Pain—Acute Versus Chronic Pain & Anesthesia

Pain is the most common symptom for which people seek medical attention. Pain can be classified with different criteria including the cause, location, mechanism, and/or duration. Clinically, the duration-centered classification is useful for identifying potential sources of pain, diagnosis, as well as guidance for treatment. Understanding how the neurotransmission of noxious stimuli (i.e., pain signals) within the nervous system results in pain is important for implementing appropriate strategies for treatment. Importantly, biological and psychosocial factors may contribute to maladaptive changes in the nervous system which may turn pain into a disease state (chronic pain). Thus, acute and chronic pain are considered different clinical phenomena with distinct management approaches. In this chapter, we provide an overview of pain processing and acute to chronic pain transition. We focus on post-surgical pain as an example of a clinical pain model for transition to a chronic pain state and discuss the risk factors for development of chronic post-surgical pain (CPSP), prevention of CPSP and pain management strategies.