Which scenario illustrates acute on chronic pain?

• A. New flare after lifting a heavy object in a patient with chronic back pain
• B. Pain lasts only a few seconds
• C. Pain due to light touch
• D. Pain that is purely psychological

Answer: (A)

Acute on chronic pain occurs when a person who already has a chronic pain condition experiences a new, sudden flare or worsening of pain, typically triggered by a new event or aggravating activity. The scenario described fits this exactly—the patient with chronic back pain experiences a new pain flare after lifting a heavy object, representing a sharp increase on top of the existing chronic pain.

The other possibilities don’t illustrate this pattern. Pain lasting only a few seconds is a brief, transient sensation and doesn’t imply a sustained flare on a chronic baseline. Pain caused by light touch suggests allodynia, a neuropathic phenomenon, rather than a typical acute flare on chronic pain. Pain that is purely psychological lacks a somatic basis and doesn’t reflect an actual physical exacerbation of a chronic condition.