Condition information
Understanding your pathway
What is pain after trauma?
Pain after an injury can continue beyond the initial recovery period and interfere with movement, work or sleep. Persistent pain does not always mean that the original injury is still worsening. It does, however, deserve a review of healing, function and any symptoms suggesting another problem that needs treatment. [1][1]
What can contribute?
Possible contributors include the original injury, nerve involvement, altered movement and sensitivity in the pain system. Sleep difficulties, stress and reduced activity may interact with symptoms. These influences do not make pain imaginary. New symptoms may have a different cause from the original injury and should be assessed on their own merits. [1][2][3][4][5]
Common presentations and symptoms
Pain may remain local, spread, become sensitive to touch or occur with reduced movement. The effects on daily tasks, fatigue and sleep help define rehabilitation goals. Marked colour or temperature change and swelling may require assessment for CRPS or other conditions, rather than automatically being described as normal recovery. [1][2][3][4][5]
Assessment and diagnosis
A review brings together the injury history, prior treatment, examination and relevant investigations. The clinician considers whether healing or another structural problem needs further assessment and whether nerve symptoms are present. Additional scans are chosen to answer a clinical question, not solely because pain has persisted for a particular length of time. [1][2][3][4][5]
Management options
A coordinated plan may include education, graded rehabilitation, psychological support and medication review. Where a specific treatable target is identified, an intervention can be considered alongside these measures. The focus is sustainable function and participation. A procedure should have an agreed purpose and follow-up plan, without a promise that pain will disappear. [1][2][3][4][5][6]
When should I seek urgent care?
Seek urgent medical assessment for new deformity, inability to use a limb, worsening weakness, fever with increasing pain or a cold or pale limb. Back pain with bladder or bowel changes or saddle numbness is an emergency. Call 000 for serious injury, breathing difficulty or collapse. [1][2][3][4][5]
Multidisciplinary care and self-management
Persistent pain can affect more than one part of life. Physiotherapy, psychological support and medical care may be combined according to your needs. Psychological care addresses the effects of pain and ways of coping; it does not imply that pain is imagined. Discuss an activity plan you can sustain rather than alternating between doing too much and stopping completely. [6][1]
Preparing for your consultation
Bring a current medicine list, relevant scan reports and details of treatments you have tried. Describe what each treatment changed, any adverse effects and the activities you most want to regain. You may wish to bring a support person. Ask what the assessment can clarify, what remains uncertain and which decisions can reasonably wait.
Follow-up and questions to ask
Agree how progress will be judged: for example, walking tolerance, sleep, work participation or confidence with a daily task. Ask when to review the plan and what changes should prompt earlier contact. Discuss potential benefits, limitations, costs and alternatives before starting treatment. If a plan is not helping, review its purpose instead of assuming that more of the same treatment is always needed. [5]
Sources and further reading
Sources support the statements cited above. Overseas guidance may describe different services or eligibility rules. A procedure leaflet explains a technique and its risks; it does not establish that the treatment is effective for every condition.
- Chronic pain — Healthdirect Australia
- Complex regional pain syndrome — NHS
- Leg pain — Healthdirect Australia
- Back pain — Healthdirect Australia
- Procedures in pain medicine clinical care standard — Faculty of Pain Medicine, ANZCA
- Options for chronic pain management — Healthdirect Australia