When our bodies hurt, we don’t usually stop to think about the kind of pain we have, we just want relief.
But to pain medicine specialists, accurately diagnosing the kind of pain the patient is experiencing is key to developing an effective treatment plan. In order to treat pain correctly, the physician needs to understand the source of the pain, when it developed and other symptoms the patient may be experiencing that can provide insight into what triggered the onset of pain.
Types of Pain
Pain is often described as chronic or acute. These classifications are generally used to indicate the timing of pain: when did it start and how long has it lasted?
Acute pain generally presents quickly and does not last for an extended period of time. It can either go away on its own with self-care such as rest and heat/cold therapy, or with help from doctors and therapists who can provide additional support through prescription medications and/or physical therapy.
Chronic pain is generally defined as pain that lasts or recurs over a period of more than three to six months. Because of its duration, chronic pain can have significant mental health implications, including increased risk for anxiety and depression. Chronic pain is often the result of nerve damage.
Breakthrough pain affects many patients with chronic pain even though they are being treated with medication. This pain can flare up spontaneously and be sharp or dull.
Sources of Pain
Although effective pain management requires an in-depth understanding of the nuances of pain, pain medicine specialists begin treatment by assessing whether the pain is caused by tissue damage, nerve damage or disfunction in the central nervous system.
- Tissue damage causes what is called nociceptive pain and is usually the source of most pain. When the body’s tissues—including bones, organs, muscles and soft tissues—are injured, the body creates an inflammatory response that results in pain and swelling. In cases of acute pain, the damage is usually the result of an injury, such as a broken bone or sprained ankle. But cases of chronic tissue pain may be the result of diseases such as arthritis or cancer (and its related treatments).
- Nerve damage results in neuropathic pain. This kind of pain is often chronic and can be caused by diseases such as diabetes or by trauma (injury) to nerves. This kind of pain can range from burning or prickling to a sharp stabbing sensation. Some patients with neuropathic pain suffer from hypersensitivity to temperature and touch. Shingles and diabetic neuropathy are common forms of neuropathic pain.
- Nociplastic pain is often the result of disfunction across the central nervous system, despite no clear evidence of actual tissue damage. This kind of pain is usually chronic and can be exacerbated by fear, depression, stress or anxiety. Fibromyalgia and complex regional pain syndrome are examples of nociplastic pain.
A Proper Diagnosis Entails More than Just “What Hurts?”
It can be easy to describe pain simply by identifying the part of the body that hurts, such as back pain, shoulder pain, knee pain, etc. But in order to accurately diagnose and treat pain, the physician needs to understand its pathology, which means both its causes and its effects.
Board certified pain medicine specialists have extensive education and training in the pathology of pain. They understand that when it comes to treating pain, one size does not fit all, especially since some patients may suffer from overlapping kinds of pain.
Patients with unresolved chronic pain should see a pain medicine specialist who has the expertise to accurately diagnose and treat their pain. They can offer pain relief through the latest advances in non-surgical interventions and help their patients regain their quality of life.
Dr. Ioannis Skaribas is fellowship-trained and double board certified in Pain Medicine and Anesthesiology. He has been performing minimally invasive treatments to address chronic pain for more than 25 years and is nationally recognized for his expertise in diagnosing and treating difficult cases of complex chronic pain.
IASP: Descriptors of Pain
Pain Science: Types of Pain
Scientific American: The Unexpected Diversity of Pain