Overview of Persistent Pain

Chronic pain, long term pain, persistent pain or constant pain – what's in a name?

While you might use any one of these terms to describe the nagging companion of unpleasant sensations you may experience on a regular basis, persistent pain may give you a more upbeat way to understand and address your condition.

Golfer with Back Pain
Jeannot OlivetMore/Collection:E+/Getty Images

Persistent Pain Definition

Many patients and practitioners have begun to replace phrases such as chronic pain, chronic back pain, chronic neck pain, etc., with persistent back pain, neck pain, etc. The reason for the switch comes from healthcare professionals and pain associations who, in the last decade or so, have noticed and reported that patients tend to relate to chronic back pain as a condition they need to cure and be done with. When framed this way, chronic pain is something patients are constantly trying to fix once and for all.

While chronic back pain refers to a likely unshakable condition, using the word persistent in place of chronic connotes pain that lasts longer than one would expect or prefer. This more succinct description can open up new possibilities for living well.

Acute vs Persistent Pain – What's the Difference?

When you first injure your neck or back, you’re in the acute (and, a little later, the sub-acute) phase. At this point, and up until about 3 months, the pain you experience is mostly due to inflammation and tissue damage. You might think of symptoms that occur during the acute and sub-acute phases of an injury as pain that makes sense. Something gets hurt, and you feel it.

But after about 3 months, the central nervous system joins in on the experience. The central nervous system, which consists of your brain and spinal cord, is a complex messaging system. Some of its many jobs include receiving stimulus – that may later become pain or another sensation such as hot, ticklish, etc. – relaying messages to other parts of the nervous system, assembling a motor (movement) response to the sensations you feel and categorizing the experience of your pain into a unique-to-you way. 

Contextualizing Your Constant Pain

The brain is the organ that makes sense of the stimuli coming in from the outside world. It then lets you know if you’re in pain, and exactly what that pain feels like. The brain also plays major roles in formulating related responses such as any depression that may accompany the pain, the decision to take a positive attitude about the inevitable change in lifestyle brought on by the injury, and much more.

And the brain can contextualize your sensations, including pain, to who you are as a person. In other words, it factors the roles you play at work, with your family, in your social life and as part of your culture in with the physical condition of your tissues. The brain is also responsible for changes in personality due to pain, These are just some of the ways the brain coordinates an experience of your injury that is individual to you.

The changes in your brain after a back or neck injury tend to stick around longer than does the tissue damage you likely sustained. Knowing this is the key to moving on with your life post-injury.

Persistent May Provide You With More Hope Than Chronic

When you use the term persistent pain, the reference to the tissue damage is taken out, and the emphasis is more on the way in which your central nervous system, again, your brain and spinal cord, processes stimuli.

It's true that for some people, switching out chronic for persistent doesn't change the way they feel; for them, any way you say it, it still means amplified pain and/or other aberrant sensations.

But you do have the ability to choose.

A wide variety of techniques and methods have been developed and/or enhanced over the past few decades that may help you turn down the volume knob on pain and learn how to clarify your thinking process so you’re not overreacting to what you feel. These include cognitive behavioral therapy, alternative therapies, and core stability exercise.

Understanding the difference between chronic and persistent pain, with chronic emphasizing tissue damage that needs to be resolved and persistent referring to how you, in your entirety, process the stimuli that brought on the pain in the first place, may help you make good lifestyle decisions. And as a result, you may find getting past symptoms and limitations is easier than you think!

By Anne Asher, CPT
Anne Asher, ACE-certified personal trainer, health coach, and orthopedic exercise specialist, is a back and neck pain expert.