Importance of Understanding and Distinguishing Different Types of Pain
So… what is pain exactly? Pain is a general term that describes an unpleasant sensation in your body. More specifically, it is a signal in your nervous system (brain) identifying that something may be wrong.1
The sensation of pain can range from mild to completely debilitating. Everyone’s perception of pain is different and individual to that specific person. Physical therapists have the unique opportunity to work with all types of individuals with significantly varying pain tolerances and pain thresholds. An individual's perception of “high pain tolerance” might be another’s perception of “low pain tolerance.” For example, one patient might have a broken toe, while another has a broken hip, and both might report "eight out of ten" pain. Neither person is wrong or right, and they have accurately reported the pain from their perspective.
Intensity of pain might not be a very useful, measurable, or objective measure. However, type of pain can be significantly valuable in helping to put a diagnosis to your pain. When you go to seek help for your pain, you will almost always be asked to describe your pain. Is your pain aching, throbbing, stabbing, shooting, cramping, numbing, burning, stinging, sharp…? Your healthcare professional might also ask when you experience pain. Is your pain constant, intermittent, only with certain movements, only at night, etc….?
So… why is it important to understand types of pain? If you, the patient, can better understand your pain, then this will help your healthcare professional diagnose the problem quicker and more accurately, and you will be able to better understand why a certain treatment plan was decided upon. Identifying the type of pain and when you experience that pain can significantly help to narrow down the potential causes and help to create a plan of care.
So… What are the different types of pain? There are several different types, but I will focus on ones we see most in physical therapy: Acute, chronic, nociceptive, neuropathic, and radicular. Pain is incredibly complex, and trying to categorize pain is a little more complicated than one might think. Some pain can fit into more than one category, which is where the complication comes in.2 But having a basic understanding is a good place to start.
Acute pain: Acute pain means the pain is short in duration. How long acute pain lasts has been widely debated, and not everyone agrees on the duration. Some might say acute pain can last minutes to weeks, and others might say it can last up to three to six months. Acute pain also tends to be related to a soft-tissue injury or a temporary illness, so it typically subsides after the injury heals or the illness subsides. Acute pain from an injury may evolve into chronic pain if the injury doesn’t heal correctly or if the pain signals are impaired.2
Chronic pain: Chronic pain is ongoing and usually lasts longer than six months. Chronic pain can continue after the injury or illness that caused the original pain has healed or gone away. Pain signals remain active in the nervous system for weeks, months or years. Some people suffer chronic pain even when there is no past injury or apparent body damage.3,4
Nociceptive pain: Nociceptive pain is caused by damage to body tissue, and often caused by an external injury. For example, if you fall and hit your knee, stub your toe, twist your ankle, you may feel nociceptive pain. It is often experienced in the joints, muscles, skin, tendons, and bones and can be both acute and chronic.2 This pain has many descriptors, but is mostly described as sharp, achy, or throbbing. This is a very common type of pain we treat in orthopedic physical therapy.
Neuropathic pain: Neuropathy is due to damage to the nerves itself or other parts of the nervous system. It is often described as shooting, stabbing, or burning pain, or it feels like pins and needles, and can also affect sensitivity to touch and can make someone have difficulty feeling hot or cold sensations. 5
Radicular pain: Radiculopathy occurs when the patient has a pinched nerve or inflammation of a nerve root in their spine. People who have radicular pain may experience a variety of symptoms, but mostly shooting pain, tingling, numbness, and muscle weakness. 5
If you or someone you know deal with any of the different types of pain described above, it doesn’t have to be that way. At The PATH Rehab & Performance, we treat all types of pain, no matter how you perceive that pain. Even if you don’t fully understand your pain, we will work with you to help educate, diagnose, and treat whatever pain you are experiencing. We understand that everyone’s pain is different, valid, and we always take it seriously. We only ask that you choose conservative treatment for pain (no matter who it is from), before more drastic or invasive measures are considered.
U.S. National Library of Medicine. (2021, September 23). Pain. MedlinePlus. Retrieved February 24, 2022, from https://medlineplus.gov/pain.html
Types of Pain. Beaumont. (n.d.). Retrieved February 24, 2022, from https://www.beaumont.org/services/pain-management-services/types-of-pain
Raffaeli W, Arnaudo E. Pain as a disease: an overview. J Pain Res. 2017;10:2003-2008. Published 2017 Aug 21. doi:10.2147/JPR.S138864
Acute pain vs. chronic pain: Differences & causes. Cleveland Clinic. (n.d.). Retrieved February 24, 2022, from https://my.clevelandclinic.org/health/articles/12051-acute-vs-chronic-pain
Nadja, B. (2019, October 23). The difference between radiculopathy and neuropathy. GO Imaging. Retrieved February 24, 2022, from https://go-imaging.com/blog/mri/the-difference-between-radiculopathy-and-neuropathy/
