Chronic pain
Pain is a fascinating topic as it covers so many parameters of living. Pain is not just an unpleasant physical sensation. It is intimately influenced by attitudes, beliefs, personality and social factors, and affects physical as well as mental and emotional wellbeing. Although two people may have exactly the same condition, their experience of the pain can be vastly different. Pain can be acute or chronic, and it poses many challenges for the researchers, the practitioners and the patients alike.
Acute vs chronic
Acute pain lasts for a short time and occurs following some trauma or a specific condition. It has survival value and serves as the body’s warning system for injury or disease. As survival value, pain encourages you to seek medical help and makes you rest in the process of recovery, and then informs you — by its absence — when you can resume normal activities. Acute pain is also a teacher reminding you of harmful situations, teaching you what to avoid in the future and what to do to prevent it. People born without the capacity to feel pain rarely live beyond childhood because they do not learn to protect themselves from injury or disease.
Chronic pain however is very different; it lasts beyond the time expected for healing, and sometimes it exists without a clear reason at all. It can also be a condition in its own right, characterised by changes in the central nervous system. Chronic pain appears to serve no adaptive purpose. It is often not responsive to treatments based on specific remedies. Chronic severe pain has many negative consequences including psychological distress, social isolation and job losses, and is strongly associated with depression and anxiety, and in severe cases even suicide.
There are various definitions of chronic pain — with the distinction between acute and chronic pain often decided by an arbitrary period of time since onset, the most common markers being of three months or six months’ duration since onset, although some medical personnel determine the transition from acute to chronic pain to be 12 months. Generally, the symptoms are considered to be persistent pain anywhere in the body, associated with anxiety or depression, fatigue and sleep deprivation. Chronic pain that has no medical explanation is understood to involve an interplay between peripheral and central neurophysiological mechanisms that have malfunctioned.
Chronic severe pain has many negative consequences including psychological distress, social isolation and job losses, and is strongly associated with depression and anxiety, and in severe cases even suicide.
Painful facts
Chronic pain is a global biopsychosocial problem and is a rapidly growing public health epidemic. In Australia in 2018, 3.24 million Australians were living with chronic pain; 53.8 per cent of these are women (1.74 million) and 46.2 per cent are men (1.50 million). People of working age make up 68.3 per cent (2.21 million).
Among older Australians (those 65 years and over), 1.03 million were living with
