What is the difference between acute and chronic back pain?

Commonly Used Terms in Back Pain

When it comes to back pain, chronic is a word that is often used incorrectly; likewise acute. But if you go to see your GP complaining of back pain, he will likely use these words in your consultation and on your prescription, so it’s helpful to be clear on what they mean.

When we suffer any type of pain, the more we understand as to its nature, the better off we will be.

Acute Back Pain

  • Caused by tissue damage or inflammation;
  • Usually lasts a specific amount of time, fading as whatever is the cause of the pain heals;
  • Has a “purpose”. Let’s say you are lifting a large, heavy object when suddenly your back “goes”. You will experience a sudden onset of back pain due to tissue damage; in addition, pain will also try and prevent you from moving in any direction that will cause further damage.

Acute back pain is usually categorised as lasting less than 3 months.

Chronic Back Pain

When pain persists, it becomes more affected by influences other than direct tissue damage. These include such things as the pain signal continuing to reach the central nervous system after the tissue has healed, lack of exercise (physical deconditioning), a person’s thoughts about the pain, as well as emotional states such as depression and anxiety. All of these conditions tend to cause a patient to experience pain long after the original tissue damage has healed. This type of pain is referred to as chronic pain.

Thus, chronic back pain is usually less directly related to identifiable tissue damage and structural problems. Chronic back pain without a clearly determined cause and fibromyalgia are examples of chronic pain.

Chronic pain can take different forms, but is often placed in one of these two major categories of its own:

  1. Pain with an identifiable cause, such as tissue damage caused by an ongoing disease process, for example, rheumatoid arthritis or ankylosing spondylitis.
  2. Chronic pain with no identifiable cause. When pain persists after the tissue has healed and there is no clear reason for the pain that can be identified, it is often termed “chronic benign pain”.

Generally speaking, chronic pain is poorly understood. It appears that pain can establish a pathway in the nervous system in some cases, becoming the problem in and of itself. In other words, the nervous system may be sending a pain signal even though there is no ongoing tissue damage. The nervous system misfires and creates the pain. In such cases, the pain is the disease rather than a symptom of an injury.

Fear-Avoidance Behaviour

In episodes of acute pain, fear can often lead to safety-seeking behaviours such as avoiding movement. But research points to the fact that in most cases this often makes the pain worse, can delay recovery of function, and increases the risk for developing chronic lower back pain.

Keep Moving As Best You Can

In cases of acute pain, any movement that is pain-free is therapeutic.

Recently, I had a lifting injury moving a huge flat-screen TV. As a result, I could neither stand up properly nor sit down. In lying, I could get comfortable and was able to lift my arms a little, move my head, and circle my ankles all without jarring my back or increasing the pain. These movements helped to keep the circulation of blood and lymph working and also filled me with the confidence of having some “control”.

I also was able to get myself lying with the Buttafly low down under my pelvis. Having not been in this situation before, I worked on the basis that as long as it did not increase my pain, then it was worth a try.

It helped and afterward, I was able to stand more upright. Over the next few days, I was careful to alternate rest and movement, mindfully building up towards normal walking and then gentle yoga postures. I was back to normal fitness in a little over a week.

Cautionary Note

If you feel unwell or have an accompanying fever along with your back pain, or have any symptoms including weakness, pins and needles, numbness, tingling, changes in bladder and bowel habits please see your GP as soon as possible.

Please note that we cannot offer individual advice through the website.