Ask A Doctor – Pain & Pain Treatment

November 26, 2017

Different types of pain

Question: How do we “feel” pain? Where does it start? How can we control it?

Answer: Treating pain means we must first understand what is causing the pain. There are basically three types of pain.

  1. Nocioceptive pain – In this type of pain there is tissue discomfort that is reported to the brain. Examples of nocioceptive pain: muscle strain, swelling, bee stings, toe stubs, IBS, fibromyalgia, and migraine.
  2. Neuropathic pain – In this type of pain there is damage to the nervous system, meaning the spinal nerves themselves. Examples of neuropathic pain: sciatica, multiple sclerosis, diabetic neuropathy
  3. Psychogenic pain – In this type of pain, there is a psychosocial disturbance. Examples of psychogenic pain are anxiety, PTSD, depression. Psychogenic pain is as real as the other two. Just because the cause of the pain cannot be “seen” on an X-ray or MRI, does not make it any less legitimate.

Individualizing pain treatment

Question: What does it mean when the pain management doctor says that pain must be individualized?

Answer: Pain is a somatosensory discomfort. It is not perceived in the same by any two people because everyone has his or her individual coping (or not coping) abilities. Other factors that must be considered in how each patient perceives pain is the context of the pain, presence of opioid-induced hypersensitivity, emotional component, prior experience with pain, expectations for future pain, repeated exposures to painful stimuli, past exposure to trauma, and acceptance of pain.

Chronic vs. Neuropathic pain

Question: What is the difference between chronic pain and neuropathic pain?

Answer: Chronic defines the length of time the patient has had pain. Pain that has lasted three months or longer is chronic. Most cancer pain is chronic as the pain of cancer has been present for three months or longer. Another example is chronic muscle strain which is brought on by weak back muscles resulting in repeated muscle injuries. Neuropathic defines the type of pain, not the length of time present. Neuropathic pain is due to damage to the nervous system, such as seen in diabetic neuropathy and multiple sclerosis. Most neuropathic pain has been present for three months or longer, no most neuropathic pain is chronic. However, most chronic pain does not involve the spinal nerves, so most chronic pain is not neuropathic.

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If you liked these questions and answers and want more, why not check out the Q&A from the ‘Ask A Doctor – Migraines & Chronic Inflammatory Disease

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