Acute Pain
Acute Pain in the context of Back Pain tends to mean pain of short duration, typically pain lasting less than 6 weeks. It is contrasted with 'Chronic Pain', but as in that case the term suggests a problem defined by time. According to the definition however 'acute' is from the Latin root 'acutus' meaning 'sharp, pointed, vicious or cunning’, a series of terms that have nothing to do with time, however using these terms makes it is easier to understand the Acute Back Pain experience.
As discussed on the 'Chronic Pain' page of this site, pain is not a sensation; rather it is a response from the brain to information after an initial warning message of tissue damage (nociception). Nociception detected by distant sensors in damaged tissue is transmitted via the spinal cord to the lower brain centres (the parts of the brain that work without thinking).
The initial response of the lower brain will usually suppress the pain while the thinking part of the brain, the higher part, will work out where the pain is and what is the likely cause. The middle part of the brain is responsible for your emotional response to the pain and will be looking for reassurance from the higher part that everything will be OK!
If you tread on a tack, you will know where to look, the explanation is obvious, the injury, although painful is clearly minor, and the emotional response is limited as there is no future likelihood of continuing pain. The damage report will continue to be suppressed by the lower brain and all you need to do is have a good shout and you will be fine.
The same cannot be said for Back Pain that comes for apparently no reason, which feels very severe and there is no way of assessing the damage because you cannot see it, it is a pain that you cannot control and that you seriously believe may affect your life in a negative way. Here the pain will be initially suppressed but after the threat cannot be allayed this will reverse and the lower brain will amplify the damage report to collect more information.
There may be an element of damage but often it is not enough to give any signs on investigation. However a vicious circle quickly develops where the initial damage report leads to local swelling and soreness, the body responds by tightening the area using the muscles between the bony segments of the spine. This logically prevents movement but can be very powerful with the literature suggesting a possible compressive spasm of about 10 times the upper body weight. The spasm in turn compresses the sore area and increases the pain and so on.
The result will be an ‘Acute Pain’ event that can spiral out of control. Effectively this is the standard Back Pain event, very painful but not serious.
Your Spine Team practitioner will be able to identify this; ironically the very fact that you are in so much pain that you cannot be examined properly is in itself diagnostic! ‘Serious Illness’ presenting as Back Pain does not do this, and therefore is easily distinguished from ‘Simple Back Pain’ that is painful enough to be disabling but is in fact not at all serious.
