September 13, 2022
Announcing that I am a pain specialist always wins me some questionable looks. No—not causing your pain or because of some sadistic interest in it, but because throughout my time in podiatry, I have realized that it is the main complaint I deal with and the most misunderstood. Pain is complex. Just as there is variation in an individual’s subjective experience of it, there are variations in the kind of pain one can experience. Below I will go over some of the different types of pain. I firmly believe in the patient being a participant. It is challenging to participate in your own healing without having the language to even describe what you are experiencing.
Acute
Acute pain is that sudden and sharp pain most people have experienced. Like acute inflammation, it is warning pain that something harmful to the body has been done. Examples of acute pain include surgical pain, traumatic pain (pain caused by a specific injury like a broken bone, burn, or a wound), and of course, the much-loathed muscle strain that can occur as a result of anything logical from exercising intensely, to the seemingly random bending the wrong way when you’re old.
Chronic
Similar to chronic inflammation, chronic pain is persistent. Medically speaking, pain is termed chronic after approximately three months, depending on the precipitating factor.
Chronic pain is the pain you experience when you are still sore or uncomfortable even after the tissues should have healed. While any pain includes physical symptoms, chronic pain has some distinguishing ones, including tense muscles, lack of mobility impairing daily life, and even lack of energy. Chronic pain is also associated with psychological/emotional symptoms—our bodies being in physical pain constantly is not natural and can make us hopeless. This can lead to depression, anxiety about never healing or being re-injured, and anger at the situation. We have come a long way to understanding how debilitating chronic pain can be. Physical medicine is still working and developing strategies to deal with people who suffer from chronic pain. Still, psychology has recently made significant steps to develop psychological supports and utilize psychological methods, such as cognitive behavioural therapy, to uniquely address the experience of chronic pain.
Neuropathic
Neuropathic pain refers to pain that is related to nerve damage. Conditions such as neuropathy (unsurprising given their phonetic resemblance) and trigeminal neuralgia are both examples of neuropathic pain conditions. We must continue to develop a deeper understanding of different types of pain as so many diseases and health conditions on the rise can also cause pain conditions. Neuropathy, for example, is often something cancer survivors struggle with after treatment making the exhausting recovery process even more difficult.
Nociceptive
Nociceptive pain is one of the types of pain I find most people have never heard of. Despite this lack of awareness, it is one of the most widely experienced types. Nociceptive pain is pain that is caused exclusively by damage to tissue in the body. If you have arthritis, mechanical back pain, or ever experienced post-surgical pain, you have experienced nociceptive pain.
Radicular
Radicular perfectly illustrates why we must see the body as interdependent rather than isolated. Radicular pain is pain radiating from an initial location where an inflamed or compressed nerve is located throughout the body. Relatedly, a condition known as radiculopathy can also occur, or occur independently, where an inflamed or compressed nerve can cause weakness, numbness/loss of sensation, and even neurological deficits.
Sources:
https://health.ucdavis.edu/livinghealthy/topic/pain-management/acute-pain-verses-chronic-pain.html
https://www.spinemd.com/name-your-pain-exploring-the-four-types-of-pain
https://www.spine-health.com/glossary/radicular-pain-and-radiculopathy