Understanding chronic pain and pain systems

This chapter aims to help you understand more about:

•   The two types of pain, acute and chronic

•   Pain systems in the body

•   The different theories of pain, including the Gate Control Theory of Pain

Understanding pain

Chronic pain problems are very common. As many as 1 in 7 people are affected by chronic pain, often in different parts of their bodies. Pain is a very personal experience and only you really know how your own pain feels. It can be difficult to find words to describe it to other people. This can make it hard for them to understand how distressing your pain is for you.

Think about how you would describe your pain to someone. For instance, you might use words that describe the pain sensation, such as ‘sharp’, ‘shooting’, ‘nagging’ or ‘aching’. Or you might use words to describe how it makes you feel, such as ‘worried’, ‘scared’, ‘angry’, ‘down’, ‘guilty’ or ‘fed up’. You might also include phrases describing what you think about your pain such as:

•   I knew I shouldn’t have lifted that heavy container at work.

•   Pain means I’ve been injured. It hurts, so I shouldn’t move.

•   Headaches run in my family. I knew I would get them some time.

•   Bad backs never get better.

•   It’s a damaged nerve after the shingles. It must be serious!

You might also say that you have to do things differently or stop doing activities

•   I am unable to bend and pick things up from the floor.

•   It alters the way I move – I walk much more stiffly.

•   The pain makes me lie down more often.

•   It stops me going out with friends.

1   Look at the pain diagram opposite and circle the words that describe your pain.

2   Add any other words that you use to describe your pain.

3   Add a new branch to the diagram if you need to.

Pain affects you as a person in many ways.

Look at the impact of pain diagram on page 41. Add anything to it that you think has been missed out.

Acute and chronic pain

A worldwide group of pain specialists (International Association for Study of Pain (IASP) define pain as:

An unpleasant sensory and emotional experience which is due to actual or potential tissue damage or which is expressed in terms of such damage.

This is the definition most doctors and other health professionals use when assessing pain problems.

Doctors, nurses and physiotherapists used to think that pain systems in the body were very simple. However, we now understand that the experience of pain is much more complex. Current research in pain is focusing on how the body’s pain systems work. This will help doctors find ways to reduce pain levels in the future.

What is acute pain?

If you twist an ankle or slip and fall on your knees you will feel acute pain as the muscles, tendons, ligaments, bones, nerves or skin are damaged. You may see a bruise or swelling, and you may feel a lot of pain at the site where the injury has happened. The body releases chemicals and diverts blood to the area in order to help repair damaged tissue. Most pain symptoms usually reduce over six weeks as tissues heal. Nearly all injured tissues are fully healed at six months.