Doctors separate pain into 3 categories: acute, chronic or intractable. When an injury or illness is in the acute phase, it has a biological basis and warns a person to seek medical help. It can also be used as a diagnostic tool in pinpointing the proper sources of pain.

Dennis (1978) suggests that acute pain is normally associated with a well defined cause (such as a burned finger or ruptured appendix), typically has a characteristic time course and goes away after the person has healed. This type of pain may be slight and last a minute such as a wasp sting, or it may be severe and last for weeks or months such as a burn.

Chronic pain is a pain state where there is persistent pain lasting a minimum of

6 months and usually the cause of the pain cannot be removed, found or otherwise treated.

Black (1973) suggests that the most important distinction between acute and chronic pain is

that the pain is no longer serving as a warning signal but has become and end unto itself and that the patient suffering from chronic pains lifestyle has been significantly altered due to the disorder. Chronic pain lingers beyond the “normal” time of healing,. It not only causes physical pain and tissue damage, but also places severe emotional, functional, social and

spiritual stresses on the individual who is suffering. Although the pain may have started as acute pain, other types of pain often develop slowly, making this type of pain difficult to treat. Chronic pain can also result from diseases such as shingles or diabetes, from trauma,

surgery or without a specific known injury or disease.

Chronic pain ranges in severity from mild to disabling and can be felt daily 7 days a week for 24 hours daily or can be experienced intermittently with times when the pain is not perceived. This type of pain is no longer valuable and used as a warning to indicate

harm or potential danger to the body. Usually the whole person suffers. Intractable pain is a more severe form of chronic pain. It is extremely different from acute pain but differs slightly from chronic pain. The definition of chronic pain does not take into account treatments already attempted, those that have

helped or failed or even the prognosis for the person suffering.

Intractable pain is pain which is extremely severe in nature, unremitting, incurable and of such severity that it dominates virtually every conscious moment, produces psychological and physical debilitation

and may produce such depression in the individual that they may wish to end their lives for the purpose of extinguishing the pain. Intractable pain is considered to be extremely severe, unremitting, and to date no cure can be found to relieve the pain problem.

The mechanics that cause chronic or intractable pain are very complex. There usually is tissue damage or a disease process, which causes chemicals such as serotonin, histamine, bradykin and prostaglandin to be released in the human body. These chemicals cause the nerves to become more sensitive to pain. As time progresses a chemical called substance P is

released from the peripheral nerve endings. This substance carries pain signals. The more substance P that the nerves release, the more sensitive the person becomes to pain.

There are numerous medical conditions, which commonly cause chronic or intractable pain.

Some of these conditions are: arachnoiditis, back injuries, failed back surgeries, migraine

headaches, fibromyalgia, adhesions and scarring from previous surgeries, rheumatoid arthritis,

osteoarthritis, cancer, systemic lupus erythematosus, reflex sympathetic dystrophy, myofascial

pain, spinal stenosis, referred pain, neuropathic pain, endometriosis, interstitial cystitis,