Acute vs. Chronic Pain Management:

When treating patient and athletes in the clinic and gym I frequently hear things like “yeah, I have had this tendinitis for years now.” Or “I have had chronic inflammation in my knee ever since my knee surgery a few years ago.”

And while tendinitis is real and chronic inflammation does exist, it does not exist in the way that most people seem to think. An “itis” is defined by a certain time frame and set of characteristics. Once outside of that time frame, it becomes an “osis,” and is characterized by a different set of characteristics.

Differences between acute and chronic:

Injuries in the acute and sub-acute phase are injuries that are less than 2 weeks old and are actively healing and being restored. An “itis” falls into this category. An injury that is not resolved past the 2 week mark is becoming classified as chronic and would be considered an “osis.” “Itis” injuries are associated with pain, swelling, and inflammation. An “osis” on the other hand has pain, swelling, but no longer has inflammation.

This is where I see a lot of faults in the way we deal with pain and injury. We think because there is pain that it must be inflamed. And because if is inflamed we must do something to decrease and control inflammation. But this is simple not true and by defining what an “osis” is we can start to see that. So what about your “chronic inflammation?”

What does it mean to have chronic inflammation?

There is only one set of problems defined by true chronic inflammation. Those things ar called Autoimmune Diseases. These are things like Crohn’s Disease, Ulcerative Collitis, or Multiple Sclerosis. The hallmark of these diagnoses is Chronic Inflammation. If you have long lasting pain in a joint or tissue in the absence of autoimmune disease you have simply mismanaged you pain and injury for a very long time. You have likely not addressed the source of the pain but have been trying to cover up the pain instead.

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