When Does Pain Become Chronic?

Chronic pain used to be defined as pain that lasts for more than 6 months. More recently it has been redefined as pain lasting more than 3 months. But whether it is 3 months or 6 months, it is less about time and more about physiology.

When pain is present for more than 3 months or so, there are physiological changes that tend to occur. These changes occur both at the site of the injury and in the brain. At the injury site, there is peripheral sensitization and in the brain there is central sensitization. This means that when pain is present for 3 months or more the body can become “used to” the pain. So even if the pain source is removed, the pain is still perceived.

Learn more about Where Back Pain Begins Here!

In peripheral sensitization, there is an increase in pain receptors on the pain fibers and increased permeability of the cell membranes on the pain fibers that make them more sensitive to pain. For central sensitization, there is increased sensitivity in the dorsal horn of the spinal cord that makes the cells respond to non-painful stimuli. Also, there are less well understood changes in the brain itself. It is as if there remains a memory of the pain even though the original pain source is gone or disappearing. It is loosely analogous to post-traumatic stress disorder, where the event is being relived although it is no longer present.

The physiology of chronic pain is very, very complex and not yet well understood. The important point is that you don’t want it to happen as it is very hard to treat. It is a main reason for long term disability with all the associated social and financial costs.

"Patients should be diagnosed quickly and treated quickly so chronic pain does not have a chance to set in."

This is the primary goal at Nucci Medical and one of the reasons we have such success in treating car accident or workplace injuries. We diagnose and treat the injured patient efficiently and get them back to their life and back to work, as soon as possible to avoid developing chronic pain.