THE CHALLENGE OF TREATING
PTSD IN THE CONTEXT OF
Jaye Wald, Steven Taylor, and Ingrid C. Fedoroff
Acute pain is an adaptive, protective response, typically coinciding with actual or potential tissue damage. This type of pain produces a withdrawal response from the noxious stimuli to allow the injured area to heal and to prevent further injury. Acute pain typically abates with physical recovery. In comparison, chronic pain is defined by the persistence of pain beyond the usual healing time, usually beyond 3 months (Merskey & Bogduk, 1994). There are many different kinds of chronic pain (e.g., chronic low-back pain, fibromyalgia, myofascial pain syndrome). Unlike acute pain, chronic pain typically has no adaptive purpose and the onset and cause may be unclear. Chronic pain can be recurrent, intermittent, or continuous. It can evolve into an entrenched, self-perpetuating cycle of psychological distress and suffering, physical deconditioning (i.e., muscle wasting and loss of physical fitness due to inactivity), functional interference, withdrawal from activities, as well as dependence on medication and health care services (Eimer & Freeman, 1998).
Chronic pain and posttraumatic stress disorder (PTSD) commonly cooccur, resulting in substantial disability, health care utilization, and public