WHAT is PAIN?

“Pain is an unpleasant sensory and emotional experience associated with actual or potential tissue damage, or described in terms of such damage… Pain is always subjective. Each individual learns the application of the word through experience related to injury in early life...
It is unquestionably a sensation in a part or parts of the body, but it is also always unpleasant and therefore an emotional experience”. (International Association for the Study of Pain, 1979)

Importantly, this definition indicates that pain can occur without a recognised or obvious cause
and may also be influenced by our emotions.There are other ways of defining pain.




Acute pain
Acute pain is pain that lasts a short time and is clearly caused by tissue damage. This includes minor and major injuries, burns and surgery related pain. Acute pain usually improves within three months. If pain lasts longer
than three months it is considered to be persistent


Persistent pain
Persistent pain (also referred to as chronic pain) is pain that lasts longer than 3 months

It includes:
– pain that has an identifiable or obvious cause (an injury), and – pain that no longer has an identifiable cause
(i.e. the original injury has healed) Persistent pain with an obvious cause includes conditions like arthritis,
spinal stenosis, degenerative disc disease, or persistent leg ulcers. In persistent pain with no obvious cause, pain continues longer than you would expect (e.g. fibromyalgia, which is generalised muscle
soreness and stiffness). In these cases the nervous system misfires and continues to send pain signals even though there may be no damage.
Persistent pain can also be made worse by a lack of exercise that causes physical weakening.
Our thoughts and emotions can also affect how we respond to persistent pain.


When persistent pain becomes a problem

1. Reduced activity, Unhelpful beliefs & thoughts, Repeated treatment failures
2. Long term use of analgesic, sedative drugs, 
3. Physical deterioration(e.g. muscle wasting, joint stiffness)
4. Feelings of depression, helplessness, irritability 

Side effects
(e.g. stomach problems, lethargy, constipation)
Loss of job, financial difficulties, family stress,

Chronic Pain = Excessive Suffering
© MK Nicholas PhD, Pain Management & Research Centre, Royal North Shore Hospital


Because relieving persistent pain can be difficult, it can take time to get back to a fuller, more rewarding life. Managing persistent pain is about much more than just medicine. By being actively involved in a multidisciplinary approach to pain management, you can help your recovery and improve the quality of your life and how you live it, even though your pain persists.A multidisciplinary approach means you consult a number of healthcare professionals, including your GP and possibly a physiotherapist, pain specialist, social worker, nurse, occupational therapist and psychologist or counsellor to develop a range of strategies for you to use in managing your pain. It is important to follow your healthcare professional’s advice. Management
strategies are always individualised, because pain varies so much from person to person. Someone with arthritis may do well with occasional use of an over-the-counter pain reliever, whereas someone else with arthritis may need a prescription pain reliever and regular appropriate exercise to feel good.
When pain persists your role in managing it becomes really important. Remember, there are ways to take some control over your pain. A good way to start is to understand that what you think, feel and do on a
day-to-day basis will have an affect on your pain.

Accepting Pain
Most people who are successful pain managers have learned to accept their pain. This means accepting that although you may not have caused it in the first place, it is now your pain. Pain may bring about feelings of anger, sadness, frustration and grief, and that is normal. However, if these negative emotions go on for long periods, they tend to make pain worse  Whilst you and your healthcare team may be involved in exploring strategies which help you with your pain, at the end of the day it is you who experiences it. Successful pain managers say that they choose a team (for example partner, doctor, counsellor, other healthcare professional) which helps them decide on the strategies that work for them, and they develop a tool kit which they use to manage their pain and which allows them to participate fully in important everyday activities.  Some examples of various tools you might choose are discussed in this booklet. Many people report they are helped by using exercise strategies, special relaxation techniques, choosing enjoyable activities that they pace well, and organising their lives so that there is less stress and worry