Acute and Persistent Pain

Acute pain is the symptom associated with how the brain interprets direct tissue trauma and the subsequent inflammatory response which initiates the tissue healing processes. Over time, as endogenous opiates have an effect and as tissue sensitivity decreases, injured tissue heals within 2 weeks to 3 months and function is restored. Acute pain is usually easily to localize (e.g, the patient can point to it or name a specific body part/structure/area).

Persistent pain is defined as:

Common causes of recurrent or persistent pain:

Psychosocial impact of persistent pain are significant and can lead to disability. Unrelenting pain sensations can result in chemical changes which impact appetite, mood, mobility, body system function, sleep, libido, and participation in work/social life. Patients who are unable to adequately manage persistently painful conditions may lose employment and strain family relationships. Individuals with persistent pain are at higher risk for depression and addiction disorders.

The role of the PT and the PTA in the treatment of persistent pain is to be an active participant in a multidisciplinary team that guides pain management. Cardiovascular endurance, pacing and prioritizing, body mechanics and posture, counseling and imagery/cognitive behavioral therapy (CBT), nutrition, stress management, and medication management comprise best practices for persistent pain management.

Pain Medication Overview:

Pain Qualities

Subjective reports of pain include a description of the pain quality. Pain descriptions may provide some insight into level of acuity and the involved structures. It is important to know that people who persons persistent pain may report a multiple and fluctuating descriptions of somatic (felt in the body) pain, without any evidence of recent tissue trauma.


A PTA must be able to make comparisons in subjective reports of pain quality and decide if interventions should be modified or discontinued based on the patient response. Marked changes in pain presentation and quality may require consult with the supervising physical therapist.

Watch and listen to "Christina describes pain qualities"

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Pain Quality

Associated Involved Structure*

cramping, dull, aching


sharp, shooting

nerve root

sharp, burning, lightning-like


burning, pressure-like, stinging, aching

sympathetic nerve

deep, nagging, dull


sharp, severe, intolerable


throbbing, diffuse



Spinal Levels and Referred Pain


Spinal Levels

Example Signs and Symptoms
















"Grant 1962 663" by Grant, John Charles Boileau - An atlas of anatomy, / by regions 1962. Licensed under Public domain via Wikimedia Commons -



101 1506_Referred_Pain_Chart.jpg

By OpenStax College [CC-BY-3.0 (], via Wikimedia Commons



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