Types of Pain: Acute, Subacute and Persistent Pain
Now that we have a clearer understanding of what pain is and how it affects us – it is important that we are able to distinguish between the different types of pain and identify them accordingly. This knowledge helps us to make better informed decisions on treatment for our pain. Aside from types of body pains (8 Body Pains You Should Never Ignore), there are three main types of pain: acute pain, subacute pain and persistent pain. The types of pain are generally classified according to duration and physiological healing time frames. In this article, we will dive deeper into each type of pain common causes of the onset of pain as well as the type of treatment best suited for the type of pain you are experiencing.
Acute pain is pain that happens suddenly and commonly from an injury. An injury sustained lesser than 3 weeks ago would be considered acute. Past 2 weeks, we would expect physiological healing to have started. Common causes of acute pain include: surgery, broken bones, muscle tears, ligament sprains and childbirth. Individuals with acute pain are generally encouraged to practice RICE (rest, ice, compression and elevation) and avoid HARM (Heat, Alcohol, Running/Exercise and Massage). Once there is a resolution of inflammation and proper healing has taken place, it is recommended to gradually return to normal activities.
Subacute pain is pain that lasts from 2 weeks to 3 months. During this stage, the inflammation has settled with formation of scar tissue as part of the healing process. Pain is now intermittent and mechanical, caused by certain movements that may irritate the injured structure or scar tissue. The goal here is to resume normal movement, strength and function. Tissue healing takes an average of 6 weeks.
Persistent pain is defined as pain that persists for at least 3 to 6 months, lasting beyond the expected duration of healing and hence lacks the warning function of acute pain.
Individuals with persistent pain may constantly feel that there must be something wrong because of the pain. Beyond physical effect, persistent pain can affect individual emotionally – resulting in anxiety, anger, depression and fear of re-injury. This fear of re-injury might limit the individual’s ability to return to their regular work or physical activity. Chronic injuries commonly include osteoarthritis, migraines and nerve pain associated with diabetes.
Persistent Pain in Singapore
Persistent pain is becoming a real problem in Singapore with an ageing population – indicating an upward trend in healthcare expenditure in the near future. With one in five Singaporean adults over the age of 60 experiencing chronic pain, according to the Well-being of the Singapore Elderly (WiSE) study published in the Pain Research and Management journal last year.
Apart from an ageing population, the sedentary lifestyles of most Singaporean adults also contribute to the prevalence of chronic back and neck pain. In a recent study, it was found that 2 out of 5 experienced body pain at least weekly in Singapore.
Living with chronic pain can be debilitating and prevent sufferers from achieving their full potential. Productivity losses due to chronic pain has been estimated to be S$8.4 billion dollars (due to decreased workplace productivity and sick leave taken as a result of the pain). Despite the prevalence of people suffering from chronic pain, 1 in 2 tend to stay silent about their pain, and about 1 in 5 will choose to ignore their pain until it goes away. Chronic pain is beginning to receive greater attention as a priority as adequate pain treatment is a human right and the duty of the healthcare system to provide it.
Singaporeans and Persistent Pain Management
Research has shown that nearly 2 in 3 Singaporeans tend to self-diagnose their pain, and approximately 4 out of 10 will treat their pain with non-prescription pain relief options that are easily available over the counter such as Panadol or Neurofen. Taking pain relief medication offers temporary relief for the pain but does not resolve the root cause of the pain. This may eventually lead to drug tolerance where your body adapts and gets used to the medication and its effect is diminished. Consuming too much nonsteroidal anti-inflammatory drugs (NSAIDs) might also have a negative impact on your kidneys.
Dr Yeo Sow Nam, the Director of The Pain Specialist at Mount Elizabeth Hospital and Mount Elizabeth Novena Hospital states that “despite the availability of many suitable and effective options for treating pain, it is concerning that Singaporeans tend to suffer in silence for longer than they should. Causing a huge burden both at a national and individual level especially for those who suffer from pain weekly. It is important that people take effective steps to address their pain.”
In the next article of our pain series, we dive deeper into why pain persists for longer than necessary and why you are experiencing persistent pain.