What Is Chronic Pain?

What is chronic pain anyway? I meet and speak with a lot of people who think chronic pain is only about physical pain. The physical pain is only part of the chronic pain story. So many people, one in every four Americans, suffer with chronic pain and the estimates are about the same for the world. What people do not often realize about chronic pain is that it includes more than physical pain. Chronic pain is any pain – physical, emotional, or spiritual – that is felt 15 days out of 30 for three months or more. It doesn’t matter to the brain what kind of pain it is. Anything that doesn’t feel good in the body sends the same signal to the brain: “it hurts”. While the acute pain that the body signals to us when we have an injury is a normal sensation arising in the nervous system, chronic pain is different. Chronic pain continues and persists. It can be felt for months or years.

Another view on how we define it is that “chronic pain is any sensation with a negative context in the mind that is holding one from being able to heal”. This perspective sees pain as sensation arising in the body corresponding to a negative emotion. When we feel emotional pain, it is associated with a physical sensation. If we leave this unresolved, then our ability to heal is compromised.

Chronic pain is a disease of the brain. I know what I said to myself when I, as a chronic pain patient early in recovery, first heard this concept: “My pain is in my back and my gut, not in my head. How can the brain get so confused about the signals? How can MY brain get so confused?” For a moment, I felt even more victimized by my condition than I already imagined. “How can I trust myself if I am getting the wrong signals from my brain?” I relaxed, letting my worry go, and took in the information my pain management team gave me. Part of the issue with the brain of a chronic pain sufferer is that there is confusion in the signaling within the brain. Fortunately, the brain has neuroplasticity, so it can heal.

We feel stress in the body through the ‘flight-or-fight’ response in the nervous system. We evolved and survived to look to the threats in our environment. We may not have tigers lurking around the corner waiting to eat us anymore, but we have bills that come due, deadlines at work, demands from our family members, and more. Our nervous system can react as if these are life threatening events. If we are constantly stressed, whether it is physical exertion, emotional pressure to perform, or a feeling of disconnection from a Higher Power, we are chronically challenged. The brain interprets all these situations as pain. We react to more and more of the events in our life as threats. Our brain perceives that we ‘hurt’ more and more often. Our health deteriorates. Chronic pain ensues, whether it is physical, mental, emotional, or spiritual. This is what chronic pain is.

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