Chronic pain is a problem that affects millions of people every day and it can be devastating, affecting the quality of life of those afflicted. But it doesn't have to be this way. There are a number of ways that chronic pain can be managed with a minimum amount of disruption to daily life. Below are listed the various types of chronic pain and the various ailments associated with them.
What Is Pain?
Pain refers to an unpleasant sensation that occurs in response to stimuli, usually an injury or illness. Most pain is acute, meaning it lasts for a short period of time, with a definitive cause and once the underlying problem is resolved, the pain will subside shortly thereafter. Pain can also be chronic, lasting for a long period of time, sometimes having no definitive cause, which can make treatment difficult.
What makes pain unique from any other sign or symptom of illness or injury is that it is highly individual. There is no test to measure pain on an overall scale. It simply can't be compared to another person's pain. Because pain is difficult to measure using scientific means, pain is instead measured on a scale that requires the person to identify where the pain falls on that scale, like a 1-10 scale.
Types Of Chronic Pain
There are several causes of chronic pain and they are separated into the following categories:
This type of pain occurs when specific pain receptors are stimulated. These receptors are responsible for sensing chemicals that are released from damaged cells, temperature, stretching and vibration. There are two types of nociceptive pain: somatic and visceral.
Somatic: This type of pain is felt on the skin along with the muscles, bones and joints. This type of pain is how the body feels inflammation, like from an injury or cut. Somatic pain is usually a sharp pain that is localized to the injured area. Pain caused by a lack of oxygen to tissue is also a type of somatic pain. Examples of chronic somatic pain include:
- Tension headaches
- Back pain
- Pelvic pain (caused by joint instability, not nerve damage)
- Muscular ischemia
Visceral: Visceral pain is felt in the organs of the major body cavities. The pain receptors in the major body cavities sense inflammation, ischemia and stretch within the organs. This type of pain is more difficult to identify as it tends to be more of a deep aching pain. This can make diagnosing the cause of the pain more difficult. Examples of chronic visceral pain include:
- Irritable Bowel Syndrome
- Prostate pain (such as in the case of benign prostate hyperplasia)
- Bladder pain (such as in the case of cystitis)
This type of pain is not caused by pain receptors, but by the nerves themselves. No pain receptors are stimulated with this type of pain. There are two types of non-nociceptive pain: neuropathic and sympathetic.
Neuropathic: Neuropathic pain is caused directly by the nerves. This type of pain can come from the peripheral nervous system, which are the nerves between the tissues and the spinal cord, or from the central nervous system, which are the nerves between the spinal cord and the brain. Neuropathic pain can be somewhat disorganized because when the nerve is injured, its signaling abilities become haphazard. This can result in feelings of numbness, tingling or aching. Examples of neuropathic pain include:
- Pinched or impinged nerve
- Peripheral neuropathy (also called diabetic neuropathy)
- Multiple sclerosis
Sympathetic: This type of pain is caused by the sympathetic nervous system, which controls how fast the peripheral nervous system works, blood flow to the tissues, and sweating. This type of pain usually occurs after some type of injury to the extremities, but it is non-nociceptive because there are no specific pain receptors involved. This type of pain can be quite intense leaving a person unable to use a limb because the pain is so severe. This type of chronic pain is not well understood because sympathetic pain is most often acute. Examples of chronic sympathetic pain include:
- Complex regional pain syndrome type I
- Complex regional pain syndrome type II
- Sympathetically maintained pain
Other Forms Of Chronic Pain
Psychogenic: This type of pain is associated with mental health problems. While there is no physical cause of pain to be treated, it is a very real type of pain none the less. This type of pain is often difficult to treat using traditional methods, though treatment for the underlying mental health problem can help provide some relief. Some examples include;
- Depressive Disorders
- Anxiety Disorders
- Somatoform Disorders
Idiopathic: This type of pain cannot be traced to any known cause, though it is quite real. Those who are most susceptible to this type of pain typically already have some type of pain condition, such as temporomandibular joint disorder or fibromyalgia. Because this type of pain is not well understood, treatment can be difficult. When this occurs the person is usually diagnosed with chronic idiopathic pain syndrome.
The treatment for pain usually depends upon its cause. Managing chronic pain, however, can be a bit more difficult because often the cause of the pain is unknown or the cause of the pain is chronic and can't be cured, such as multiple sclerosis. The type of pain makes a difference as well. For example, those experiencing psychogenic pain won't benefit as much from pain relievers as they would from anti-depressants or anti-anxiety medication just as those with neuropathic pain may not benefit as much from COX2 inhibitors as they would from neuroleptic medications.
It's important to know that there is no single treatment that is appropriate for everyone. There is often quite a bit of trial and error before the right combination for each person can be found.
Common treatment methods include:
- Pain relievers
- COX2 Inhibitors
- Neuroleptic medication
Some psychological treatments include:
- Relaxation training
There are a number of complementary or alternative therapies available for managing chronic pain. The effectiveness of these treatments varies as many have not been verified by scientific research. While most are regarded as safe, they should always be discussed with your regular doctor first. These therapies include:
Chronic pain can be quite frustrating. The goal of managing chronic pain is to ease the pain and not make it the focus of daily life. With the right combination of treatments people with chronic pain can return to a normal quality of life.