Acute vs. Persistent Pain
Pain is key to survival; it alerts us to potential hazards and motivates us to take action to protect ourselves. We refer to this pain as acute pain. Acute pain is provoked by a specific injury and characterized by actual or potential tissue damage. Acute pain usually comes on fast and typically resolves in weeks if appropriately treated. But what happens when your pain doesn’t go away?
When pain lasts longer than the typical tissue healing time (e.g. greater than three months), it gets referred to as chronic or persistent pain. Pain that persists is typically not linked to the initial injury and results from changes to a person’s nervous system. Our nervous system, which includes our brain, spinal cord, and nerves, can change and become more sensitive to various inputs. Here are a few of the changes that can take place:
- Nerve endings can become more sensitive
- Our brains begin to devote more space and energy to the body part
- Our thoughts and beliefs influence and further sensitize our pain systems.
Unfortunately, with persistent pain, we change how we move and begin to move less and less freely. If you’ve experienced chronic back pain, you’ll understand how you change how you bend to pick things up and now avoid certain activities to prevent a ‘flare-up’ over time.
Physiotherapy and Feeling Better
Treating acute pain from tissue damage is something that we, as physiotherapists, do daily. We have a variety of approaches ranging from ultrasound/TENS to acupuncture and specific rehabilitation exercises. Treating persistent pain requires a different approach. We want to retrain the brain as much as needing to retrain particular muscles and joints. We want to harness the power of neuroplasticity (the brain and nervous system’s ability to change) and reduce an overly sensitive nervous system. We aim to reteach the brain that movement is safe and will not cause further damage.