Pain is a complex physiological and psychological phenomenon. The emergence and perception of pain occurs through many neurological structures, biochemical interactions and emotional reactions. There is no objective measurement method for pain, but individuals' responses to injury, stress and pain are completely different. There are also significant differences between acute and chronic pain in many aspects. It is important for the physician treating the patient with pain to understand the mechanisms of acute and chronic pain, the psycho-social events that may be related to various issues, and how these factors change with different treatment interventions.
Chronic pain is considered and treated in the same way as acute soft tissue injury. It is a different problem that cannot be solved. Recognizing patients with spinal pain who are at risk of delayed recovery is an important component of acute evaluation and allows early use of treatment methods to prevent long-term disability. In treating people with chronic pain, multifaceted issues associated with the chronic pain condition need to be identified. Restoring both physical and psychosocial function is as important as eliminating the underlying source of pain. Chronic pain is not a pathological diagnosis, but rather a diagnosis of impaired function. Pain may begin with specific tissue damage, but the observable pain behaviors and associated disability are greater than would be expected from the degree of physical impairment. The transition from acute to chronic pain has been an important area of study, as physicians seek to determine how it occurs.
'Why do some people develop chronic, excruciating pain after injury, while others who have been exposed to the same degree of trauma do so easily? gets better'.
The answers to these and similar questions are still a matter of research. Many different factors have been identified regarding the transition from acute to chronic pain. These can be divided into those related to the nature of the damage and those related to the person's occupational, social structure and psychological characteristics. However, it is important to emphasize that often the psychosocial factors associated with chronic pain are better predictors than any of the actual physical factors associated with the damage. Some of the different occupational factors that have been shown to be associated with the development of Chronic Pain are: Heavy physical work, lack of light duty opportunities upon return to work, poor working environment or job dissatisfaction, low level of education and short-term employment in a job. Psychological factors play a very important role in the development of chronic spine pain. Psychological variables are clearly associated with the transition from acute to chronic pain and generally have a stronger influence than biomedical and biomechanical factors. Some of the emotional factors are depression, anxiety, boredom, poor health of a person. Cognitive and behavioral factors are also thought to play key roles in the development of chronic pain conditions. These are passive coping style, excessive exaggeration, catastrophizing and fear-avoidance beliefs.
In the treatment of the patient with chronic pain, methods of coping with stress and relaxation methods should be taught to the patient. The negative contribution of psychosocial factors to pain and how they affect the healing process should be explained, and the patient's full compliance with the treatment should be ensured. The psychological damage caused by chronic pain to the patient should be known and the physician should approach the patient with full empathy and sympathy.
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