Acute vs. Chronic Pain, and how to treat them differently

Acute vs. Chronic Pain, and how to treat them differently

Pain should be on the radar of every health care provider, as it affects more Americans “than diabetes, heart disease and cancer combined,” according to the American Academy of Pain Medicine.(1) While it’s typically an unpleasant experience, pain serves an important biological function, “warning the body of impending danger” as part of the fight or flight response of the nervous system according to a 2017 study in the American Journal of Nursing.(2) It’s also one of the most frequent complaints of patients who are checking into emergency departments (ED). The study also found that pain is the cause of about 42% of ED visits.(2)

While acute and chronic pain can have similar effects on both physical and mental well being of patients, their origins and treatment approaches should be different:

Acute pain

Acute pain tends to occur most commonly as a result of trauma(2) to the body, both accidental—such as a broken ankle, or a car accident—or as a result of medical treatments such as surgeries or injections. This sort of pain is “adaptive” according to the American Pain Society(3)—a natural response to the damaged tissue, but likely to ease over time with proper care. Despite its tendency to resolve within approximately six weeks,(4) acute pain can cause physical and psychological consequences, including “excessive stress response, progression to chronic pain, inability to comply with rehabilitation, patient suffering and dissatisfaction.”(3) It is important to treat acute pain promptly and adequately so that it does not become chronic pain. With early intervention, acute pain has a good success rate.(3)

The American Pain Society [‘s recommendations] include the following treatments for acute pain: (3)

  • Early intervention, with continual and timely adjustments to therapies and medications if pain is not controlled.
  • Reduction of pain “to acceptable levels.”
  • Treatment of any underlying disease or injury to promote recovery.

Chronic pain

Chronic pain is pain that persists for longer than 12 weeks, or longer than the expected time of recovery.(4) It may have started out as acute pain, but for whatever reason, “pain signals keep firing in the nervous system for weeks, months, even years,” according to the American Academy of Pain Medicine.(1) Chronic pain is associated with “significant physical, emotional, and social disability,” according to the American Pain Society. One hundred million people in the United States, and 1.5 billion people worldwide suffer from chronic pain’s persistent, often life-altering effects(1) including “significant physical, emotional, and social” aspects.(3)

The American Pain Society [‘s recommendations] include the following treatments for chronic pain:(3)

  • Help the patient reduce physical suffering through [various therapeutic strategies, which can include combination drug therapy], regional anesthesia, and/or rehabilitative therapies.
  • Help patient increase and restore “physical, social, vocational, and recreational function” through functional rehabilitation(3)—a toolkit of skills that includes education, assessing the progress of pain at regular intervals, attending to other disorders that could be exacerbating pain, such as depression, and helping the patient to set realistic treatment goals
  • Help patient create “self-help strategies,” that provide a greater reliance on the self and reduce dependence on the health care system, professionals, and even friends and family.

References

  1. American Academy of Pain Medicine. “AAPM Facts and Figures on Pain.” Available online at http://www.painmed.org/patientcenter/facts_on_pain.aspx#chronic
  2. Jungqhist, Carla R. AJN. “Assessing and Managing Acute Pain: A Call to Action.” The American Journal of Nursing: March 2017 – Volume 117 – Issue 3 – p S4–S11 doi: 10.1097/01.NAJ.0000513526.33816.0e
  3. National Pharmaceutical Council monograph. “Pain: Current Understanding of Assessment, Management, and Treatments.” Section IV: Management of Acute Pain and Chronic Noncancer Pain. December, 2001. https://www.npcnow.org/system/files/research/download/Pain-Current-Understanding-of-Assessment-Management-and-Treatments.pdf
  4. Human Performance Resource Center. “What is the difference between acute and chronic pain?” 30, April, 2018.