Pain Guide for Healthcare Providers

Pain is a complex experience within the human body that is comprised of interactions between physical, cognitive, emotional and environmental factors. Pain can be acute or chronic. Acute pain is pain lasts under 3-6 months and is typically caused by an event or injury. Chronic pain lasts 3-6 months or longer and is characterized as a condition or state of being. Chronic pain persists well beyond expected healing time and often serves no purpose in the body (e.g., migraines or back pain). Pain is often times poorly understood. Pain, acute or chronic, can be absolutely debilitating and lower a person’s overall quality of life.

Neuropathic Pain

Neuropathic pain, otherwise known as neuropathy, is caused by a lesion or dysfunction in the central or peripheral nervous system. It can also be associated with abnormal processing of sensory function. It can be characterized as a burning, shooting, tingling or shock-like sensations in the body. The two types of neuropathy are peripheral and central.

  • Peripheral neuropathy is by far the most common type. It is typically caused by trauma or disease to one or more peripheral nerves. Common causes of peripheral nephropathy are diabetic neuropathy and trauma or nerve entrapment. The body can often sustain trauma and while the skin and bones typically heal overtime, the nerves do not. The damaged nerves can continue sending pain signals to the brain.
  • Central neuropathy originates from a tissue damage or dysfunction in the brain or spinal cord (Central Nervous System, or CNS). Examples of central neuropathy include phantom pain and post-stroke pain.

Nociceptive Pain

Nociceptive pain can be acute or chronic and is caused by inflammation from trauma, injury or disease within the body’s tissues. Nociceptive pain originate within the nociceptors located throughout the body. These receptors are responsible for detecting painful stimuli such as extreme heat, stretching or pressure- the pain you may feel when you stub your toe or touch a hot stove. Injury or inflammation causing diseases (e.g., arthritis) can cause these receptors to be constantly activated. There are three types of nociceptive pain:

  • Somatic pain is a pain arising from the superficial parts of the body such as the skin and subcutaneous tissues, muscles and joints. Examples of this are bruising, lacerations, or arthritis.
  • Visceral pain is a pain that is detected by the nociceptors located on the body’s internal organs. Examples of this are inflammation, infection, or tumors within the body. Visceral pain can be caused by conditions such as constipation or gastrointestinal infections or from more serious conditions such as cancerous tumors or internal bleeding. Often times it is felt on a different region on the body than the actual source of inflammation or trauma. This is called referred pain. The reason for this is the brain sometimes cannot differentiate the different sources of pain signals if they are located on the same ascending nerve pathway in the body.

Leave a Comment