Chronification

Chronification might be my new favorite word. Apparently this new word, used since the 1990s, has appeared in research, journals, and literature. I didn't know there was a word for this process, but apparently there is and it means this (credit to the researchers):

    “Pain chronification describes the process of transient pain progressing into persistent pain; pain processing changes as a result of an imbalance between pain amplification and pain inhibition; genetic, environmental and bio-psychosocial factors determine the risk, the degree, and time-course of chronification.”

Okay, one sentence at a time.

First, what is pain?

The International Association for the Study of Pain (IASP) defines chronic pain as “pain without apparent biological value that has persisted beyond the normal tissue healing time (roughly 3 months)”. Acute pain typically has a protective function, an evolutionary alert system, signaling the brain of a bodily injury. But chronic pain does not enjoy the duality of a positive evolutionary alert system with the negative aspects that accompany pain. Chronic pain is gratuitous and completely without evolutionary value. 

This traditional definition of chronic pain by the IASP addresses only the physical healing timeline and ignores the psychological, social, financial, and physiological implications and patterns of persistent pain. 

"Pain chronification describes the process of transient pain progressing into persistent pain..."

This makes logical sense that there is a process by which pain goes from new, novel, and acute to same, old, chronic pain. Is this a linear process? Is it the same for everyone? Impossible. Pain cannot be the same for everyone, cannot be measured across people, and the factors by which chronification takes place cannot be the same. So what makes pain change over time? 

"...pain processing changes as a result of an imbalance between pain amplification and pain inhibition..."

So an imbalance between the intensity of the pain and how it is mitigated by the brain? That makes sense, but on second thought, does pain inhibition refer to physiological mitigation or social and cultural factors? 

The last part of the chronification definition is this:

genetic, environmental and bio-psychosocial factors determine the risk, the degree, and time-course of chronification.”

So the last part essentially says that all of these additional factors determine ALL aspects of chronification. Well yes, life experience, gender, access to healthcare, proximity to healthcare…and much more. 

So transient pain turns into chronic pain. There is a process that involves many factors and then what? 

Pain management options for chronic pain appear to be less than effective. Inflammation management options, at least the ones I have tried, have been worse due to their unique combination of ineffectiveness combined with their formidable side effects that require their own management.

While it is interesting that chronification has been studied and is better understood, I wonder if our methods to deal with chronic, unceasing, pain rise to the level of the five letter word that details the process.