Is there a way to prevent Acute Pain from becoming Chronic Pain?

It seems so simple – you have an ongoing health condition and we focus on finding and using good pain management strategies. If you have an ongoing health condition, the whole point of pain management is to “stay on top of your pain and comfortable”. But what if your pain is a result of a single event or injury, is there something you can do to prevent acute pain from becoming chronic?

Every person perceives pain differently, but there are some things that you can do to prevent pain from becoming chronic once you understand some of the risks.

Risks for Developing Chronic Pain

Certain events have been identified as being high risk for developing chronic pain.

• Surgeries. Though most all surgeries are painful, some are particularly associated with developing chronic pain: mastectomies, thoracotomies (opening up the chest), joint replacements, amputations, and spine surgeries like laminectomies and fusions. With each of these different types of surgeries, it is common to experience persistent nerve pain related to the operation.

  There are ongoing studies looking for ways to block excessive nerve irritation during these surgeries, including starting anti-neuropathic pain medications, like pregabalin, gabapentin, and venlafaxine prior to the surgery. If you have one of these procedure schedules, talk to you surgeon before surgery to see if these are options for you.

• Acute trauma.  Motor vehicle accidents or fall injuries (acute trauma), carry an elevated risk of chronic pain. High-impact injuries from falling off a ladder or getting rear-ended on the freeway, cause significant jarring to joints, ligaments, tendons, and nerves of the body. These type of injuries cause a chain reaction leaving your musculoskeletal system overly tensed and your nervous system over-activated in such an intense way that it may not let up.

  Re-living an auto accident or falling off a ladder is pretty scary and can cause a lot of stress and anxiety. Checking in with a behavioral health specialist and gaining some insight and new tools to reduce your emotional responses, can reduce symptoms early on and diminish the chances of chronic pain.

• Low back pain. When you sprain an ankle or hurt your knee, RICE (rest, ice, compression and elevation) is the standard course of treatment. RICE is not the treatment for low back injuries though and prolong bedrest may do more harm than good.

Chronic Pain Prevention

It is important to see your doctor or physical therapist to diagnose what is causing the low back pain. Use over-the-counter pain relief for pain and inflammation. It seems odd to move through low back pain” but your recovery will be quicker when you can return to your typical daily activities early on. A physical therapist can teach you graded exercises that will stretch and strengthen back muscles and will not only help with pain but prevent a further injury.

Past studies suggest that belief patterns also play a role in the development of chronic pain. For example, catastrophizing, when we think the absolute worst about a given situation, can lead to feelings of anxiety, depression, fear, and hopelessness. Catastrophizing is a known risk factor for developing chronic pain, while more optimistic seems to be associated with improvements in health and well-being.

One theory on how chronic pain can develop is known as fear-avoidance, where pain or even the anticipation of pain creates so much fear about further injury, that a person starts to shut down and avoids certain movements. That fear of movement increases the likelihood of developing more widespread and lasting pain. Working with a behavioral health specialist can help you understand this fear and how to move on beyond it.

There are many different factors that contribute to chronic pain and Pacific Rehabilitation Center’s interdisciplinary functional restoration approach is an evidence-based approach. Our team includes medical, physical and occupational therapists, behavioral health and vocational specialists who provide education, exercise, physical therapy, nutrition and counseling as early to longer term interventions.