What are the basic types of pain?
There are many sources of pain. One way of dividing these sources of pain is to divide them into two groups, nociceptive pain and neuropathic pain. How pain is treated depends in large part upon what type of pain it is.
Nociceptive pain
The body's nervous system is working properly. There is a source of pain, such as a cut, a broken bone or a problem with the spine. The body's system of telling the brain that there is an injury starts working. This information is passed on to the brain and one becomes aware that they are hurting.
Neuropathic pain
The body's nervous system is not working properly. There is no obvious source of pain, but the body nonetheless tells the brain that injury is present.
What are types of nociceptive pain?
Most back, leg, and arm pain is nociceptive pain. Nociceptive pain can be divided into two parts:
Radicular pain:
Radicular pain is pain that stems from irritation of the nerve roots, for example, from a disc herniation. It goes down the leg in the distribution of the nerve that exits from the nerve root at the spinal cord. Associated with radicular pain is radiculopathy, which is weakness, numbness, tingling or loss of reflexes in the distribution of the nerve.
Somatic pain:
Somatic pain is pain limited to the back or thighs. The problem that doctors and patients face with back pain, is that after a patient goes to the doctor and has an appropriate history taken, a physical exam performed, and appropriate imaging studies has shown that most back pain that does not go away after conservative treatment usually comes from one of three structures in the back: the facet joints, the discs, or the sacroiliac joint. The facet joints are small joints in the back of the spine that provide stability and limit how far you can bend back or twist. The discs are the "shock absorbers" that are located between each of the bony building blocks of the spine. The sacroiliac joint is a joint at the buttock area that serves in normal walking and helps to transfer weight from the upper body onto the legs.
Neuropathic pain includes:
The various neuropathic pains can be difficult to treat. However, with careful diagnosis and often a combination of methods of treatments, there is an excellent chance of improving the pain and return of function.
Medications are a mainstay of treatment of neuropathic pain. They work by influencing how pain information is handled by the body. Much pain information is filtered out by the central nervous system, usually at the level of the spinal cord, so that you never need to deal with that information. For example, if you are sitting in a chair, your peripheral nerves would correctly send the response to the pressure between your body and the chair to your nervous system. But, because that information serves no usual purpose, it is filtered out in the spinal cord. Many medications to treat neuropathic pain operate on this filtering process.
There are many sources of pain. One way of dividing these sources of pain is to divide them into two groups, nociceptive pain and neuropathic pain. How pain is treated depends in large part upon what type of pain it is.
Nociceptive pain
The body's nervous system is working properly. There is a source of pain, such as a cut, a broken bone or a problem with the spine. The body's system of telling the brain that there is an injury starts working. This information is passed on to the brain and one becomes aware that they are hurting.
Neuropathic pain
The body's nervous system is not working properly. There is no obvious source of pain, but the body nonetheless tells the brain that injury is present.
What are types of nociceptive pain?
Most back, leg, and arm pain is nociceptive pain. Nociceptive pain can be divided into two parts:
- radicular
- somatic.
Radicular pain:
Radicular pain is pain that stems from irritation of the nerve roots, for example, from a disc herniation. It goes down the leg in the distribution of the nerve that exits from the nerve root at the spinal cord. Associated with radicular pain is radiculopathy, which is weakness, numbness, tingling or loss of reflexes in the distribution of the nerve.
Somatic pain:
Somatic pain is pain limited to the back or thighs. The problem that doctors and patients face with back pain, is that after a patient goes to the doctor and has an appropriate history taken, a physical exam performed, and appropriate imaging studies has shown that most back pain that does not go away after conservative treatment usually comes from one of three structures in the back: the facet joints, the discs, or the sacroiliac joint. The facet joints are small joints in the back of the spine that provide stability and limit how far you can bend back or twist. The discs are the "shock absorbers" that are located between each of the bony building blocks of the spine. The sacroiliac joint is a joint at the buttock area that serves in normal walking and helps to transfer weight from the upper body onto the legs.
Neuropathic pain includes:
- Complex regional pain syndrome (CRPS)
- Sympathetically maintained pain
- Interstitial cystitis; and
- Irritable bowel syndrome.
The various neuropathic pains can be difficult to treat. However, with careful diagnosis and often a combination of methods of treatments, there is an excellent chance of improving the pain and return of function.
Medications are a mainstay of treatment of neuropathic pain. They work by influencing how pain information is handled by the body. Much pain information is filtered out by the central nervous system, usually at the level of the spinal cord, so that you never need to deal with that information. For example, if you are sitting in a chair, your peripheral nerves would correctly send the response to the pressure between your body and the chair to your nervous system. But, because that information serves no usual purpose, it is filtered out in the spinal cord. Many medications to treat neuropathic pain operate on this filtering process.