Most people experience acute pain, but ignoring persistent or severe symptoms and not seeking treatment can allow the pain to move into a chronic state.
One game that many older adults don’t enjoy is the “pain of the day” game, which involves saying what hurts and how much.
Often the new discomfort, called acute pain, is short-lived and goes away on its own or subsides with a combination of rest and over-the-counter remedies. But sometimes, the sharp pain persists and worsens into severe chronic pain.
“People can look at the occasional acute pain as the price of advancing age and learn to live with it,” says Edgar Ross, MD, chief clinician at the Harvard-affiliated Brigham and Women’s Hospital Pain Center. “But ignoring any pain level often leads to major problems that become difficult to treat and manage.”
Pain names
Most acute pain comes from damage to body tissue. It is known as nociceptive pain and results from physical trauma such as a sports or exercise injury, a broken bone, a medical procedure, or a household accident such as stubbing a toe, cutting a finger, or bumping into something. The pain can be sharp, stabbing, or shooting and usually heals in a few days or weeks.
In comparison, chronic pain lasts at least two to three months, often long after the injury or illness has healed, and may even become permanent. The symptoms and severity of chronic pain vary and may include dull, aching, burning, throbbing, or electric-shock-like pain, as well as sensations such as tingling and numbness.
Chronic pain may be related to tissue damage or ongoing inflammation, as in arthritis. However, persistent pain signals often originate in the brain, even when the nociceptive pain has disappeared. The brain has been modified to feel pain even when body tissues are not actively involved.
According to the CDC, 20 percent of adults suffer from chronic pain – most affected are those over 65 – and 7.4 percent experience chronic pain that limits their activities.
Seek help
Sometimes acute pain becomes chronic because the problem wasn’t addressed early on. “People think they can live with it or change their lifestyle to accommodate the pain, so they don’t get the right treatment,” Dr. Ross says.
Another barrier is psychological. “Sometimes people need regular movement, exercise, or physical therapy as part of acute pain management, but because it can be painful or uncomfortable, they avoid it, which can make their condition worse,” Dr. Ross says.
Avoiding treatment and allowing acute pain to persist can make people more sensitive to pain. “It makes the pain worse than it is and harder to bear,” Dr. Ross says.
The best way to prevent acute pain from becoming chronic is to face it head-on. “Don’t ignore it. Seek medical advice and get appropriate pain treatment, whether it’s heat and ice therapy, physical therapy, medication, rest, or a combination of the two,” Dr. Ross says. “The longer acute pain persists without appropriate treatment, the more likely it is to become chronic.”
Individual treatment
Chronic pain can be difficult and sometimes impossible to eliminate. In this case, the goal may be restoring function, controlling flare-ups, or reducing symptoms.
Of course, each treatment strategy depends on the individual’s medical history, the origin of the chronic pain, and its severity. A traditional approach is to work with a pain specialist to design an individualized treatment plan. This may include a combination of prescription pain medication, steroid injections, physical therapy, complementary treatments, and behavioral therapy.
Sometimes a psychological evaluation is recommended. Chronic pain can be traumatic and cause depression and anxiety that must be treated. There may also be personal stressors that make chronic pain worse, such as relationship or financial problems.
“It’s not easy to share personal issues, but exploring them can support and enhance the treatment and management strategy,” Dr. Ross says.
Treating chronic pain takes time and dedication. Depending on the duration of the pain, therapy can take months or even years. “Yet dealing with chronic pain is not hopeless,” says Dr. Ross. “There are many options to help people improve their quality of life.”
