Acute and chronic (or persistent) pain have different causes and solutions. So knowing which you have can help you reduce, manage and prevent pain better. In brief, here’s what you need to know …

Background Fact

The body and brain work closely together in how we feel and recover from injury and pain. What each does, how they do it, and why, changes as injury or pain continues.

Acute Pain: Need to Know

Cause: Injury or disease.

Purpose: Key to our survival, pain is a helpful warning sign. It guides us to protect the damaged area from the moment of damage, until we are healed.

Duration: Each injury has its own expected healing time depending on; which tissue is injured (e.g., muscle, tendon), the extent of damage, and factors like your age and general health. Your medic or physio should be able to tell you what to expect. But as most tissues heal within 3 months, acute pain is pain that you have had for under 3 months.

Intensity: Can be excruciating, but fades as the tissues heals.


  • It’s important that you see a trusted medic, physio, etc, to check there are no serious underlying concerns. Then ask for and follow their advice on how to rest and start/increase activity.
  • Ensure you have and use helpful injury and pain-related beliefs and thoughts.
  • Give careful thought whether you really need over-the-counter or prescribed pain medications. If you do, ALWAYS ask a doctor or pharmacist for advice on how and how long to take them: ALWAYS follow this advice.
  • ‘Passive treatments’ (those done by someone else), e.g., massage, acupuncture, as and when advised by your medic, physio, etc.

Chronic (or Persistent) Pain: Need to Know

Chronic pain can be ‘primary’ (without an underlying medical condition) or ‘secondary’ (with an underlying condition): It’s possible to have both together. Here, I only discuss Chronic Primary Pain.

Duration: Pain that persists for more than 3 months: Often with good days and day days.

Intensity: The pain can be excruciating and can come from different places in the body.

Cause: In most cases, chronic pain is NOT due to new damage. Instead,

  • The original injury/physical cause of pain might not have improved as it might.
  • You might be experiencing reduced mood and stress which has led to tension and pain: Be assured – This pain is very real, even if there is no obvious physical damage.
  • You might have learnt to feel pain. Again, this pain is also very real, even though any tissue damage has healed. Here, the brain has become over-protective and has adapted to continue to interpret otherwise helpful (and non-pain-related) messages from the body as signs of potential danger. It then acts to ensure the body continues to take protective action: The brain and body continue a feedback loop that leads to pain.

Purpose: Unknown. Alas, it appears to have no useful purpose. Our brain just doesn’t know how not to learn.


  • Check with a trusted medic, physio, etc. to see if any physical treatment, manual therapy or exercises can help with any remaining physical concerns.
  • Retrain your brain to stop it from being overprotective. To do this, it’s helpful:
    o To understand what you can do to help manage pain and what you should not do.
    o To overcome protective beliefs and thoughts that stop you from doing helpful things.
    o To reduce pain-related worry and stress.

Important to Know if You Have (or Someone You Know Has) Chronic Pain:

  • For those with chronic pain, it can be very hard to believe that there’s nothing physically wrong. And very distressing not to have something physical and obvious that the medics can fix.
  • Having chronic pain is particularly difficult when those around you expect pain to have a physical reason.
  • Chronic pain is very real. The brain plays a key role in interpreting pain, BUT this is very different from pain being ‘Made up’ or ‘All in the mind’. Nor is pain a sign of being weak or inadequate in any way.
  • BUT, with a greater understanding of pain and the brain’s role in pain, and by being prepared to work to make the right changes, chronic pain can usually be better managed and reduced.

I hope this article has been helpful.

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