Two Types Of Pain:
Acute Versus Chronic Pain

Acute pain is generally defined as:
    •   Sudden pain related to tissue injury that is only present for the time it takes the injury to heal.
        The IASP indicates that this is usually less than six months.
    •   The source of this pain is clear.
    •   The treatment defined.
    •   The pain is usually resolved.
    •   Acute pain medications are used for treatment.

Chronic pain is:
    •   Pain that persists long after actual tissue healing and may not have a clear source. IASP defines
        this as more than six months.
    •   Pain is centralized, which means that the central nervous system has gone through biochemical         changes and now is relaying “false” messages to the higher sensory parts of the brain.
    •   This pain is perceived as actual pain from an area of the body, which appears normal upon  physical           examination.
    •   Certain types of injuries such as joint injuries and nervous system injuries take a long time to heal
         and, because of this, allow the biochemical changes to take place that cause chronic pain.
    •   Chronic pain patients are treated with entirely different medications than acute pain patients. It is         important with any type of pain patient that their pain be controlled and kept below the “pain         threshold,” which is why pain doctors will ask the patient to take their pain medication on a  “time         contingent” basis (every so often even if there is no pain), so that the pain will not become chronic.         Many patients have difficulty understanding this instruction and only take their  medications if they         are experiencing pain. It is very important to carefully follow your doctor’s  instructions with all         medications.

Many TMD and orofacial pain patients are chronic pain patients. They must understand:
    1. The process to relieve their pain is going to be tedious.
    2. They may get only partial pain relief and have to endure some pain for an indefinite period.
    3. They often need a multidisciplinary approach for treatment, which will involve different medical         disciplines such as neurology, rheumatology, counseling, etc.