What is Pain?
Pain is defined as “An unpleasant sensory and emotional experience associated with actual or potential tissue damage, or described in terms of such damage”. (IASP)
Pain simply is categorized according to different prospective. For example, it can be Acute or Chronic, Somatic or Visceral, Nociceptive or Neuropathic
Acute pain has many examples in our life. For example post surgical pain, after a fall or trauma, after lifting heavy object and injuring your lower back, thoracic upper back, neck pain (whiplash), acute sciatica, and other acute spinal nerve problems, acute muscle pain (sprains, tear, trauma, tender points in the muscle or tendon), ligament pain (partial tear, sprain), acute arthritis of the joint (inflamed joint, bursitis, osteoarthritic joint) or sports Injuries.
Inflamed appendices, renal colic, inflammation of the pancreas, obstruction or inflammation of the gall bladder, ulcer in the stomach or bowels, inflammation or perforation of the gut, are also examples of acute pain.
If any of the above lasts for more than 12 weeks, despite of adequate treatment/management; it is then categorised as Chronic Pain.
Chronic pain is characterised by pain which persists despite adequate time for healing. There is no clear definition but it is often defined as pain that has been present for more than 12 weeks. Some experts define it as lasting longer than 6 months. Any pain that last for three months or more with or without an obvious reason would be considered as Chronic Pain.
Chronic pain is different than acute pain in that -in many cases- it is not easy to find the cause. Diagnosis can reveal no injury in the body at all, and yet the patient can be experiencing very debilitating pain.
Scientists have found that repeated pain from an acute injury changes the way the brain lets you know you have pain. Even after the injury has healed, pain messages replay over and over again.
Pain is often multifactorial; there may be multiple primary and secondary pain generators. In general, Chronic Pain is broadly categorized into:
|Nociceptive Pain: the pain stimulus is originated due to activation of the peripheral receptors (nociceptor) in any body organ/s or part/s. For example; skin, joint, muscle, tendon; hence it is called “Somatic Pain”.
If it is originated from the skeletal system and the surrounding muscles; it is called “Musculoskeletal Pain”. If it is due to a problem within the viscera, it is called “Visceral Pain”.
|Neuropathic Pain: (also called neurogenic) implying that the pain is due to damage, injury or dysfunction of a nerve, or part of the nervous system.
If the pain is originating from a peripheral nerve (in the arms, legs, chest abdomen, face, or nerves originated from the spinal cord from the vertebral column), it is the called “Peripheral Neuropathic Pain” such as postherpetic neuralgia. If the pain is due to a problem within the central nervous system (brain or spinal cord), it is called “Central Neuropathic Pain”, such as Central Post Stroke Pain”.
Mixed Pain: Since different pain-generating mechanisms possibly underlie Chronic Pain, the term mixed pain syndrome was established. Mixed pain involves a combination of Nociceptive and Neuropathic pain
In Lincs Pain Management Clinic, we can deal with most, if not all, this types of pain