How To Identify Your Pain

painAs a physician dedicated to managing peoples’ pain, one of my most important duties is to accurately identify the type of pain a patient is experiencing, and then recommend the most effective course of treatment.

Because you are reading this blog about pain, there’s a likelihood you are experiencing some level of pain right now, or are anticipating recurring pain. Depending on its location and severity, that pain might be causing you discomfort, distress or even agony. The pain might be steady and constant; in which case it could be an ache. It might be a throbbing pain, or a pulsating pain. It might have a pinching sensation, or a stabbing one. 

Pain is a very individual experience, so only the person who is experiencing it can describe the sensation accurately. I’m presenting this basic pain guide to help you understand the different types of pain we have all felt at one time or another. It is not meant to help you diagnose your condition, or to suggest a treatment. It is purely for your information. If you have concerns about your pain or it is extreme or long lasting, and it hasn’t been responding to home care and over-the-counter medication, please contact a physician for a professional diagnosis.

In follow-up blogs, I’ll write about how pain is measured, and the various treatments offered by the medical community.

Types of pain

Acute Pain – This is an intense and short-lived pain, that could be an indication of an injury. If it is, when the injury heals, the pain usually goes away.

Chronic Pain – Mild or intense, chronic pain lasts much longer than acute pain.  

Classifications

Nociceptive Pain – Specific pain receptors are stimulated and sensitive to hot/cold temperature, vibration, stretching, and chemicals released by damaged cells.

Somatic Pain – Generally sharp and very localized, if the affected area is touched or moved, it will hurt more. This pain might be felt on the skin, or in muscles, joints, bones and ligaments – known as musculo-skeletal pain. With somatic pain, pain receptors are sensitive to temperature (hot/cold), vibration and muscle stretch. They are also sensitive to inflammation, which could be from a cut, or a sprain that causes tissue damage.

Visceral Pain – Felt in the internal organs and main body cavities, which are divided into the thorax (lungs and heart), abdomen (bowels, spleen, liver and kidneys), and the pelvis (ovaries, bladder and the womb). The pain receptors are sensing inflammation, stretching and/or oxygen starvation (ischemia).

Visceral pain is more likely to be a vague deep ache that is harder to pinpoint than somatic pain. Colicky and cramping sensations are often types of visceral pain. It commonly refers to some type of back pain – lower, abdominal, mid back, or upper back.

Nerve Pain/Neuropathic Pain – Nerve pain is also called neuropathic pain. It comes from within the nervous system itself and is often referred to as a pinched nerve, or trapped nerve. The pain can originate from the nerves between the tissues and the spinal cord, and the nerves between the spinal cord and the brain (this is known as the central nervous system).

When a nerve is injured it becomes unstable, which causes its signaling system to act haphazardly. The brain interprets these abnormal signals as pain. This chaos can cause other unpredictable sensations, such as numbness, pins and needles, tingling and hypersensitivity to temperature, vibration and touch. 

Neuropathic pain can be caused by nerve degeneration, for example, from a stroke, multiple-sclerosis, or oxygen starvation. It could be due to a trapped nerve, which creates pressure on the nerve. A torn or slipped disc will cause nerve inflammation, which will result in neuropathic pain. A nerve infection, such as shingles, can also cause neuropathic pain.

Sympathetic Pain – The sympathetic nervous system controls blood flow to the skin and muscles, perspiration, and how quickly the peripheral nervous system responds. The pain usually occurs with a fracture or a soft tissue injury of the limbs. Much like neuropathic pain, the nerve is injured, becomes unstable and fires off random, chaotic, abnormal signals to the brain, which interprets them as pain. 

In general, with this kind of pain the skin and the area around the injury become extremely sensitive and, often, the pain becomes so intense the sufferer doesn’t want to use the hurting arm or leg. Over time, this can cause other problems, like muscle wasting, osteoporosis and stiff joints.

Referred Pain/ReflectivePain – This is pain felt either nearby, or at a distance from the origin of an injury. Good example: during a heart attack, the affected area is the heart, but the pain is often felt in the arms, shoulders, back and neck, rather than in the chest. Doctors have been aware of referred pain for centuries, but researchers have not been able to identify what causes it.

Look for my upcoming blogs on how pain is measured, and range of available treatments. Remember, if you are experiencing pain that concerns you, call your physician, or contact New JerseyPain Care Specialists to discuss an expert evaluation.