we receive from the stove also reminds us not to let anything come in contact with the wound while it heals, to avoid infection or possible further damage.
Internal stimuli can produce acute pain, such as stomach pain while passing gas. An aching knee weeks after a severe injury serves as a reminder to go easy on the joint and prevent further damage, providing a feedback framework to work with during rehabilitation, whereas a severe or sharp pain in the abdomen might tell us to rush to an emergency room.
What Is Chronic Pain?
Chronic pain is separated from acute pain by the recurring nature and length of the pain, and presupposition that chronic pain is no longer serving as a warning system or method of self-preservation. When a body part suffers major physical trauma, the acute pain can last weeks.
It takes a long time for the body to heal from certain wounds and injuries, and during that time, we may feel the pain come and go as our body recovers. But when the pain continues to persist despite an injury having healed, it may have become chronic. Pain that continues to persist for at least 3 to 6 months is considered chronic pain, but the definition can also depend on the condition or cause of the pain in question.
Acute vs Chronic Pain
When it comes to acute vs chronic pain, both are regarded and treated differently. Whereas acute pain is a normal consequence of injury and disease and is often included in the management and treatment of a patient’s illness or condition, chronic pain describes a large subset of conditions that may not necessarily be related to their initial trigger, if one existed at all. Conditions that can cause prolonged and chronic pain include:
Why Does Chronic Pain Occur?
In many cases, chronic pain is caused by damaged nerves sending errant pain signals to the brain. In other cases, the pain may be a consequence of other systemic issues, including prolonged and widespread inflammation, recurring viral infections, or attacks by the body’s immune system on itself.
Different causes require different treatments, even if the general symptoms of the pain appear similar. There is also a psychological element to consider. Chronic pain can be exacerbated by a patient’s mood and mental state – and in some cases, it can be treated through a combination of medication as well as psychiatric therapy.
Treatment for Acute vs Chronic Pain
Pain in general is treated both at the source and in our nervous system. Different medications are skilled at reducing or disrupting communications between our nociceptors and our central nervous system. Some drugs are less effective than others, especially over long periods of time. Some drugs specialize in reducing pain by reducing inflammation, including so called anti-inflammatories (NSAIDs). Other treatments include physical therapy and rehabilitation to reduce stress on an area post-injury and help promote healing.
Surgical interventions may be necessary in recurring injuries or unstable ones, especially spinal injuries with extensive damage. Certain injections can help treat locational pain far more precisely than oral medication, including short-term nerve blocks. Any pain management plan will depend entirely on the cause and circumstances of the pain. There are treatments that might seem effective for acute pain, but less so for a chronic problem.
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