What is Pain?
According to the American Pain Society, approximately 50 million people suffer from pain every day! Pain is medically defined as, “an unpleasant sensory and emotional experience associated with actual or potential tissue damage or described in terms of such damage.
We also believe that pain is a very personal experience, and is best defined by the person experiencing pain. Pain is a physical and emotional experience that may warn the person that something is wrong (e.g. illness, injury, imminent danger). The way you describe your pain can give clues to the cause and help determine effective treatment. This may include a combination of medication, procedures, and diet and exercise as well as other complimentary therapies.
It is important that your health care provider get a complete understanding of your pain. You should be prepared to answer the following questions. Write the answers and bring them to your next appointment.
- Where is the pain?
- How intense is the pain (on a scale on 1 – 10, 1 being mild, 10 being horrible)?
- Can you describe the pain (see common words)?
- When does the pain start, how long does it last?
- What makes it better?
- What makes it worse?
- How does it affect your life (sleep, mood, appetite, activities)?
Types of Pain
Pain can be acute, such as from a broken bone or from an operation, chronic (non-malignant) such as from an illness, such as shingles or a condition, like diabetes or from cancer (malignant). Acute pain is pain that will go away over days to weeks. It is generally limited to the time it takes the injury to heal. Chronic pain is any pain that lasts beyond what is expected in the ‘normal’ healing process. Cancer pain can be caused from the destruction of healthy tissue, from chemotherapy or from radiation.
Pain is further divided by the area or tissue causing the pain. The three basic categories here are organ/organ covering (visceral/pleural), nerve (neuropathic) pain and bone, joint, muscle, skin (somatic). These types of pain are very different and are treated differently.
ACUTE PAIN
This type of pain is usually treated with over-the-counter medications, like Tylenol or Advil, or with prescription medications, usually a mild narcotic such as vicodin or Percocet. Acute pain is relieved when the cause of the pain is healed.
CHRONIC PAIN
Chronic pain happens when the cause of acute pain is healed but the pain remains. There are numerous treatment options for this type of pain. Frequently, patients are referred to pain management specialists to help. Certain types of chronic pain can be cured, while other types can only be managed.
CANCER PAIN
Cancer pain can be either acute or chronic. Pain that is due to a treatment or surgical procedure will, more than likely, resolve with little treatment. Tissue destruction or tumor invasion from a cancer that is not or no longer treatable can be chronic. There are exceptions to both of these examples. For more information about cancer pain go to www.cancer.org or www.painfoundation.org/page.asp?file=ManageYourPain/Cancer/Intro.htm.
VISCERAL/PLEURAL PAIN
This pain is caused by the stretching or distention of the chest or abdominal cavity. It is usually described using words like crampy, gnawing, aching and tight. The pain can be difficult to put your finger on and may hurt in an area away from the actual cause ( an example is gallbladder pain. This is also felt in the shoulder area). Examples of visceral/pleural pain are bowel obstruction, appendicitis, ulcers, and certain types of cancer.
Treatment for this type of pain varies greatly depending on the cause. If the cause is acute, such as bowel obstruction or appendicitis, surgical correction should relieve it. However if the cause is chronic, medications, procedural interventions, or alternative therapies may be helpful.
SOMATIC PAIN
Somatic pain is caused by damage to the bone, joint, muscle, skin or connective tissue (ligament, tendon or cartilage). Aching or throbbing are the most common words used to describe the pain. When asked to point to the pain, it is relatively easy to do. Examples of somatic pain are broken bones, arthritis, ‘pulled’ muscles, sprained ankles and bruises.
Treatment for somatic pain is most commonly anti-inflammatory medication and/or physical therapy.
NEUROPATHIC PAIN
Neuropathic pain is a result of damage to a nerve or nerve root and can be acute or chronic. It is described as burning, shooting, knife-like or pins and needles. This type of pain can travel to another site however you can usually easily trace the path of the pain with your finger. Phantom limb pain, post mastectomy pain, shingles, sciatica and diabetic neuropathy are examples of neuropathic pain.
Treating neuropathic pain can be a challenge. There are medications that can help as well as interventional procedures.
Common words used to describe pain
There are many words that can be used to describe your pain. These words will help your practitioner determine the type of pain that you have. Sometimes there can be more than one type of pain so don’t be concerned if there are several words that match your pain.
Visceral/Pleural Pain Aching Crampy |
Somatic PainAching |
Nerve PainBurning |