What causes acute musculoskeletal pain to turn into a chronic pain condition? This is one of the most difficult questions to answer in medicine. Studies of chronic pain have overturned older ideas about its causes and origins. We now know that the amount of pain a patient experiences does not necessarily correlate with the amount of damage they have. Oddly, many patients with chronic pain don’t have any detectable underlying injury or disease. This makes chronic pain difficult to treat and frustrating for patients.
Current research suggests that chronic pain has more to do with the nervous system, including the spinal cord and the brain, than with the muscles or joints in the painful area. This throws a wrench in traditional treatment protocols that use surgery or other invasive methods in an attempt to cure chronic pain. As many as 40% of back surgeries fail to relieve pain. Surgery comes with other risks, such as addiction to opioid medications. Unfortunately, our health system has been slow to catch up with the research, and many patients with both acute and chronic back pain are prescribed inappropriate and ineffective treatments.
Here’s what the latest research says about acute and chronic back pain:
The Difference Between Acute and Chronic Pain
Acute pain is caused by an injury or strain. It comes on quickly and lasts for a relatively short amount of time. Pain in the neck or back that occurs along with fever or loss of bladder control could indicate a serious problem, and urgent medical care is warranted. Muscle or neck pain that occurs without other symptoms is typically not serious and will resolve on its own with proper care.
The key phrase there is “with proper care.” Research into pain management best practices has revealed that patients with acute back or neck pain who receive treatments such as prescription pain medication, referrals to specialists, or imaging and diagnostic tests are more likely to have their pain become chronic. The researchers cite several possible reasons for this confounding statistic, including a suboptimal understanding of musculoskeletal medicine among most physicians as well as overwhelming caseloads.
So why do people visit a physician after a back injury? Many patients may be unaware that their primary care doctor is ill-equipped to deal with back pain. Others may be concerned that their pain is a sign of a serious condition. Studies have shown that most cases of acute back pain resolve quickly and that the likelihood of underlying conditions is very low. Doctors often fail to educate their patients about the body’s healing process and instead prescribe pain medication or additional tests.
In our fast-paced world, waiting on nature can seem frustrating, but our bodies are built to heal. The healing process includes several stages. An injured muscle, ligament, or disc will usually cause a high level of discomfort for a few days to a week. After the worst of it clears up, your body will still be working to heal and strengthen the injured area. The full process can take up to twelve weeks. Pain that persists after twelve weeks is considered chronic.
Chronic Pain Risk Factors
As we’ve just seen, patients who are given inappropriate treatment are more likely to end up suffering from chronic pain. Other risk factors for chronic pain include obesity, smoking, anxiety disorders, and depression. The reasons behind these risk factors are not completely understood. Researchers think that obesity and smoking may be risk factors because they cause an unhealthy inflammatory response in the body. The role of anxiety and depression in chronic pain may have to do with serotonin levels, inflammation, or something else scientists have yet to discover. In any case, the nervous system and, by extension, the immune system play a key role in determining if acute pain will become chronic.
Your immune system creates inflammation as part of an injury’s healing process; if this process doesn’t go right, persistent low-level inflammation can lead to chronic pain. Your nerves are supposed to send pain signals to the brain when you are injured and stop sending these signals after healing has progressed. This process can also go awry. The nervous system regulates the immune system (and every other system in your body). If the nervous system is not functioning optimally, the healing process can become impaired.
Preventing Chronic Pain
The most up-to-date best practices call for patients to be prescribed chiropractic and at-home care. Chiropractors are specialists in the musculoskeletal and nervous systems. They can evaluate your pain and recommend appropriate treatments that will encourage natural healing. Spinal adjustment corrects subluxations that can impair the nervous system, freeing it to function at its best. Stretches, adjustments, and at-home treatments are safe and effective for acute pain and reduce the risk of chronic pain.
Several studies have associated chiropractic care for acute pain with better long-term pain outcomes. When these treatments are not recommended for first-line care, acute pain patients have a 63% chance of becoming chronic pain patients. Modern research shows that chiropractors are uniquely suited to address not only the injury that’s causing acute pain but the underlying neurological factors that cause chronic pain.
Patients who see a chiropractor first are less likely to need prescription pain medications. This is important because the physically addictive nature of opioids can cause chronic pain and nerve dysfunction. Muscle relaxants are only approved by the FDA for short-term use alongside other care. In most cases, chiropractic care combined with at-home treatments relieves pain quickly and removes the need for addictive drugs.
Education is another important tool in the prevention of chronic pain. Chiropractors educate their patients about posture and lifestyle issues that can help prevent further injury. They also provide maintenance care to prevent everyday wear and tear from accumulating and causing lasting problems.
Our Chiropractors in Michigan are experts at helping patients heal from acute injuries. If your back hurts, call us first. We follow the latest recommended guidelines that are proven to reduce your risk of chronic pain.