Acute pain

Supportive care |
Acute pain

Acute pain

Acute pain is a highly invalidating
sensory and emotional experience that
can last from a few days to 12 weeks.
Istituto Gentili accompanies Patients
to ensure this condition is effectively
managed and does not evolve into
chronic pain.

Characteristics

go-top

Pain is an unpleasant sensory and emotional experience associated with actual or potential tissue damage.

Acute pain is a type of pain that lasts from a few days up to 12 weeks. It is usually the result of a specific event and is caused by direct tissue injury that is likely to resolve.

The body perception of pain is mediated by various factors of a:

sensory,
emotional,
cognitive,
and social nature.

The pharmacological treatment of acute pain must be personalised to suit the clinical paint of each Patient.

An effective management of this condition can prevent the transition to chronic pain.

Pathophysiology

How does acute pain arise? This process involves a series of complex chemical and electrical events that occur between the painful (noxious) stimulation in the tissues and the subjective pain experience.

Here is an overview of the main mechanisms involved:

Acute pain is often associated with a sympathetic nervous system hyperactivity response, which can include:

tachycardia,
increased blood pressure,
dilation of the pupils.

Psychological factors, like anxiety and stress, can also modulate the intensity of the perceived pain.

Causes

Acute pain can have many causes, including:

Physical injuries: e.g., cuts, burns, contusions, and bone fractures.
Surgical procedures: postoperative pain is common.
Infections: some infections can cause acute pain, for instance appendicitis or pancreatitis.
Illnesses: conditions like headache, backache, and renal colic.
Inflammation: inflammatory conditions like arthritis or tendinitis.

Treatment

The treatment of acute pain varies depending on the cause and the intensity of the pain.

ANALGESIC DRUGS:

NSAIDs (nonsteroidal anti-inflammatory drugs): such as ibuprofen and naproxen, are often used for mild to moderate pain.
Paracetamol: which is effective for mild to moderate pain, but does not have anti-inflammatory effects.
Opioids: which are used for severe pain, but with caution due to the risk of addiction.

PHYSICAL THERAPIES:

Ice or heat application: ice can reduce inflammation and swelling, while heat can relax contracted muscles.
Rest: resting the affected part can favour healing.

COMPLEMENTARY THERAPIES:

Acupuncture: which can be useful for certain types of pain.
Relaxation techniques: like biofeedback and hypnosis, which can help to manage pain.
Cognitive and behavioural intervention: these interventions help Patients to develop adaptation strategies in order to cope with the pain and reduce the related disability.

Useful information

Allodynia: a pain impulse felt by a person following an innocuous stimulus (often simply touching the affected part can cause a sensation of pain).
Analgesia: no pain felt in response to a stimulation that should have resulted in pain.
Causalgia: intense, burning pain that is subject to paroxysmal exacerbations and triggered, above all, by tactile stimuli. It is the result of peripheral nervous injury or amputation.
Central pain syndrome: pain that is initiated or caused by a primary lesion or a central nervous system dysfunction, that can be circumscribed to a small or large part of the body or limited to the face and/or limbs.
Hyperpathy: an abnormally painful reaction to a sensory stimulus; it is classified as a type of hyperaesthesia.
Hypoalgesia: diminished pain in response to a stimulus that would usually be painful.
Paraesthesia: an abnormal perception of sensory stimuli (an abnormal sensation that can be either spontaneous or provoked).

REFERENCES

Amaechi O, Huffman MM, Featherstone K. Pharmacologic Therapy for Acute Pain. Am Fam Physician. 2021 Jul 1;104(1):63-72.
Anekar AA, Hendrix JM, Cascella M. WHO analgesic ladder. InStatPearls [Internet] 2023 Apr 23. StatPearls Publishing.
Gan TJ. Poorly controlled postoperative pain: prevalence, consequences, and prevention. J Pain Res. 2017 Sep 25;10:2287-2298. doi: 10.2147/JPR.S144066.
Grubb S, George W. Pasvankas. “Anatomy and Physiology: Mechanisms of Nociceptive Transmission.” Academic Pain Medicine: A Practical Guide to Rotations, Fellowship, and Beyond (2019): 1-7.
Hooten WM et al. A Conceptual Framework for Understanding Unintended Prolonged Opioid Use. Mayo Clin Proc. 2017 Dec;92(12):1822-1830. doi: 10.1016/j.mayocp.2017.10.010.
My Personal Trainer. Terapia del Dolore: cos’è, come funziona, quando si pratica. Available at: https://www.my-personaltrainer.it/salutebenessere/terapia-del-dolore.html Last access: December 2024.
Torrinomedica. Cosa prendere per dolore acuto? Available at: https://www.torrinomedica.it/farmaci/dolore/cosa-prendere-per-doloreacuto Last access: December 2024.