Chronic pain on the other hand, is pain that lasts longer than 6 months, and continues long after the area of injury has healed. Chronic pain is more complex and requires a multifaceted approach to manage effectively. This is not the typical pain humans experience. Chronic pain management requires a specific yet individualized approach, often involving several health disciplines ranging from physicians, physiotherapists, psychologists, occupational therapists, kinesiologists and others who have a special knowledge base and training in the area of chronic pain.
The normal or typical pain humans experience addressed here is the acute kind. Pain that is intermittent in nature, in a specific location, made worse or better with certain movements is benign in nature. Benign meaning the pain is not life-threatening or sinister. For the purposes of this discussion, let’s use a low grade lateral ankle sprain as an example.
While stepping off the curb, Sally planted unknowingly on a rock causing her to roll over on her ankle. She experienced immediate pain on the outside of her ankle and foot and could barely put weight on it. This was followed by:
- swelling and change in colour in the form of bruising
- Her pain was constant for the first few days, but with rest and time, her pain became intermittent (would go away completely if she was non-weight bearing).
- Her swelling decreased significantly after 7 days and she was able to fully weight bear by day 10.
- By day 5, her pain no longer disrupted her sleep and she rarely needed to take advil.
On day 11, she consulted her physiotherapist and was given the green light to return to her outside walks which brings her joy. She looks forward to this exercise each day. Normally, Sally walks 5 km per day at a fairly brisk pace. She hasn’t walked this far for over 10 days nor has she walked at her typical pace. But Sally is feeling really good and she is excited to get back to her happy routine, plus her physiotherapist told her she could. The physiotherapist suggested she only do 2-3 km to start. But the sun is shining and Sally’s foot and ankle feels almost 100%. So she decides to go for it and walks her 5 km route. Well that evening, Sally is experiencing pain, almost like what it felt like when she first injured it. She notices a bit of swelling. She decides to rest that evening, but is very anxious and worried she has reinjured it. Luckily, she has an appointment to see her physiotherapist the next day.
Do you think she has reinjured it?
~ Lisa Lepage, Physiotherapist