Persistent / Chronic Primary Pain

Nobody wants to be in pain. By its nature it is distressing, but that is the point. Pain is an alarm in your brain. It is designed to get your attention. But our understanding within society of what pain is telling us, is not always what we think. We can easily understand the paper cut, and the broken bone or muscle tear with the local damage to the tissues causing nerve fibres to fire off resulting in the brain producing pain, so we protect the area to allow optimal healing. However, when the pain lasts longer than the period of time it takes for the area to heal, or the pain starts on its own with no obvious physical trauma, this becomes a little more confusing.

Chronic (meaning prolonged) pain can be much more distressing that acute pain because the sufferer has much less control of their symptoms. There is less hope as time goes on and no end to the ordeal is obvious. In contrast to a torn muscle that we know will take anywhere from 3 weeks to 3  months depending on the severity of the tear, chronic pain can last for years. One can modify their life for a short period of time when you know it is temporary. This is not the same with chronic pain, as the end point at which you get your life back is unknown. This is really hard.

Traditional methods of treating pain have revolved around managing the pain. Learning to cope with the pain experience; coming to terms with the fact that you are a chronic pain sufferer and you need to just push on with life anyway. Whilst this approach may be appropriate for certain conditions where a structural cause has been identified and nothing more can be done (eg cancer, severe arthritis), but it is not so helpful in conditions where the healing has taken place and the pain still persists, or where there is no obvious cause for the pain. This pain is now referred to as primary pain and makes up a large percentage of chronic pain problems. The pain management approach may have been helpful for some to get some of their life back, but for others this approach has condemned them to a life of misery, progressing disability with no hope of recovery, despite the lack of a structural diagnosis being responsible for their pain.

Our understanding of pain and what it means is improving all the time to the point that we now see  chronic primary pain as treatable. There are plenty of success stories of people having moved on from very disabling pain and an understanding of the mechanisms at play in chronic pain allows us to see why this is possible.