Management of Acute and Chronic Pain
The principles to be followed in the management of pain are the same, regardless of whether the pain is acute or chronic (Chapter 13). There are, however, specific pragmatic differences between these two states (Table 14.1). Acute pain is associated with a specific injury to the body (nocicep tive) that is usually easily identifiable, frequently expected (postoperative pain), and usually limited in time and location. Chronic pain, while often caused by tissue injury, may also be due to an injury to the central nervous system that disturbs the normal transmission of sensations (deafferentation pain) or may have a psychogenic component manifested by considerable pain without an obvious cause. The chronicity of the pain, regardless of cause, also produces psychologic disturbances that must be addressed if successful pain relief is to occur.