Chronic Pain

Abstract

The major dichotomy that must be addressed when you evaluate a patient with pain is whether the pain is acute or chronic. Acute pain,very simply, is pain that almost always has a clear etiology and may last for days or weeks. Chronic pain, on the other hand, may or may not have a clear and rational etiology and has lasted for 6 months or longer. Although acute pain involves both “physical” and “psychological” components, it is usually thought of as being primarily “physical” in etiology. Chronic pain, on the other hand, is widely believed to have a significant psychological component in addition to a physical component that initiated the pain process. The psychological component (whether it involves a comorbid depressive spectrum illness, fear of being injured again, fear of succumbing to unbearable pain and dying, activity or work avoidance, or other factors) is sometimes believed to be a contributor to the persistence of pain after the physical healing processes should have been completed. (This concept assumes that the underlying tissue damage which originally caused the pain has been healed and is not recurrent.)