Chronic Pain

Let’s continue to look at chronic pain in the same way as we examined acute pain and by asking the same questions. We can look at the answers that come back and compare them to each other to see if it teaches us anything.

In the acute pain model we looked at all the things we did know, what injured us, how to treat it, how long it would last etc. If we now do the same thing for chronic pain we get totally different answers.

This is a problem if we don’t understand that chronic pain is a different animal from acute pain and needs to be understood, treated and managed in a wholly different manner.

What we know about chronic pain:

• We often don’t know what was the cause of our chronic pain, or what made it become long term.
• We don’t know what has occurred inside our bodies, whether damage or an injury has occurred.
• We don’t know how to treat the pain. If we did know this it would improve or get better!
• We don’t know how long it will take for the pain to change.
• We don’t know when or if we will be able to be normal again.

That’s a big difference from what we know about acute pain! This means everything we know about acute pain is useless when we are trying to understand chronic pain. The map we have relied on is not accurate, all the signposts have been changed and the area we have found ourselves in is strange and unfamiliar.

Thinking about chronic pain using the Acute Pain Model is guaranteed to have two immediate effects, confusion and conflict. Typical questions are: What brought on the pain? There must be something wrong inside to explain this level of pain? Surely an investigation will find the cause and a treatment can then be found?  When is the pain going to subside? When can I get back to doing normal things?

A new way of thinking about pain processes is necessary to understand and deal with chronic pain. The challenges of this kind of pain cannot be faced without some new concepts and techniques.

As most chronic pains do not have any tissue damage identifiable to explain the pain CHRONIC PAIN DOES NOT EQUAL HARM is the way we think about this kind of pain.

Chronic pain is a USELESS PAIN, because if it was useful it would guide us in how to manage our problem and it would get better. Since we don’t get better, this kind of pain has no function.

It’s very important to understand this about chronic pain, and next we will go on to how pain is generated in normal circumstances before venturing into how it happens in pathological states.

Check out the third instalment of the Pain Ecourse.