Overview

Pain is an unpleasant sensation that is linked to tissue damage. The purpose of pain is to let the body react and prevent further tissue damage. Pain is felt when a signal is sent through the nerve fibers to the brain to be interpreted. 

The pain experience differs in each person as there are different ways of feeling and describing pain. This makes defining pain very difficult.

Pain may be short-term or long-term, stay in one place, or it can spread throughout the body.

Types of pain

Although the pain experience varies from person to person, pain may still be categorized as:

Chronic pain

Chronic pain differs from other types of pain in that your body a long period after an injury. Chronic pain is one that lasts for 3 months or more. Chronic pain affects your day-to-day life, including mental health. 

Chronic pain comes from a series of messages that flow through your nervous system. When you are hurt, the injury turns on the pain sensors in the area, which send an electrical signal from the nerve to nerve until the message reaches the brain. the brain processes the electric signal and sends out the message that you are hurt. Typically, the signal stops upon resolution of the cause of the pain. With chronic pain, the nerve continues to send signals even after you have been healed.

Nerve pain

Nerve pain or neuropathic pain is a shooting or burning pain, which can go away on its own but in most cases is chronic. At times, it severe and unrelenting, or it may come and goes. This type of pain is often the result of nerve damage or a malfunction in the nervous system. Nerve pain changes the nerve function at the site of the injury and areas around it.

Psychogenic pain

It is a pain disorder that is typically associated with psychological factors. Mental or emotional problems can cause, or prolong the pain. A person with psychogenic pain may complain of pain that does not match his symptoms.

Musculoskeletal pain

It is pain that affects the muscles, ligaments, tendons, and bones. The causes of this pain are varied such as:

• Muscle tissue damage due to wear and tear of daily activities
• Trauma to an area
• Postural strain
• Repetitive movements
• Overuse
• Prolonged immobilization

Chronic muscle pain

It is caused by the incorrect use of muscles or using the muscles too much or too little.

Abdominal pain

Abdominal pain could be a mild ache, cramps, or sharp pain. This pain can have many causes, which usually are worrisome. Your doctor should diagnose and treat the problems.

Joint pain

Joints are the connections between bones, providing support and helping you move. When the joints are damaged by disease or injury, it will interfere with your movement and cause a lot of pain. Joint pain is very common, with knee pain being the most common complaint.

Central pain syndrome

A stroke, spinal cord injury, or multiple sclerosis may lead to burning syndromes and chronic pain from damage to a region of the brain.

Complex regional pain syndrome

It is an intensely painful disorder that may develop from a seemingly minor injury. It is believed to result from high levels of nerve impulses sent to the affected disorder.

Diabetes-related nerve pain or neuropathy

Nerve damage is one of the complications of diabetes. The nerve complication can cause severe burning pain, usually at night.

Shingles pain or postherpetic neuralgia

Shingles is a painful condition arising from the reactivation of varicella-zoster, the virus that causes chickenpox. 

Trigeminal neuralgia

It is an ongoing pain condition affecting certain nerves in the face. It is also known as tic douloureux. The pain is often described to be like an electric shock, which at times can be intense.

Causes

The various types of pain have different causes:

Chronic pain – Chronic pain may begin without any obvious cause. In most cases, it starts after an injury or because of a health condition. Some of the leading causes of chronic pain include:

• Back problems
• Arthritis
• Past injuries or surgeries
• Migraines and other headaches
• Infections
• Nerve damage
• Fibromyalgia

Nerve pain – Neuropathic pain has no obvious cause in most cases. Some of the common causes of neuropathic pain include:

• Amputation
• Alcoholism
• Diabetes
• Chemotherapy
• HIV infection
• Facial nerve problems
• Multiple sclerosis
• Multiple myelomas
• Nerve or spinal cord compression
• Spine surgery
• Shingles
• Syphilis
• Thyroid problems

Psychogenic pain – This type of pain is caused by some types of emotional or mental problems.

Musculoskeletal pain – Musculoskeletal pain has various causes such as tissue damage, trauma to an area of the body, postural strain, muscle overuse, repetitive movements, and prolonged immobilization.

Chronic muscle pain or myofascial pain – It is pain and inflammation in the soft tissues of the body. It may develop from an injury in a muscle or serious strain on a particular muscle or muscle group, tendon or ligament. Other causes include:

• Repetitive motions
• Injury to muscle fibers
• Lucky of activity

Abdominal pain – Abdominal pain has many causes such as constipation, indigestion, a stomach virus, and menstrual cramps for women. Other causes of abdominal pain include:

• Irritable bowel syndrome
• Food poisoning
• Crohn’s disease
• Gas
• Food allergies
• Hernia
• Kidney stones
• Gallstones
• Endometriosis
• Appendicitis
• Gastroesophageal reflux disease
• Diverticulitis

Joint pain – Many conditions can result in painful joints, such as rheumatoid arthritis, osteoarthritis, gout, bursitis problems, sprains, strains, and other injuries.

Central pain syndrome – It is caused by dysfunction that affects the central nervous system. It can occur in people who have had strokes, Parkinson’s disease, multiple sclerosis, limb amputations, brain tumors, brain injuries, or spinal cord injuries.

Complex regional pain syndrome – This is caused by a dysfunction in the central or peripheral nervous systems.

Diabetes-related nerve pain or neuropathy – This is caused by damage to the nerves that allow you to feel sensations. The condition is often the result of high blood glucose.

Shingles pain or postherpetic neuralgia – The pain is caused by the reactivation of the varicella-zoster virus.

Trigeminal neuralgia – The pain starts with irritation of the trigeminal nerve, which also can be injured by an accident, surgery, or stroke.

Diagnosis and Treatment

The diagnosis of pain depends on the person’s subjective description of it. There is no objective scale to identify the type of pain, so the doctor will take the pain history of the patient. 

The doctor will ask the patient to describe:

• The character of all pains the patient feels, such as stabbing, stinging or burning
• The site, radiation, and quality of pain, or where it is felt, how far it spreads, what it feels like
• The factors that aggravate or relieve the pain
• The time of the day when the pain occurs
• The impact of the pain on the person’s mood and daily function
• The person’s understanding of his pain

The patient should clearly communicate to the doctor everything that he knows about his pain.

Measuring scale

Some of the pain measures that are commonly used include:

• Numerical rating scales – The measure of the pain from 0 to 10, where 0 means no pain and 10 means the worst pain imaginable. 
• Verbal description scale – This is used to measure the pain level of cognitively impaired children or people with dyslexia or autism. Instead of numbers, the doctor will as descriptive questions to identify the type of pain the patient feels.
• Faces scale – A series of faces is shown to the person in pain, from distressed to happy. This measure is often used with children and people with autism.
• Brief pain inventory – This is a detailed questionnaire to gauge of effect of pain on the person’s activity, mood, sleep patterns, and how it affects the person’s interpersonal relationships.

Treatment

Different types of pain are treated in different ways. A treatment that worked on a person may not work on another.

Acute pain treatment

The treatment of acute pain often requires some medicines.

Non-steroidal anti-inflammatories or NSAIDs are a type of painkiller or analgesic that reduces pain and helps a person perform his daily function. NSAIDs may be available over-the-counter or on prescription are different strengths. 

NSAIDs also relieve localized inflammation and pain caused by swelling. They often result in bleeding in the digestive system.

Opioids are prescribed for the most extreme acute pain, such as cancer, surgery, bone fractures, and burns. They are highly addictive and lose effectiveness over time. 

Discuss with your doctor all medication options, and inform him about your current medications.

Risks of Having Pain

Pain can result from various diseases, situations, and injuries. The following are the three main risk factors for chronic pain:

• Old age – The bodies age as people grow older. Old people need more ways to manage their pain.
• Genetics – Some conditions that cause pain are believed to be linked to genetics. Some genetic conditions can make a person more sensitive to pain that requires more chronic pain management.
• Obesity – People who are overweight often develop chronic pain because of their poor health.
• Race – Hispanics and African-Americans are at a greater risk for chronic pain.
• Previous injury – People who have just recovered from a traumatic injury run a greater risk because of poor health.

When to Seek Medical Attention

When your pain starts, you can take an over-the-counter pain reliever and apply ice. If your pain is severe, lasting several weeks, and keeps you from performing your normal daily activities, you should see a doctor. You should seek medical care immediately if you have:

• Fever associated with your pain
• Pain after trauma
• Loss of strength
• Loss of bowel or bladder function
• Unexplained weight loss associated with the pain

Be more cautious if you have special risk factors such as cancer, infection, or fractures.

Table of Medications

• tramadol
• gabapentin
• Norco
• ibuprofen
• oxycodone
• Dilaudid
• Vicodin
• acetaminophen / hydrocodone
• acetaminophen
• hydrocodone