What Causes Chronic Pain?

Published on Jun 01, 2017

Everyone experiences the occasional ache or pain—it’s a normal response to an injury. For example, if you get a paper cut on your finger, pain signals travel from the injury site up the spinal cord and to the brain. But chronic pain is different. It is described as pain lasting 3 months or more and can occur even after an injury heals. For some people, there is no apparent cause for their chronic pain.

Pain is complex and can be experienced differently from person to person. There are several ways healthcare providers can measure pain in order to diagnose and manage it.

Describing your pain accurately is one of the most important things you can do

That’s because your description is the best clue for your doctor to determine what type of pain you have and what can be done about it. Let’s look at the three types of pain and describe how they might feel.

Nociceptive pain can feel:

  • Sore.
  • Throbbing.
  • Dull.
  • Tender.
  • Aching.
  • Cramping.

Nociceptive pain is caused by tissue damage from injury or inflammation. When inflammation or trauma is ongoing or chronic, it causes pain receptors (called nociceptors) to send persistent pain signals to the brain. Conditions that may cause this type of pain can include osteoarthritis, rheumatoid arthritis, tendonitis, gout, neck or back pain, tumor-related pain, sickle cell disease, inflammatory bowel disease.

Neuropathic pain can feel:

  • Hot and burning.
  • Like small electric shocks.
  • Like a stabbing sensation.
  • Painfully cold.
  • Tingling.
  • Prickling.
  • Like pins-and-needles.
  • Numbness in hands or feet, legs or arm.

Neuropathic pain is caused by damage to the nerves that send pain signals to the brain. With this type of pain, the nerves are dysfunctional and send pain signals to the brain, even when there is nothing to trigger pain. Examples of this type of pain can include neuropathy due to diabetes, pain after having shingles, spinal cord injury, post-stroke pain, pain caused by tumor or chemotherapy.

Centralized pain can feel like general widespread pain throughout the body. It is accompanied by:

  • Excessive fatigue.
  • Problems sleeping, concentrating, or low mood.
  • Abnormal sensitivity to bright lights, loud noises, and strong odors.

Centralized pain may be caused by a dysfunction of pain centers in the brain that amplify or “turn up” the pain response. People with centralized pain may experience pain from ordinary touch or pressure. Often there is no identifiable tissue or nerve damage, which can make centralized pain difficult to diagnose. It occurs in conditions such as fibromyalgia, irritable bowel syndrome, tension headaches, neck or back pain without any structural damage, chronic fatigue syndrome.

Keep in mind that chronic pain may be caused by more than one type of pain. For example, people with conditions such as osteoarthritis, rheumatoid arthritis and cancer, can have a combination of the pain types mentioned above—i.e., mixed pain types.

Having a pain management plan tailored to your needs is vital

Knowing what type or types of pain you have can help you and your healthcare provider successfully manage your chronic pain. It’s important to work with your healthcare team to accurately diagnose your pain, so be sure to describe your pain with as many details (e.g., how long your pain has lasted, the type of pain you feel, when you feel the pain, whether anything you do or take helps). Consider recording your symptoms with this Chronic Pain Questionnaire.

To find useful communication tools, check out the American Chronic Pain Association here.

Watch the video below to learn more:

Stephen Watt, BSc, MBChB, MPhil, MRCP, MFPM is a physician and the Enterprise Benefit Risk Medical Lead at Pfizer Inc.

[1] [2] [3] [4] [5] [6] [7]

References

  • 1. Callin S, Bennett MI. Assessment of neuropathic pain. Contin Educ Anaesth Crit Care Pain. 2008;8(6):210-213. Accessed December 2, 2016.
  • 2. NIA. Pain: You Can Get Help. Accessed November 28, 2016.
  • 3. NIH. Chronic Pain: Symptoms, Diagnosis, & Treatment. Accessed November 28, 2016.
  • 4. NINDS. Pain: Hope Through Research. Accessed November 28, 2016.
  • 5. NRSCIS. Pain after Spinal Cord Injury. Northwest Regional Spinal Cord Injury System. Accessed December 2, 2016.
  • 6. Stanos S, Brodsky M. Argoff C, Clauw DJ, et al. Rethinking chronic pain in a primary care setting. Postgraduate Medicine. 128:5;502-515. Accessed November 22, 2016.
  • 7. Tarlov Cyst Disease Foundation – Advances in Neuropathic Pain. Accessed January 5, 2017.
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