Acute vs. chronic pain: Differences and treatments

When it comes to treating pain, it’s important to understand what type of pain you’re experiencing, as the treatment approaches for acute and chronic pain are different. 

This article will help to differentiate between acute and chronic pain so you can determine what type of pain you’re experiencing and find the right solution.

Why do we feel pain? 

When there is danger or an injury to heal, your brain generates unpleasant feelings of pain in order to change your behavior and protect you. For example, if you were to touch a flame, the brain sends a message of pain to make you remove your hand from danger.

In the body’s tissues, there are specific neurons that respond to harmful stimuli. When these neurons are activated by a stimulus, like touching a hot flame, they send a warning signal to the spinal cord, which can in turn send a signal to the brain.

Once the warning signal reaches the brain, it makes sense of the message based on both the information arriving and a vast amount of stored information, including our prior experiences, environmental context, and our mood at the time.

If there’s good reason to think that protection is required, then the brain creates pain. This pain will direct you to change your behavior to avoid the danger, like moving your finger away from the flame.

Acute vs chronic pain: what is the difference?

Pain is a very personal thing and each individual will experience pain differently. To help categorize pain, pain experts have developed criteria that differentiate between pain that is acute and pain that is chronic. 

Acute pain is pain that is experienced in response to an injury or illness. It often begins suddenly and can feel sharp, severe, and intense. Acute pain is designed as a protective mechanism to warn the brain that something is wrong. The goal of this is to stop you from doing anything that could further damage the area. 

Almost all acute injuries will heal within three months, and the pain should go away. However, this isn’t always the case. 

Chronic pain is any pain that lasts beyond expected healing time after injury or illness. It is a complex condition, and the pain experienced can be anything from mild to severe. The defining characteristic of chronic pain is that it is ongoing and experienced on most days of the week.

There are two broad categories of chronic pain:

• chronic pain with an identifiable cause, including pain due to arthritis, cancer, or a persisting injury
• chronic pain with no identifiable cause, such as when pain persists after the tissue has healed and there is no clear reason for the pain.

How does acute pain turn chronic? 

The longer you experience pain, the better your nervous system, including the spinal cord and brain, get at producing it. This occurs due to the development of neural pathways in the brain.

Neural pathways are made up of thousands of brain cells that are organized for a specific purpose. They help us learn new behaviors and activities. We develop neural pathways for everything: when we learn to walk, talk, type, ride a bike, and so on.

Once a neural pathway is developed, it gets stored into our memory. Just as the brain can learn and remember activities, it can also learn and remember pain.

This helps to explain how acute pain can turn chronic. For most people, acute injuries will heal within three months and the pain will go away. But for some people, even when the body recovers, the pain continues. 

How common is chronic pain? 

Chronic pain is a common condition, with over a quarter of people in the United States experiencing this at some point in their lives. Chronic pain is also on the rise; research shows that doctor visits for chronic pain are up 67% in the past 10 years.

Overall, women have higher rates of chronic pain than men , but men are also less likely to report or seek treatment for pain compared to women. 

Chronic pain costs the global economy more than diabetes and cancer combined and is the leading cause of disability worldwide.

The most common types of chronic pain conditions include: 

• arthritis or joint pain
• back pain
• neck pain
• musculoskeletal pain 
• headaches and migraines 
• endometriosis pain 
• nerve pain
• fibromyalgia 
• cancer pain 

What does chronic pain do to you?

Chronic pain can have a profound impact on someone's life. Impacts vary from person to person, but it’s common to experience: 

• fatigue and sleep disorders 
• anxiety
• depression 
• irritability
• cognitive changes 
• difficulty going to work, school, or social activities
• difficulty with physical tasks such as household chores, lifting, or exercising
• family problems.

There is also a growing focus on the risks of opioid dependence among individuals with chronic pain due to concerns regarding addiction, tolerance, and adverse effects associated with long-term opioid use. Almost 50% of patients with chronic pain are using two or more opioids simultaneously. 

Treatments for acute pain 

The cause of your acute pain will determine what treatment approach is best, and it’s important to consult with your doctor or healthcare professional to find the right solution. 

There are multiple pharmacological, adjunct, nonpharmacological, and interventional treatments for acute pain. The most common include: 

• Medications: Over-the-counter pain relievers such as acetaminophen (Tylenol) or nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen (Advil, Motrin) or naproxen (Aleve) are often used to manage mild to moderate acute pain. For more severe pain, prescription medications like opioids may be prescribed, although their use is increasingly scrutinized due to the risk of addiction and other side effects.
• Rest and ice: Resting the affected area and applying ice packs can help reduce inflammation and alleviate acute pain, especially in cases of injury or trauma.
• Heat therapy: Heat therapy, such as warm compresses or heating pads, can also be effective in relieving acute pain by promoting blood flow and relaxing muscles.
• Physical therapy: In some cases, physical therapy may be recommended to improve mobility, strength, and flexibility, which can help reduce pain and prevent further injury.
• Injections: Injections of corticosteroids or local anesthetics may be used to directly target and alleviate pain in specific areas, such as joints or nerve roots.
• Nerve blocks: Nerve blocks involve injecting anesthetic or anti-inflammatory medication near nerves to block pain signals, providing temporary relief from acute pain.
• Surgery: In certain cases, surgical intervention may be necessary to address the underlying cause of acute pain, such as repairing a fracture or removing a damaged organ.

Treatments for chronic pain 

Treatments for acute pain are generally very effective at providing relief and helping people return to their normal function once the body has healed. Unfortunately, the same cannot be said for chronic pain. Research shows that current chronic pain treatments only result in an estimated 30% decrease in a patient's pain scores.

If you are experiencing persistent, ongoing pain, it’s important to speak to your doctor to rule out any physical or structural problems that may be causing the pain. 

It’s very common for people with chronic pain to be told there is no structural reason why they are experiencing ongoing pain, which can be incredibly frustrating. For example, 85-95% of chronic lower back pain cases are not related to any physical or structural problem in the body. 

If there is no structural damage, then it doesn’t make sense to treat the physical body. Despite this, most existing treatments for chronic pain are only focused on treating the physical or structural damage through medications, surgery, or physical therapy interventions.

Thankfully, updated clinical guidelines for the treatment of chronic pain are starting to acknowledge the importance of addressing social and psychological factors that may be contributing to the pain. 

This includes things like: 

• emotional state
• stress levels
• beliefs about pain
• past experiences
• sense of identity 
• social support networks 
• work situation 
• economic factors
• societal expectations 
• cultural influences. 

When it comes to chronic pain, psychologically-based interventions are an essential part of the treatment process. Addressing people’s fears, attitudes and beliefs, is a vital part of pain management, as well as exploring how a person understands and copes with their pain.

Different approaches have been recommended, including:

• multidisciplinary pain management programs
• behavioral therapies
• cognitive behavioral therapy (CBT)
• mindfulness meditation
• hypnotherapy/hypnosis

Hypnosis, in particular, has been receiving increased attention as a holistic, evidence-based pain management technique that can help to rewire neural pathways in the brain that are contributing to chronic pain. 

If you’re interested in trying hypnotherapy for chronic pain, you can register your interest for Mindset Health’s upcoming chronic pain program, which has been developed in consultation with Neuroscience Research Australia. This program combines pain reprocessing techniques with pain science education to help you turn down the volume of your pain, increase your capacity to cope with the pain and improve your ability take part in, and enjoy, normal life activities.  

The Wrap Up 

Chronic pain affects millions of people worldwide, impacting daily life and often leading to psychological distress. It’s important to understand the distinction between acute and chronic pain, as these conditions respond differently to treatments. In particular, chronic pain requires a comprehensive treatment approach, addressing not only physical but also psychological and social factors. With a growing focus on reducing opioid dependence, alternative therapies like hypnosis are gaining recognition for their potential in rewiring neural pathways and offering holistic pain relief.