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Chronic Pain
The image of aged hands struggling to play the piano due to chronic pain conveys a powerful visual narrative about the challenges faced by individuals dealing with this type of pain. The hands, which once expressed skill and dexterity, now reveal the obstacles imposed by chronic pain, affecting the ability to enjoy previously cherished activities. The visual representation captures the struggle and transformation in the daily experiences of these individuals, emphasizing the need for understanding and support in managing chronic pain.


An unpleasant sensory and emotional experience associated with, or resembling that associated with, actual or potential tissue damage.

Six key notes and etymology:

  • Pain is always a personal experience that is influenced to varying degrees by biological, psychological, and social factors.

  • Pain and nociception are different phenomena. Pain cannot be inferred solely from activity in sensory neurons.

  • Through their life experiences, individuals learn the concept of pain.

  • A person’s report of an experience as pain should be respected.

  • Although pain usually serves an adaptive role, it may have adverse effects on function and social and psychological well-being.

  • Verbal description is only one of several behaviors to express pain; inability to communicate does not negate the possibility that a person experiences pain.

Pain is an essential process for survival, as it serves to alert the individual. It is a primitive escape system, which serves to escape harmful events. It prepares the organism to take care of an injury and avoid further injuries.


In medicine, there is a distinction between acute and chronic pain. Acute pain is the body's normal response to an injury, and it usually resolves with treatment of the injury. This lasts for a limited time, which can be from a few days to a few months, but it eventually disappears when the cause of the pain is treated.


Chronic pain is pain that lasts for a long time, such as many months or even years. In the chronic form, pain ceases to act as a warning and can cause physiological (sleep disorders, appetite), emotional (depression, anxiety, stress), behavioral (physical disability,  dependence on third parties) and social changes ( family conflicts, occupational, economic problems).


There is no “exact time frame” that differentiates chronic from acute pain. A common way of thinking about the difference is that acute pain goes away with treatment, while chronic pain takes longer than expected to heal.


There are many causes for chronic pain. An untreated muscle injury can cause pain that lasts for many months. Another example is when bad bone formation causes an inadequate distribution of body weight, causing pain that is difficult to treat.

In some cases, the pain continues even after the injury has been treated. In these cases, the pain is considered chronic because it persists even though it does not correspond to an injury to the body. They are pains that arise (installed) or persist (maintained) because of psychological events. Some examples are chronic headache, fibromyalgia, chronic low back pain, arthrosis and arthritis, among others.


In many cases of chronic pain, there is a need for follow-up by another health professional, such as a psychologist, physiotherapist, neurologist, psychiatrist, among others. In the case of psychology, treatment is carried out through therapy, which seeks to redefine how the patient understands and interacts with pain. This means broadening the interpretation of complaints paying attention to situations and behaviors. It is not about following explanations or adopting strategies proposed by the psychologist, but about changing the attitude of the patient himself, who must be the active agent in this change.

There are relaxation techniques that help in the perception and control of pain.




The effect of medications on chronic pain treatments is uncertain. For few people there is partial or total pain relief, but due to the chronic nature of the pain it tends to return when the medication is discontinued. This makes opioid medications inadvisable, as their prolonged use can bring adverse effects.

All and any medication must be taken with the accompaniment of a qualified professional, prescription and appropriate dosages for each individual.



Cognitive behavioral therapy


Cognitive Therapy is a psychotherapy, proposed and developed by Dr. Aaron Beck and his collaborators. It is a set of techniques and therapeutic strategies based on empirical studies that confirm the effectiveness of these interventions.


Relaxation is a process that brings about the interaction between the physiological, psychological and the environment, and provides the patient with an understanding of how they interact. About 30% of psychotherapy have reduced stress levels and 92% report improvements in pain coping skills. A reduction in pain intensity was noticed in 70% of the participants. This type of intervention improves the participants, especially in the intensity and management of pain, improving the person's quality of life.





VANDENBERGHE, L. Behavioral Approaches to Chronic Pain. Psychology: Reflection and Criticism. V.18. P.47-54, 2005.

MELZACK, R., LOESER, J. D. Pain: on overview. The Lancet, v. 353, p. 1607-(1609, 1999.)

TANNÚS, P.M.; MANZINI, A. P. B. ; ZIN, G.O.; LAVANDOSKI, M. ; ASSUMÃO, M. B. ; FAUSTINO, M. ; LUIZ, N.C.; MULLER, V. ; AMARAL, M. R. C. ; CARDOSO, L. ; TRAVENSOLO, M. . Evaluation of the effectiveness of a behavioral intervention for people diagnosed with chronic pain. 2013. CIC - Scientific Initiation Congress

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