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. 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. There are several ways doctors can measure pain to help them diagnose and treat it.
Describing your pain is one of the most important things you can do when working with your doctor.
That’s because your description is the best clue to determine what types 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.
If your pain feels
Then you may have nociceptive pain.
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 include osteoarthritis, rheumatoid arthritis, tendonitis, gout, neck or back pain, tumour-related pain, sickle cell disease, or inflammatory bowel disease.
If your pain feels:
- Hot and burning
- Like small electric shocks
- Like a stabbing sensation
- Painfully cold
- Like pins-and-needles
- Numbness in hands or feet, legs or arm
Then you might have Neuropathic pain.
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 tumour or chemotherapy.
If your pain feels
- Widespread throughout the body
And is accompanied by
- excessive fatigue
- problems sleeping, concentrating, or low mood
- abnormal sensitivity to bright lights, loud noises, and strong odours
Then you might have Centralised pain.
Centralised pain may be caused by dysfunction of pain centres in the brain that amplify or “turn up” the pain response. People with centralised pain may experience pain from ordinary touch or pressure. Often there is no identifiable tissue or nerve damage, which can make centralised pain difficult to diagnose.
It occurs in conditions such as fibromyalgia, irritable bowel syndrome, tension headaches, neck or back pain without any structural damage, or chronic fatigue syndrome.
Keep in mind that chronic pain may be caused by more than one type of pain. People who have mixed pain types include those with conditions, such as osteoarthritis, rheumatoid arthritis and cancer.
Important points for working with your doctor
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 doctor successfully manage your chronic pain. Your GP may also refer you to a pain specialist for further help. It’s important to work with your GP and/or pain specialist to accurately diagnose your pain. Here are some questions they might ask you:
- How long has your pain lasted?
- How does the pain feel?
- When do you feel the pain?, and
- Does anything you do or take help?
- 1. Stanos S, Brodsky MArgoff C, Clauw DJ, et al. Rethinking chronic pain in a primary care setting. Postgraduate Medicine. 128:5;502-515