Acute Vs Chronic Pain

  • Munira Ali  MSc Medical Biotechnology and Business Management, Life science, University of Warwick
  • Isobel Cronshaw BEng in Biomedical Systems Engineering, University of Warwick

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Introduction

Pain is a common complex physiological process linked with an unpleasant emotional and sensory experience. Specialised nerve cells called nociceptors, or pain receptors, are responsible for transmitting pain signals to the brain. Pain acts as a crucial early warning system, informing us of possible danger and directing our course of action. Comprehending both acute and chronic pain is essential for providing efficient treatment for an injury. When an accident occurs, acute pain usually subsides quickly, but chronic pain lasts for longer periods and frequently results in long-term distress and functional damage. Accurate diagnosis and treatment depend on being able to distinguish between the two. This article will give a clear and thorough framework for examining the main distinctions between acute and chronic pain.1,2

Acute pain

Acute pain is a sharp, intense ache typically resulting from specific triggers and injuries. Common causes of acute pain include injuries, such as sprains and fractures, surgical procedures, and infections. Acute pain is characterised by its abrupt onset, brief duration, and typically localised nature, which is often limited to the site of injury. Diagnosis and assessment of acute pain involves evaluating the underlying cause, pain intensity, and patient history. Treatment options for acute pain include the use of pain relievers to alleviate discomfort, rest to facilitate healing, and physical therapy to aid in recovery, ensuring a faster return to normal function.2,3

Chronic pain

Chronic pain is persistent and long-lasting discomfort that endures for more than 3 months.4 Chronic pain is often a result of disease or injury, and is considered as a separate condition rather than a symptom. Examples of common causes of chronic pain include arthritis and fibromyalgia, nerve damage, and psychological factors such as stress or depression.5 Chronic pain is characterised by its sustaining nature, potential diffusion to multiple areas, and its substantial impact on daily life and overall well-being. Diagnosis and assessment involve a comprehensive evaluation of the underlying causes, pain management history, and the patient's overall health. Treatment options for chronic pain include the use of medications, physical therapy, psychological therapy, and lifestyle adjustments, aiming to improve the patient's quality of life and provide long-term relief.6

Key differences between acute and chronic pain

Duration:

  • Acute Pain: Acute pain is characterised by its short-lived nature, typically resulting from a specific injury or medical condition. It lasts for a relatively brief period and often resolves once the underlying issue is treated.
  • Chronic Pain: Chronic pain, in contrast, persists for a prolonged duration, lasting more than 3-6 months. It can become a long-term or lifelong challenge, often without a clear endpoint.

Causes:

  • Acute Pain: Typically arises from well-defined causes such as injury, surgery, or infections, making it easier to identify and treat.
  • Chronic Pain: Is more complex and can be caused by ongoing medical conditions like arthritis, fibromyalgia, nerve damage, or psychological factors, making diagnosis and management more challenging.

Intensity:

  • Acute Pain: Tends to be intense, but its severity often corresponds with the underlying cause. Once the cause is addressed, the pain typically diminishes.
  • Chronic Pain: Can vary in intensity over time. It can be constant or episodic, ranging from mild to severe, and may not always align with the severity of the underlying condition.

Localisation:

  • Acute Pain: Is typically localised to the specific site of injury or trauma, making it easier to pinpoint.
  • Chronic Pain: Can be widespread, affecting multiple areas of the body, and may not always be limited to the source of the underlying condition.

Impact on daily life:

  • Acute Pain: Although acute pain can be severe, it is often short-lived and does not typically lead to long-term disruption of daily life.
  • Chronic Pain: Chronic pain significantly impacts daily life, potentially causing disability, impairing mobility, and affecting mental and emotional well-being. It can result in substantial lifestyle adjustments and persistent challenges.

Understanding these key differences between both acute and chronic pain is essential for accurate diagnosis and effective management, as the approaches to treatment and coping strategies differ significantly between these two categories.7,8

Management and coping strategies

Early intervention is paramount in addressing acute pain effectively. Swift medical attention can prevent the escalation of pain and potential complications. This may involve pain relief medication, rest, and treatment of the underlying cause, such as setting a broken bone or treating an infection. The timely management of acute pain can promote a quicker and more complete recovery, reducing the risk of it transitioning into chronic pain.9 Chronic pain often necessitates an approach involving a multidisciplinary team of healthcare professionals, including physicians, physical therapists, psychologists, and pain specialists. This collaborative effort addresses the multifaceted nature of chronic pain, offering a comprehensive treatment plan that may include medication management, physical therapy, psychological interventions, and alternative therapies. This holistic approach can improve the quality of life for individuals with chronic pain, as it tackles both the physical and emotional aspects of their condition.10

Patients with chronic pain can play an active role in their treatment by learning self-management techniques. These may include lifestyle adjustments, exercises, mindfulness, and stress reduction strategies. Empowering patients to manage their pain and improve their overall well-being is a critical aspect of long-term pain management.11

Both acute and chronic pain patients benefit from access to a support network and educational resources. Support can come from friends, family, or support groups, providing a sense of understanding and camaraderie. Access to informational resources helps patients make informed decisions about their care, promoting better-coping strategies and self-advocacy. Support and resources play a crucial role in helping individuals navigate the challenges that pain can bring and improve their overall quality of life.12


Summary

Distinct differences exist between acute and chronic pain in terms of duration, causes, intensity, localisation, and impact on daily life. Understanding these disparities is vital for accurate diagnosis and effective management. Proper diagnosis and treatment are paramount for pain management. A precise diagnosis lays the foundation for appropriate interventions, whether it's instant intervention for acute pain treatment or a more complex, long-term approach for chronic pain.

Managing pain is a collaborative effort involving both patients and healthcare professionals. Patients can actively participate in self-management techniques, while healthcare providers offer expertise and guidance to ensure the best possible outcomes. It's crucial to encourage individuals to seek help when experiencing persistent pain as early intervention can prevent acute pain from developing into chronic pain. Timely diagnosis and treatment can improve the quality of life for those dealing with long-lasting pain.

References

  • How We Feel Pain. The National Vulvodynia Association [Internet]. [cited 2024 Mar 12]. Available from: https://www.nva.org/learnpatient/how-we-feel-pain/.
  • Pain | National Institute of Neurological Disorders and Stroke [Internet]. [cited 2024 Mar 12]. Available from: https://www.ninds.nih.gov/health-information/disorders/pain.
  • Hsu JR, Mir H, Wally MK, Seymour RB, the Orthopaedic Trauma Association Musculoskeletal Pain Task Force. Clinical Practice Guidelines for Pain Management in Acute Musculoskeletal Injury. Journal of Orthopaedic Trauma [Internet]. 2019 [cited 2024 Mar 12]; 33(5):e158–82. Available from: https://journals.lww.com/00005131-201905000-00011.
  • Treede R-D, Rief W, Barke A, Aziz Q, Bennett MI, Benoliel R, et al. A classification of chronic pain for ICD-11. Pain [Internet]. 2015 [cited 2024 Mar 12]; 156(6):1003–7. Available from: https://journals.lww.com/00006396-201506000-00006.
  • Mills SEE, Nicolson KP, Smith BH. Chronic pain: a review of its epidemiology and associated factors in population-based studies. British Journal of Anaesthesia [Internet]. 2019 [cited 2024 Mar 12]; 123(2):e273–83. Available from: https://linkinghub.elsevier.com/retrieve/pii/S0007091219302272.
  • Fenske JN, Berland DW, Chandran S, Van Harrison R, Schneiderhan J, Hilliard PE, et al. Pain Management [Internet]. Ann Arbor (MI): Michigan Medicine University of Michigan; 2021 [cited 2024 Mar 12]. Available from: http://www.ncbi.nlm.nih.gov/books/NBK572296/.
  • Dueñas M, Ojeda B, Salazar A, Mico JA, Failde I. A review of chronic pain impact on patients, their social environment and the health care system. JPR [Internet]. 2016 [cited 2024 Mar 12]; 9:457–67. Available from: https://www.dovepress.com/a-review-of-chronic-pain-impact-on-patients-their-social-environment-a-peer-reviewed-fulltext-article-JPR.
  • Grichnik KP, Ferrante FM. The difference between acute and chronic pain. Mt Sinai J Med. 1991; 58(3):217–20.
  • Abdolrazaghnejad A, Banaie M, Tavakoli N, Safdari M, Rajabpour-Sanati A. Pain Management in the Emergency Department: a Review Article on Options and Methods. Advanced Journal of Emergency Medicine [Internet]. 2018 [cited 2024 Mar 12]; (In press). Available from: https://doi.org/10.22114/ajem.v0i0.93.
  • Pergolizzi J, Ahlbeck K, Aldington D, Alon E, Coluzzi F, Dahan A, et al. The development of chronic pain: physiological CHANGE necessitates a multidisciplinary approach to treatment. Current Medical Research and Opinion [Internet]. 2013 [cited 2024 Mar 12]; 29(9):1127–35. Available from: http://www.tandfonline.com/doi/full/10.1185/03007995.2013.810615.
  • Rod K. Finding Ways to Lift Barriers to Care for Chronic Pain Patients: Outcomes of Using Internet-Based Self-Management Activities to Reduce Pain and Improve Quality of Life. Pain Research and Management [Internet]. 2016 [cited 2024 Mar 12]; 2016:1–8. Available from: http://www.hindawi.com/journals/prm/2016/8714785/.
  • Molina-Mula J, Gallo-Estrada J. Impact of Nurse-Patient Relationship on Quality of Care and Patient Autonomy in Decision-Making. IJERPH [Internet]. 2020 [cited 2024 Mar 12]; 17(3):835. Available from: https://www.mdpi.com/1660-4601/17/3/835.

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Munira Ali

MSc Medical Biotechnology and Business Management, Life science, University of Warwick

Munira holds an MSc in Medical Biotechnology and has a long-standing interest in how we can apply scientific findings to our everyday life. Munira finds that her day job as a scientist gives her the structure and discipline that scientific writing requires. Munira ultimately aspires to make science comprehensible and accessible to the general public.

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