Chronic means the pain has been present for more than 3 months most days of the week.
Why is it still painful?
The pain may be 'mechanical', called nociceptive pain, where there is tissue damage. However, tissue damage mostly heals within 3 to 6 months after an injury (or surgery). Then the pain may be generated by different pain sources. It this point it may be unhelpful to be chasing after more scans and "damaged tissue" diagnoses, because the fault is no longer in the tissues but in the central nervous system - the brain and spinal cord.
This does not mean the pain is all in the mind.
Pain resulting from a 'fault' in the central nervous system is called central sensitisation.
(Google alert- when central sensitisation is chronic,
researchers are now calling this nociplastic pain.)
The patient may have a mix of nociceptive pain and central sensitisation. They may have feelings of anxiety, fear of re-injury and loss of confidence in their ability to move and function well.
Dr. Jacqui Clark will spend time understanding the patient's circumstances, the patient's natural characteristics before they had the pain, their difficulties and realistic goals. She will assess their movement patterns and sensory-motor function. Discussion with the patient will involve understanding their own capacity and how to tailor rehab to suit you.
Often the common goal is to reduce the central sensitisation in the brain and spinal cord to reduce their pain and restore daily activities.
Rehab will involve strategies which address the central nervous system and sensory sensitivities.
