What are the differences in the psychology of acute versus chronic pain?
Acute pain involves an evolutionary-based survival mechanism to repair damaged tissue through sympathetic nervous system activity and inflammatory processes. The emotions generated in acute pain are anxiety, fear, disorganization, and uncertainty. Acute pain is self-limited, and the underlying condition most often responds fully to treatment. Chronic pain is determined after a period of acute pain that fails to resolve with treatment. There is no survival value in chronic pain. The person becomes depressed, withdrawn, and vegetative. The attitude may be one of giving up and hopeless despair. There is an overall parasympathetic response that results in a decrease in vital functions, including psychological ones. Often with chronic pain the underlying condition is insufficient to explain the extent of debilitation and suffering—hence psychosocial factors may impinge. There is a growing realization among pain practitioners that timely multidisciplinary intervention (including psychological care) can decrease the frequency and/or severity of the transition from acute to chronic pain.