Chronic pain is a major health problem. It frequently devastates the lives of its sufferers and their families. It challenges and often overwhelms the medical care system. It is an extremely expensive burden to individuals, insurers and society. It differs substantially from acute pain and is best considered and treated as a separate, complex disease. Unfortunately, it is often treated as if it is acute pain.
Acute pain serves to alert us to and protect us from injury and illness. It compels us to fight or to escape danger and to rest and recover. Our responses to acute pain are essential for survival. Chronic pain has no known purpose or value. It causes or is caused by changes in any or all of the major parts or the nervous system. Perception of stimulation can become so severely altered that a benign stimulus becomes obnoxious and intolerable. Previously injured tissue may have healed completely but still is perceived as extremely painful. Chronic pain causes cognitive and memory impairment, depression, anxiety, panic, loss of libido, loss of pleasure, social withdrawal, hopelessness, helplessness, dependency, despair and more.
Intuitive responses to acute pain do not work for chronic pain. The avoidance of pain that promotes healing after acute injury or disease causes worsening of chronic pain. Chronic pain patients need to learn to understand and accept the condition of chronic pain in order to regain productive lives. They need to overcome fear of physical activity. They need to learn to overcome negative, self-destructive emotions and behaviors. They must learn how to eliminate anger and blame. They must overcome the expectation of failure, loss of hope and feelings of helplessness. They must master the skills required of a good pain manager.
