Different Types of Pain

What is pain?

Pain is “An unpleasant sensory and emotional experience arising from actual or    potential tissue damage or described in terms of such damage”.

Pain has the dubious distinction of being the commonest symptom for which a person approaches medical care.

There are many sources of pain. One way of dividing these sources of pain is to divide them into two groups, nociceptive pain and neuropathic pain. How pain is treated depends in large part upon what type of pain it is.

Nociceptive pain

The body's nervous system is working properly. There is a source of pain, such as a cut, a broken bone or a problem with the spine. The body's system of telling the brain that there is an injury starts working. This information is passed on to the brain and one becomes aware that they are hurting.

Neuropathic pain

The body's nervous system is not working properly. There is no obvious source of pain, but the body nonetheless tells the brain that injury is present.

What are types of nociceptive pain?

Most back, leg, and arm pain is nociceptive pain. Nociceptive pain can be divided into two parts, radicular or somatic.

Radicular pain:

Radicular pain is pain that stems from irritation of the nerve roots, for example, from a disc herniation. It goes down the leg in the distribution of the nerve that exits from the nerve root at the spinal cord. Associated with radicular pain is radiculopathy, which is weakness, numbness, tingling or loss of reflexes in the distribution of the nerve.

Somatic pain:

Somatic pain is pain limited to the back or thighs. The problem that doctors and patients face with back pain, is that after a patient goes to the doctor and has an appropriate history taken, a physical exam performed, and appropriate imaging studies (for example, X-rays, MRIs or CT scans), the doctor can only make an exact diagnosis a minority of the time. Research has shown that most back pain that does not go away after conservative treatment usually comes from one of three structures in the back: the facet joints, the discs, or the sacroiliac joint. The facet joints are small joints in the back of the spine that provide stability and limit how far you can bend back or twist. The discs are the "shock absorbers" that are located between each of the bony building blocks (vertebrae) of the spine. The sacroiliac joint is a joint at the buttock area that serves in normal walking and helps to transfer weight from the upper body onto the legs.

Fluoroscopically (x-ray) guided injections can help to determine where pain is coming from. Once the pain has been accurately diagnosed, it can be optimally treated.

What is acute pain?

Acute pain begins suddenly and is usually sharp in quality. It serves as a warning of disease or a threat to the body. Acute pain might be caused by many events or circumstances, including:

•             Surgery

•             Broken bones

•             Dental work

•             Burns or cuts

•             Labor and childbirth

Acute pain might be mild and last just a moment, or it might be severe and last for weeks or months. In most cases, acute pain does not last longer than six months, and it disappears when the underlying cause of pain has been treated or has healed. Unrelieved acute pain, however, might lead to chronic pain.

What is chronic pain?

Chronic pain persists despite the fact that the injury has healed. Pain signals remain active in the nervous system for weeks, months, or years. Physical effects include tense muscles, limited mobility, a lack of energy, and changes in appetite. Emotional effects include depression, anger, anxiety, and fear of re-injury. Such a fear might hinder a person’s ability to return to normal work or leisure activities. Common chronic pain complaints include:

•             Headache

•             Low back pain

•             Cancer pain

•             Arthritis pain

•             Neurogenic pain (pain resulting from damage to nerves)

•             Psychogenic pain (pain not due to past disease or injury or any visible sign of damage       inside)

Chronic pain might have originated with an initial trauma/injury or infection, or there might be an ongoing cause of pain. However, some people suffer chronic pain in the absence of any past injury or evidence of body damage

What is the difference between acute and chronic pain?

•             There might be no known cure for the disease (such as arthritis or phantom pain) that is causing the chronic pain.

•             The cause of chronic pain might be unknown or poorly understood.

More articles on Pain Management are coming soon.