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It is important to understand the difference between the terms acute and chronic. In medicine and the psychological world, acute is something that has happened immediately. In the dictionary, it is defined as a present experience of a severe or intense degree. On the other hand, chronic means an ongoing issue that has not been resolved. In the dictionary, it is defined as persisting for a long time, or constantly recurring.
Pain is neither good nor bad; rather it is a warning signal that something is wrong. Similar to a warning light on your car, pain is a symptom warning you of something that is wrong in the brain and/or body.
The warning signal of pain helps you to react and respond. Acute pain is an early warning signal. Its psychological component, or symptom, is Anxiety, which helps you to react quickly to the threat. For example, when too close to fire, acute pain tells you to react to its heat so that you can remove your hand and avoid getting burned.
Chronic pain is long lasting, often having a life of its own. Its psychological component is depression. Thus, chronic pain and depression often go hand in hand. Chronic Pain is also called Post-Traumatic Pain, since the source of the depression and pain has often happened at a much earlier time. Since Chronic Pain affects you emotionally, psychologically, physically and spiritually, there needs to be a more complex program in order for the treatment to be successful.
Muscular and emotional injuries from any type of direct trauma can be painful and slow to heal, but movement problems, emotional trauma, and Chronic Central Nervous System (CNS) Pain from diffuse brain injury, rotation injury, and blast injury may linger even longer. In some instances, these conditions may become permanent.
Pain, as defined by the International Association of the Study of Pain, is “an unpleasant sensory and emotional experience associated with actual or potential tissue damage, or described in terms of such damage.” The perception of pain is a complex operation that involves an intricate network of connections to and from the spinal cord and brain, which collectively are known as the Central Nervous System, or CNS. The location of the brain’s pain centers and the fine points of pain perception remain under research, but it is known that the CNS allows you to sense pain when something is not right with your body.
In a typical muscle or soft-tissue injury, the brain perceives that the area has been injured and sends a message to the muscle to respond by tightening, or spasming. This in turn causes the sensation of pain to be sent back to the brain, completing what is called the pain-spasm cycle. In addition, the actual injury causes the body to react and repair through an inflammation response.
Pain can be extremely difficult to assess, because it is personal and unique to the person experiencing it. Therefore, both subjective methods (what a person feels) and objective methods (diagnostic assessments) of scientific measurement are used in the assessment of pain.
The mnemonic device “COLDER” helps in assessing what your pain feels like. The letters stand for Character (whether the pain is stabbing, pinching, burning, etc), Onset, Location, Duration, Exacerbation (what makes the pain worse), and Relief (what makes the pain better). In addition, the frequency and severity of the pain is also assessed.
In questioning the character of your pain, your doctor may ask you to rate it from 0 to 10, with 0 meaning no pain and 10 meaning the most pain. The doctor may also ask you to rate the pain’s sensation, with 0 being dull pain and 10 being very sharp pain. Thus, a 10-10 would signify the most, extremely sharp pain.
The book Conquering Chronic Pain After Injury, by Doctors Simon, Ehrilich, and Sadwin, contains the following descriptions of the sensation of pain:
A history is also taken to see if the type of pain being experienced existed prior to the current injury or Brain Injury, such as a Concussion or Stroke. If so, the Concussion may have caused the pre-existing pain to increase. A review of medical records is needed to pinpoint what caused the pain before and what methods were helpful in its relief.
There are a vast number of clinical tests done to assess chronic pain. There is electrophysiological testing, such as the Nerve Conduction Velocity (NCV) study, which is used to investigate where damage has occurred in nerves supplying the various muscles in the body. Also, there are imaging tests to look for structural damage, along with psychological pain assessments such as the Vanderbilt Pain Management Inventory, Cognitive Coping Strategies, and the Multidimensional Pain Inventory. Each of the test methods provides information to help the clinician make a proper diagnosis and provide the most suitable treatment to help you manage and cope with your Chronic Pain.
Our integrative team of Brain Health Experts provides you with help from Chronic Pain Condition and can work with your current providers to help you regain your life again. Depending where you live in the world, the Brain Health Experts can provide virtual treatment too. If this is not possible, Dr. Diane and/or the Brain Health team expert will find someone in your locale to help you.
If you want an end to your suffering from Chronic Pain Condition and a customized approach designed for you, consult Dr. Diane. There is a Way!