The Role of Transitional Pain in Bridging Acute and Chronic Pain

Transitional pain describes the clinically important phase in which acute pain resolves or progresses to chronic pain. This phase is particularly relevant after surgery and trauma, where the onset of tissue injury can be identified. Evidence suggests that chronic postsurgical or post-traumatic pain may arise through the interaction of biological, psychological, and social mechanisms, including peripheral and central sensitization, neuroimmune activation, psychological distress, pain catastrophizing, functional avoidance, and prolonged opioid exposure. Transitional Pain Services address this risk period through early identification, multidisciplinary intervention, opioid stewardship, rehabilitation, and psychological support. Current evidence suggests benefits for opioid tapering, pain interference, mood, and function, although stronger trials are needed to confirm whether such services reduce the incidence of chronic pain. Therefore, transitional pain should be understood as a modifiable risk state and a promising target for preventive perioperative pain care.