When acute pain becomes chronic

Acute pain vs. chronic pain

Acute pain is usually short-lived (less than a month), and has a specific cause, such as having had oral surgery or spraining an ankle. Acute pain commonly goes away when the original cause of the pain is no longer present or when the healing takes place.

Chronic pain, however, may not go away so quickly (lasting 3 months or longer), and may be around long after the healing takes place. In fact, chronic pain may continue for months or years, such as back pain caused by degenerative disc disease or arthritis. Pain from these types of conditions may be more difficult to resolve because of the chronic nature of these conditions. Sometimes the pain may become chronic simply because there is no known cure for the cause, such as with rheumatoid arthritis. Other times the cause of the chronic pain might be unknown or poorly understood.

Examples of acute pain

Acute pain is pain is often directly related to an identifiable event or injury, like post-surgical pain – and will usually resolve with time and may or may not need short-term treatment. Some other examples of health issues that involve acute pain include: pain from a broken bone, back strain, dental work, burns or cuts, and labor and childbirth.

Examples of acute pain that can become chronic pain

Chronic pain may result from acute pain that lasts for a longer than expected amount of time, and may require a variety of therapies to manage. In some cases, the pain may never totally resolve. Some examples of acute pain that can become chronic pain: certain types of headaches (migraines), some types of back pain, cancer-related pain, arthritis pain, and neuropathic pain.

 

Managing pain

There is a vast array of ways to treat pain, ranging from over-the-counter medications to prescription medications. Options for the treatment of pain might include one or more of the following: non-steroidal anti-inflammatory drugs (NSAIDs, such as ibuprofen)  acetaminophen, prescription opioid medications, local anesthetics, nerve blocks, electrical stimulation, physical therapy, surgery, psychotherapy (talk therapy), relaxation techniques (such as deep breathing), biofeedback (treatment technique in which people are trained to improve their health by using signals from their own bodies), and behavior modification.
Other complementary and alternative methods (CAM) may also be options to explore with your healthcare provider— including massage, acupuncture, herbal remedies, meditation, and yoga. These methods may be useful on their own or in addition to traditional analgesic treatments.

Short-term disability

Employees may quickly “use up” their paid sick days if they suffer an illness or injury that leads to acute pain. Short-term disability plans provide you with an income source when you have used up your paid time off. Some employers and government agencies fund these plans for employees, but you can also buy your own disability insurance if you are not covered by a group plan. Short-term disability plans are optional, but the Family and Medical Leave Act (FMLA) applies to employees in all 50 states.

Treating acute pain to prevent chronic pain

There may be ways to manage and treat acute pain in order to prevent the changeover to chronic pain. In other words, there may be ways to help prevent a short-term disability from becoming a long-term one. In some cases, there may be signs or situations that make acute pain likely to become chronic. By discovering these characteristics, healthcare providers can personalize the treatment plan for acute pain, and try to help you prevent the pain from becoming chronic. In certain cases, there may be biological “markers” that signal whose acute pain is likely to evolve into a chronic form. For example, new brain imaging studies can predict which people will suffer from chronic pain after the acute phase, and treatment can be adjusted by the physician accordingly. Scientists are also trying to determine if acute pain causes brain changes in certain people that might enhance pain sensitivity and make it more likely to lead to chronic pain.

There may also be behavioral changes that can be applied to avoid developing chronic pain from acute pain, and psychological therapy may also be helpful. Dr. Michael Clark’s article, referenced below, goes into more detail on this topic.

When you are suffering from acute pain, the goal is always to better understand what’s causing it, how best to treat it, and how to prevent it from becoming chronic whenever possible.

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References

Ciaran, J. (2015). FMLA vs. Short Term Disability. Retrieved from http://smallbusiness.chron.com/fmla-vs-short-term-disability-40527.html

Clark, Michael, MD, MPH, MBA. (2013). How best to prevent acute pain from becoming chronic? Retrieved from http://www.chronicpainperspectives.com/topics/neuropathy/article/how-best-to-prevent-acute-pain-from-becoming-chronic/910995b0c5c10d56ce8a484abb4fab4a.html

Collins, Francis, MD. (2013).  How Does Acute Pain Become Chronic? Retrieved from http://directorsblog.nih.gov/2013/08/13/how-does-acute-pain-become-chronic/

Department of Labor. (2015). Need Time? The Employees Guide to the Family Medical Leave Act. http://www.dol.gov/whd/fmla/employeeguide.pdf

Zacharoff, Kevin L., MD. (2015). When Acute Pain Becomes Chronic. Retrieved from http://conference.painweek.org/painweekend/media/mediafile_attachments/03/263-1whenacutepainbecomeschronic.pdf