The big three: What is long-term pain?

What is long-term pain?

Long-term or chronic pain is defined as any pain with a duration of 3 to 6 months or longer. If it’s three or six seems to depend on who you ask, but the relevant question isn’t really about the duration but rather about the response. The remarkable thing about long-term pain is that it results in consequences other than just that specific pain. The pain in and of itself is troublesome, but being in pain for months takes a toll. It makes your brain interpret the pain signals as stronger than before, and the pain might spread to cover a bigger area, regardless of if the cause of the pain is changed. There’s the same input – more pain – and often a decent bunch of other symptoms in addition to that.

Long-term pain from practically whatever will affect the brain and be a major stressor.

This is regardless of why you’re in pain. Your brain doesn’t care if the pain originates from herniated discs, nerve damage, arthritis, fibromyalgia, Ehlers-Danlos syndrome, surgeries that went wrong, dysfunctions in muscles or joints with or without trauma, rheumatism, intangible lower back pain without explanation, or something entirely different. The pain does, of course, come in various degrees, and so do the after-effects or consequences of it.

Those with long-term pain get even better than others at feeling pain. The sensitivity to pain doesn’t decrease; it’ll increase. Said pain often spreads around what usually hurts or to entirely new places. Goodbye, logic. Things hurt without good reason. The pain might increase for a few days for what seems to be nothing. Said pain could come and go without you having a clue as to why. Muscles not involved with the original pain could very well get stiff, tense, and uncomfortable, and body parts could feel… strange where motor skills could go out the window, and you could have a hard time finding the muscles involved.

With long-term pain, pain is obviously the foundation, but it doesn’t end there. Fatigue and trouble sleeping is common. In some cases, sleep doesn’t just get interrupted once in a while when you wake up, but the rest you do get might be less restful in addition. Those troubles sleeping could be with or without depression since that also comes with the pain. The brain practically interprets physical and mental pain as the same – and one isn’t enough. If you’ve got one, you might as well get the other. Pain and suffering bring us down, and depression is what we’ll find, which isn’t very fitting since you might get more pain with a worse mood if you’re bothered by long-term pain. Those affected are often influenced enough to get sensitive to stimuli like sound, smells, or light.

Who is bothered by long-term pain?

Some statistics say that 40% to 55% of Swedish people between ages 25 and 54 live with pain. Other statistics say that 1 out of every 4 or 5 Americans suffers from chronic pain, defined as “pain most days or every day for at least three to six months”. The definition of long-term pain varies, but the requirements are usually that it lasts for 3-6 months or that someone “experience pain for a longer time than it ought to take for the injury to heal,”. If the definitions vary, so will the statistics. The statistics vary depending on who’s asking, when it’s being asked, and what definitions are used – but it’s pretty clear that plenty of people are involved and suffer. Chronic pain interrupts people’s daily lives, and the interventions don’t do enough. If they did, they wouldn’t be a part of the statistics. Rest, painkillers, and surgery are often the go-to tools – if those worked wonders for everyone – the patients would be done and gone.

The relevant question for the individual isn’t about the duration but rather about the response: more pain – and further consequences from said pain. As time goes by, because the interventions don’t help, hopelessness and demoralization set in, and with those, perhaps aspects of mental health problems. As a result, you’re getting hindered from doing life. You’re getting trapped. Plenty of learning later, the pain grows rather than goes away.

The change into long-term pain is generally slow. You start somewhere, you’re injured, wounded, or hurt by something – or you’ve got some genetic defect or pathology that does its thing. Initially, it hurts, and it’s troublesome… But over time, it’ll start controlling your life, and you’ll learn more and more to listen to the pain. You’ll learn how to avoid pain by avoiding a lot of what you used to love. This slow adaptation to the pain and altering of life is rarely apparent. Long-term pain means that it “starts” in three to six months at its earliest, which doesn’t mean that it couldn’t be slower, more gradual, and more diffuse. People could be in pain for years. With a teacher like pain always by your side, there are a lot of teaching moments. Your every move could be one, so it’s a great facilitator of change. With long-term pain, it’s rarely a change for the better.

If you want more information on pain and pain science, check out the book at www.mbdolor.com/book.

Full series:
The Big Three: What Is Long-Term Pain?
Why Do We Get Long-Term Pain?
Treat Long-Term Pain

What is long-term pain?

Long-term or chronic pain is defined as any pain with a duration of 3 to 6 months or longer. If it’s three or six seems to depend on who you ask, but the relevant question isn’t really about the duration but rather about the response. The remarkable thing about long-term pain is that it results in consequences other than just that specific pain. The pain in and of itself is troublesome, but being in pain for months takes a toll. It makes your brain interpret the pain signals as stronger than before, and the pain might spread to cover a bigger area, regardless of if the cause of the pain is changed. There’s the same input – more pain – and often a decent bunch of other symptoms in addition to that.

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