Episode 26 – Acute vs Chronic Sciatica Pain

Most people might not know exactly what pain is. When dealing with pain, the terms acute and chronic can be used interchangeably without having an actual meaning or indication of which is better suited to address this pain. There are three stages of the pain injury sequence; the acute stage, sub-acute stage, and chronic stages of pain. 

What is Pain?

According to Oxford Dictionary, pain is physical suffering or discomfort caused by illness or injury. In a broader sense, pain is a sensation, an electrical impulse that travels from a specific injured area to our brain. And this sensation is a warning sign that something is damaged, allowing us to avoid or change our behavior to prevent further damage. It is a signal that helps us protect our bodies.

Acute Phase

The first stage in the pain cycle and happens upon initial injury of the presence of pain is the Acute Pain which lasts for about 6 weeks. In fact, it’s not a mechanism or sensation that makes an injury more acute or chronic, rather, it is the length of time that elapses since the initial onset of pain. This actually can happen if you trip and twist your ankle or fall and scrape your knee. For sciatica issues, it can be related to sitting in a chair for too long, standing for too long, twisting in a weird way, or lifting in the object very quickly. Hence, during the first couple of days of injury, the initial purpose of this phase is to facilitate healing and to protect the injured area since there will be going to be inflammation, swelling, redness, and pain. And because of the swelling, joints and muscles will feel stiffer, making it harder to move. To ease the pain during this phase, you must protect the joint or body part you injured to make sure that we’re not causing more injury, but that does not necessarily mean not moving at all. Because the more you’re in the rest mode, it may have a negative impact on recovery, you’ll feel stiffer, become more anxious, and in some cases, your pain can intensify. Find positions and stretches that would actually bring the pain down. 

Sub-acute Phase

This phase starts at the six-week mark and ends at about 12 weeks. The pain intensity could actually be more or less or the same, which depends on what happened during the first six weeks of the acute phase of pain. There’s a lot more tissue healing and there’s less swelling and this is at the point where the brain is conditioned to feel pain. So it is crucial to have positive self-talk to re-wire our brain not to really feel the pain and impact our pain levels. To lessen the pain, do the same thing during the acute phase but with more movements. You need to do more of what feels good, whether it be stretching, exercises, or just moving in general. Break that pain cycle in your brain before it actually starts to be accustomed to experiencing that pain, to begin with.

Chronic Phase

If by the end of 12 weeks, and you’re still in pain, you have officially reached the chronic stage of pain. So you might wonder and ask “why do I still feel this pain?” Studies show that components like poor body mechanics, depression, and other factors can actually have an impact on longer-term recoveries and can contribute to pain reaching the chronic stage. However, one major cause is poor management at the initial phase of injury, because of the fact that the first two components were overlooked. So if your movement and life habits are actually causing you to put a lot of wear and tear on your body, you will continue to be in pain. Instead, you have to look at what you do on a daily basis. Are your life habits facilitating healing or removing the irritating state stimulus? Just like in the sub-acute phase, look into your own brain, conditioned it that it’s already okay to move since your tissue is already healing. Because the brain is out conditioned to feel pain, even with the smallest emotions, you might be at a point where you have to reassure yourself that whatever you’re doing isn’t actually causing you pain in the first place. This is where activities like meditation or gentle walking can help because it calms the nervous system down to allow a reset and help you understand what movements are painful and not. 

If you hurt yourself by one mechanism of action, chances are you can actually hurt yourself again by doing the same thing. Regardless of whether it’s acute, sub-acute, or chronic stage of pain, the main goal is to get you out of pain. That means that every action you do to address should be providing some sort of relief. So it’s important for you to reevaluate and see if there’s any change that you can make to that specific action. And remember, you don’t have to live in this pain forever, and you absolutely deserve to live pain-free without medications or surgery.

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