Chronic Pain is pain that has persisted for an extended period of time. The point at which acute pain becomes chronic pain is not well defined; 3-6 months is generally defined as the length of time the pain must persist before it is considered ‘chronic’, although this transition point is essentially arbitrary, meaning there is no specific reason why 3-6 months was chosen as the duration necessary to define chronic pain. Some also make the distinction between pain which is caused by the activation of nociceptors (the nerve receptors which signal the presence of ‘pain’), and pain which is caused by neurological damage or malfunction. Culture can play a huge role in the illness experience. Because it is often difficult to determine the cause of chronic pain, the presence of the illness rests entirely on the patient’s word. It is not uncommon for the patient to not be taken seriously when they complain of their pain, since some physicians believe that the individuals with chronic pain actually have a mental disorder and are just trying to gain attention for themselves, and are not actually in pain. (Werner – “Illness stories on self and shame in women with chronic pain”) This has a significant effect on the self-esteem and psychological health of the individual with chronic pain. Despite the fact that many believe that poor mental health can cause ‘chronic’ pain, it has been found that the opposite is actually true, and that chronic pain often leads to a degradation in mental health.( Fishbain, David A.; Cole, Brandly, Cutler, R. Brian, Lewis, J., Rosomoff, Hubert L., Rosomoff, R. Steele (1 November 2006). “Chronic Pain and the Measurement of Personality: Do States Influence Traits?” Pain Medicine 7 (6): 509–529.) It has also been found that once chronic pain is managed through therapy, mental health often makes an improvement. (JESS, P.; T. JESS, H. BECK, P. BECH (1 January 1998). “Neuroticism in Relation to Recovery and Persisting Pain after Laparoscopic Cholecystectomy” . Scandinavian Journal of Gastroenterology 33 (5): 550–553. )
I believe that this can make management and treatment of chronic pain very difficult, since it can be hard for the patient to convince anyone that they are actually in pain and not lying about it. This further complicates the patient’s health, as not being believed in this manner is often discouraging.
In regards to the connection between belief and healing, I believe that individuals who maintain a positive attitude are often healthier. If they believe that they are being treated, then they will be more confident that they will recover and be healthy again. In the case of arthroscopic surgery for arthritis of the knee, it was found in clinical trials that essentially the entire benefit of the surgery was a placebo effect. (Placebo: Cracking the Code)