"Chronic pain has a distinct pathology, causing changes throughout the nervous system that often worsen over time. It has significant psychological and cognitive correlates and can constitute a serious, separate disease entity."
- Relieving Pain in America, Report by US Institute of Medicine, 2011
The International Association for the Study of Pain (IASP) defines pain as "an unpleasant sensory and emotional experience associated with actual or potential tissue damage."
All pain is an individual human experience that is entirely subjective and can only be truly appreciated by the person experiencing the pain.
Acute Pain: When pain is brief or short term (acute pain), it acts as a warning for the body to seek help. Acute pain occurs most commonly following injury or surgery and most patients can be helped with appropriate treatment. Effective timely treatment is essential to prevent transition to chronic pain.[i]
Chronic pain: Chronic pain is severe pain that occurs day after day, night after night for more then three months, and often continues long after the healing from an injury or surgery, or other condition that has been treated.
Some forms of chronic pain, for example pain associated with severe osteoarthritis, may be treated with therapy which may include medication or surgery; however other types of chronic pain, such as neuropathic pain or migraine, may be far more difficult to diagnose and treat.
When pain does not go away with treatment, becomes severe, and persists for several months, it can cause severe physical, psychological and environmental changes that result in the pain becoming a disease in its own right.
A large body of basic research indicates that chronic pain is associated with neuroplastic changes in the nervous system at peripheral, spinal cord and brain levels. Thus chronic pain is shown to have a distinct pathology that often worsens over time, and constitutes a serious separate disease entity.[ii]
Left untreated, chronic pain can have a devastating impact on all aspects of sufferers' lives. About 65 percent of people with chronic pain report interference with daily activities including sleep, sex, work, exercise and routine self-care, which can have a negative effect on personal relationships, social interactions and lifestyle.
Cancer Pain: Pain is one of the most feared aspects of cancer, It can occur in patients with both early stage and advanced disease, and in cancer survivors as a severe and debilitating side-effect of treatment.
[i] Macintyre PE, Schug SA, Scott DA, Visser EJ, Walker SM; APM:SE Working Group of the Australian and New Zealand College of Anaesthetists and Faculty of Pain Medicine (2010), Acute Pain Management: Scientific Evidence. Third edition. Australian and New Zealand College of Anaesthetists and Faculty of Pain Medicine, Melbourne.
[ii] Siddall PJ and Cousins MJ, 2004. Persistent pain as a disease entity: Implications for clinical management. Anesth Analg 99:510-520.
Chronic Pain in Children and Adolescents
Although the greatest incidence of chronic pain occurs in the 50-54 age bracket for women and the 55-59 age bracket for men, it also occurs in children and adolescents.
Children and adolescents can experience chronic pain through a wide range of medical conditions such as juvenile rheumatoid arthritis, scoliosis, cancer, migraine and chronic abdominal pain, or as a result of spinal cord injuries.
Untreated chronic pain in children is likely to manifest in low school attendance, poorer grades, and cessation of sporting or other activities.
For some, the eventual result is social isolation and depression, and these children tend to become adults who are not able to achieve their potential.
Therefore, parents and carers should seek medical advice if children or adolescents under their care are complaining of pain on a regular basis.
Understanding Pain: What to do about it in less than five minutes?