Back to basics: the Chronification of Pain

Spine & Nerve

In this week's episode of the Spine & Nerve podcast Dr. Nicolas Karvelas and Dr. Brian Joves go back to the basics to discuss a fundamental topic: pain chronification. Pain chronification is defined as the process of acute pain progressing into chronic pain. Acute pain is a normal, predicted physiological response to adverse stimuli (chemical, thermal, mechanical) and has a clear protective function. Chronic pain, however, is pain without apparent biological value (not immediately protective) that has persisted beyond the normal tissue healing time (usually about 3 months). The Change Pain Chronic Advisory Board provides the following definition of pain chronification: “Pain chronification described the process of transient pain progressing to persistent pain; pain processing changes as a result of an imbalance between pain amplification and pain inhibition; genetic, environmental, and biopsychosocial factors determine the risk, degree, and time-course of chronification.” Listen as the doctors go over important definitions, and discuss critical aspects of chronification of pain including peripheral and central sensitization. This podcast is for information and educational purposes only, it is not meant to be medical or career advice. If anything discussed may pertain to you, please seek council with your healthcare provider. The views expressed are those of the individuals expressing them, the may not represent the views of Spine & Nerve. References:1. Borsook D, Youssef AM, Simons L, Elman I, Eccleston C. When pain gets stuck: the evolution of pain chronification and treatment resistance. Pain. 2018;159(12):2421-2436. 2. Ossipov MH, Morimura K, Porreca F. Descending pain modulation and chronification of pain. Curr Opin Support Palliat Care. 2014 Jun;8(2):143-51. 3. Morlion B, Coluzzi F, Aldington D, Kocot-Kepska M, Pergolizzi J, Mangas AC, Ahlbeck K, Kalso E. Pain chronification: what should a non-pain medicine specialist know? Curr Med Res Opin. 2018 Jul;34(7):1169-1178. 4. International Association for the Study of Pain