Transition from acute to chronic pain
Abstract
A Feizerfan FRCA G Sheh BHB MBChB FAFRM(RACP) FFPMANZCA Matrix reference 3E00 Key points Physiology of pain involves activation and complex interactions of autonomic, peripheral and central nervous systems, endocrine and immune systems. Persistent nociceptive stimulation may cause various changes in pain physiology leading to pain sensitization. Cellular changes and central nervous system result in peripheral and central sensitization. Cerebral disorganization, pathophysiological changes in neurones are associated with a hyper-excitable neuronal state. Transition of acute to chronic pain may be minimized by early recognition of risk factors and early biopsychosocial pain management. Pain is commonly classified into acute and chronic. Acute pain implies a painful condition with a rapid onset or of a short course whereas chronic pain is referred to as a painful condition persisting beyond the normal time of healing. Transition of acute pain to chronic pain is an observed entity associated with enormous burden on the healthcare system. Minimization of this transition has been a challenge for decades. Numerous studies have investigated different factors that increase susceptibility in transition of acute to chronic pain. This article focuses on the basic science and pathophysiological changes during pain processing and clinical modalities aiming to minimize the risk