things aren’t always what they seem with persisting pain.

I’ve spent the last 8 years or so as a rehabilitation consultant, liaising between injured workers, employers, doctors and insurers to find the best way to assist a worker in the return to work process. A challenging job to say the least.

A large percentage of the people I have worked with have had chronic pain in some form. Protracted claims are problematic for insurers. They like defined time frames and things to be black and white. They have guidelines as to how long a certain injury should take to get better, or when the impact of a certain injury would be deemed to be over. More often than not, the injured worker doesn’t fit with the magic numbers and everyone gets a little antsy.

I’ve watched this happen time and time again and pondered all the reasons as to why this is so. And I think the answer is probably more simple than everyone thinks. Chronic pain is not acute pain. It doesn’t behave the same way. It is a completely different beast. Evidence suggests that expecting an acute back sprain to resolve in a month or two with some analgesia, rest, physio treatment and exercise is very reasonable. There is little evidence to suggest the same outcome from back pain that has persisted for 12 or 18 months. Sending that person off for active treatment that hasn’t made much difference the previous 2 times they tried is likely to be a waste of time and money.

Persisting pain is no less real or valid than acute pain. But there is one big difference – there is no new tissue damage. There are other factors contributing to the ongoing pain. Things that may not be obvious. It may require standing back to see the bigger picture. Because things aren’t always what they seem with persisting pain.