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Mandy: I presume there must be different categories of pain beyond acute and chronic. What are the main kinds of pain that sufferers are likely to experience / What are the different causes of pain?

Phyllis: Pain has the dubious distinction of being the commonest symptom for which a person approaches medical care. It is important to recognise that usually the acute pain situation is the first warning symptom that causes us to notice that we have a problem. It is necessary because as a result we take action to relieve ourselves either with known medication that usually helps or seek out the medical profession if the symptoms do not settle. We also may limit ourselves in movement by trying to keep still in order not to aggravate the condition. There are important aspects to this situation – it has now been discovered that severe, acute pain from whatever cause, that has been experienced for even less than twenty four hours may develop into a chronic pain syndrome and the key to preventing chronic pain is to treat acute pain immediately. Also continuing to remain inactive as a protective mechanism may in some situations perpetuate pain due to lack of circulation and inactivity which creates weakness of muscles as in low back pain conditions.

Pain in itself is an entirely individual experience – “it is unique to an individual and is also perceived differently by each individual” writes M Jackson in her book Pain – the fifth vital sign. Pain is relayed via the nervous system which consists of the brain, spinal cord, autonomic nervous system, nerves that supply the musculoskeletal system, the internal viscera or organs of the body and the skin. If pain is very severe or continues for a protracted period it will activate and disturb a part of or the whole nervous system. Pain also affects the psyche and it may cause anxiety, fear, depression and even anger. In fact according to researchers Okifuji, Fernandez and Burns (2002) it is accepted that anger may precipitate, predispose an individual to pain, exacerbate pain, become a consequence of pain or even perpetuate pain. The most disturbing aspect of chronic pain is that it causes suffering!

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