There are a lot of misconceptions about the term “Chronic Pain,” and it has been a highly researched area in recent years. A 2020 Centers for Disease Control and Prevention (CDC) analysis of data from the National Health Interview Survey estimated that 20.5 percent (50.2 million) of adults in the United States had chronic pain and 10 percent of adults (24.4 million) had high-impact chronic pain with work limitations **
According to the International Association for the Study of Pain, the definition of pain is: the unpleasant sensory and emotional experience associated with actual or potential tissue damage, or described in terms of such damage. The differences between acute and chronic pain include:
Acute pain - lasts 3-6 months, resolves when tissue healing occurs, psychological symptoms of fear, anxiety, sleeplessness improve when tissue healing occurs
Chronic pain- lasts greater than 3-6 months, extends beyond tissue healing, psychological symptoms of fear, anxiety, and sleeplessness last long past when the tissue has healed.
Treatments are very different for acute versus chronic:
Acute: control swelling (RICE - rest, ice, compression, elevation), fracture management, wound care, treat infection
Chronic: the above issues have been resolved so focus shifts to monitoring the whole person- especially the Central Nervous System (CNS) including the brain, nerves, and spinal cord. In order to understand chronic pain, we need to understand the path a stimulus takes in the body as in the pathway below:
PAIN PATHWAY… a stimulus activates specialized nerve cells in the body tissues -> pain signal enters the spinal cord -> thoughts, feelings, and beliefs affect the signal and change it into the person’s “pain experience” -> pain signal enters the brain and the pain experience is interpreted -> more nerves send descending signals down the spinal cord that cause a reaction to the stimulus (whether this is to heighten the sensation or minimize it).
Some things that affect the interpretation of the stimuli include past experience, mental status at the time of injury, fear of re-occurrence, anxiety towards an unrelated situation, and the status of the current physical environment (chaos vs calm). The CNS can magnify pain signals and other sensory input and then they are processed by the brain as a threat. Even ordinary stimulus (such as a light touch) can be interpreted as painful by the brain
Retraining the brain and sensory system should be part of every chronic pain program-along with increasing awareness of the body systems and adding activity modification training and pacing. Exercise is a major factor in managing chronic pain. Yoga provides meditation, breath-work, and mindfulness to decrease outside sensory stimulation and allow the person to center themselves in a calming environment. The physical practice of yoga (asana) can restore confidence in movement and instructors can guide their clients through poses that restore function.
Since chronic pain derives from physical, social, and emotional factors, it typically takes a team approach to manage it. At Radect, we want to help our members find ways to identify and overcome these symptoms of chronic pain to improve their quality of life.
Written by Rochell Paulson PT, RYT
**Zelaya CE, Dahlhamer JM, Lucas JW, Connor EM, Chronic Pain and High Impact Chronic Pain Among US Adults, 2019. NCHS Data Brief 2020