When pain persists

25 May 2020, 11:32AM

Chronic pain differs to sudden or acute pain and can be described as a sensitivity of the nervous system.

It’s also known as persistent pain since the pain persists beyond the expected healing time following an injury or illness – usually lasting longer than 12 weeks.

This can be due to changes in the body’s electrical wiring and brain pathways which detect and transmit pain signals. As a result, your body becomes more sensitive to pain and continues to send pain signals to your brain, even after the external painful stimuli has passed. The longer pain is left untreated, the higher the risk that your body will become sensitised to pain and that it will become chronic. So it’s essential to address acute pain quickly and effectively to prevent it transitioning to chronic pain. Seeking prompt advice from a healthcare professional can help at such times.

Chronic pain can occur in nearly any part of your body and may not feel the same in all areas or at different times. In some cases, chronic pain can be elusive to detect – the cause may show up on a scan or test, or there may be no physical explanation for its existence. Nevertheless, chronic pain can reduce and limit mobility, flexibility, strength and endurance, making it challenging to get through daily tasks and activities.

Persistent pain plagues our population

  • One in five Australians are reported to be living with chronic pain
  • 54% are women and 46% are men
  • 68% of those are of working age
  • Those over 65 years of age are twice as likely to be living with chronic pain
  • 35% of children and teenagers are living with pain
  • The prevalence of chronic pain amongst Australians is estimated to double by 2050

Highway to the danger zone

Risk factors for chronic pain include:

Biological risk factors:

  • Previous injury
  • Surgery
  • Being overweight or obese
  • Being a woman
  • Older age
  • Genetics

Psychological risk factors:

  • Childhood trauma
  • Mood disorders

Lifestyle risk factors:

  • Stress
  • Smoking
  • Unhealthy diet
  • Sedentary lifestyle and prolonged sitting, especially at a computer
  • Having a high-risk job that involves heavy lifting or strenuous physical activity
  • High exposure to chemicals and pollution which can promote inflammation

Chronic conditions

Conditions that may involve chronic pain are best discussed with your healthcare professional. Conditions associated with chronic pain include:

  • Arthritis and joint pain
  • Lower back pain
  • Neuralgia and nerve pain
  • Pelvic pain
  • Sciatica
  • Migraines and headaches
  • Abdominal pain and IBS
  • Musculoskeletal aches and pains
  • Muscular spasms
  • Fibromyalgia
  • Persistent post-injury pain
  • Persistent post-surgical pain
  • Post-trauma pain
  • Psychogenic pain (pain that isn’t caused by disease, injury, or nerve damage)

Insights into inflammation

Like pain, inflammation is another of the body’s natural defence mechanisms, designed to help fight illness and protect you from further harm. It works by activating the immune system to help fight off infection, or in response to tissue damage. This generates the red, hot, swollen and sore area around wounds or injuries. Your body attempts to strengthen the area that’s under threat by calling in an influx of immune cells and fluid to the area, to fight foreign invaders and bolster your protection.

Inflammation is a necessary part of the healing process. It’s designed to die down and stop once the danger has passed. The immune cells switch from attack-mode to healing-mode. As signs of inflammation ease off, the tissue returns to normal.

When the body fails to switch off this inflammatory response and it becomes faulty, it can lead to chronic conditions. The immune system remains stuck on, continuing to release inflammatory molecules and, in some cases, damaging the body’s own cells even in the absence of a foreign threat. Inflammation continues and can be released at vulnerable sites such as the gut or joints.

In the modern world, inflammation triggers are everywhere, including environmental pollutants and daily stress. This keeps your immune system constantly armed and operating in a low-level state of inflammation. Whilst not exhibiting overt effects, this low-grade inflammation can complicate your internal environment which can potentially lead to more unpleasant conditions.