McKenzie Method, back pain in flexed posture picture What Makes Chronic Pain Different?

Most of us have encountered at least one person with chronic pain. Chronic pain is different the acute pain and can last months to years. Chronic pain is generally defined as pain that persists for 3 months or longer. It can lead to physical decline, functional limitations and even emotional distress.

Pain can be classified in many different ways and is experienced differently by everyone. Pain really comes from our brain when we interpret information as painful. This comes in handy when we step on a tack or touch a hot stove. However, how pain can get over stimulated. Even though you no longer touching the hot stove, you brain thinks you are. 

Chronic pain can be classified and explained in 3 main categories:

  • Central sensitizer
  • Affective
  • Motor autonomic

Central Sensitizers

People who are experiencing this type of pain, their nervous system is very overactive. Meaning, they always feel like they’re in pain and that they are causing themselves harm. There is usually involvement of a large are of the body and people will feel like their pain is spreading. When asked to describe the pain, they will usually choose a word that is equivalent to “harm” such as, “tearing”, or “ripping”.

People will generally avoid activities due to fear of causing harm to themselves. However, when distracted, they will be able to complete the activity or movements they usually avoid. Once the pain realizes that the fearful activity was done, neuron overstimulation happens, and pain response sets back in.
This happens because the pain is stuck in the overprotective mode.

An important thing to remember is, if after completing an activity (ideally the one that is feared the most), range of motion is unchanged even if there is presence of pain, no harm is being caused. When going for physical therapy, expect to work through pain and be gradually progressed. 

Affective

Symptoms are usually described as localized, low grade but constant, dull ache. People will also report experiencing this low grade pain for weeks or months and then all of sudden, with no apparent reasons, they will experience increase in pain.

This type of pain will usually correlate to emotional/social issues. People may notice that every time they visit a relative they dislike, their pain gets worse. This type of pain occurs when exposed to an some type of emotional distress. This is because our brain will react in a way that it will decrease the blood flow to certain parts of the body and therefore, cause us to feel pain.

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When tested in physical therapy, there will be no objective findings such as, tightness, decrease in strength or range of motion. This type of patient will benefit the most from aerobic type of exercises. 

Motor Automatic

One way that this type of chronic pain differentiates from the other two described above is because it involves skin changes. Pain is localized and there may be some skin discolorations such as redness, changes such as lymphedema or even nail changes. 

People with this type of pain will report that rest has no effect on their symptoms, and every movement makes the pain worse. Hypersensitivity to touch will also be present.

In physical therapy, a lot of sensory work will be done before reintroducing the person to an activity they fear the most. 

Contact Us!

If you liked this blog and want to learn more about how pain works, check out or previous blog. If you want to learn more about BeneFIT reach out to us at 908.203.5200 for Bridgewater or 908.879.5700 for Chester. You can also reach us by messaging us on Instagram!