Painful times

Pain is commonly defined as chronic when it exists for longer than the expected timeframe for healing. The most common definitions consider pain to be chronic when it continues beyond between periods of three or six months (Ashburn & Staats, 1999; Turk & Okifuji, 2001). It can occur in the presence of actual or potential identifiable tissue damage, injury or pathology. A publication that summarised two systematic reviews and 13 primary studies found that when the classification of the International Association for the Study of Pain was used, ie chronic pain as “pain that persists beyond the point at which healing would be expected to be complete or that occurs in disease processes where healing would not be expected to take place”, the mean prevalence of chronic pain in adults seen in primary care settings was 35.5%, ranging between 10.5-55.2% (Ospina & Hartstall, 2002). Chronic pain has significant costs, for instance in the UK the direct cost associated with chronic back pain was estimated