What are the types of pain

Chronic pain> Origin and types of pain

1. The most important things in a nutshell

Chronic pain is called pain that persists longer and the cause of which is either unknown or cannot be treated. There are different types of pain. These have different causes and have different symptoms. Often there are mixed forms of these types of pain.

2. Development of a chronic pain disorder

Usually are acute Occurring pain is limited in time and has a Warning functionthat forces the body to act protective. As soon as the cause of the pain has been successfully treated, the pain will subside within a foreseeable period of time.

However, if the pain persists for 6 months, it can settle chronify. The cause of the chronic pain cannot be found or is known and the cause cannot be treated. The warning function has been lost. The pain becomes an independent disease, which is called "Chronic pain disorder with somatic and psychological factors" referred to as.

 

Diseases that can lead to chronic pain include:

  • Diseases or injuries of the musculoskeletal system, e.g. arthritis, osteoarthritis, rheumatism, osteoporosis, bone fractures such as hip and vertebral fractures
  • Tumor diseases, e.g. breast cancer, prostate cancer
  • Diseases of the nervous system, e.g. shingles, multiple sclerosis, Parkinson's
  • Mental illnesses, e.g. anxiety disorders, depression
  • Diseases of internal organs, e.g. chronic inflammation of the pancreas, chronic inflammatory bowel diseases

Other factors can also play an important role in the development and maintenance of chronic pain, e.g. psychosocial stress or permanent stress.

In order to avoid chronification, should acute Pain is taken seriously and treated in a timely manner. Is the pain chronic, the treatment should be "multimodal", see Chronic Pain> Treatment and Rehabilitation for more information.

3. Nociceptive pain

Nociceptive pain occurs when pain signals are sent to the brain as a result of tissue damage. A pain signal is triggered by injuries (e.g. broken bones, cuts, burns) or by the body's own processes such as inflammation or tissue damage.

Nociceptive pain is divided into somatic pain, if it occurs, for example, in the bones, skin or joints, and visceral pain, if the pain signals come from the intestines.

3.1. Somatic pain

Somatic pain is divided into:

  • Surface pain
    Formed by irritation of pain receptors in the skin and are usually piercingly sharp at the beginning, quickly weakening and often sounding burning and dull afterwards.
  • Deep pain
    Formed by irritation of pain receptors in muscles, joints, bones, ligaments or connective tissue and are rather dull and difficult to localize.

 

Somatic pain includes, for example:

  • Back pain
  • Joint pain
  • Rheumatic pain
  • Osteoarthritis pain
  • Pain after surgery
  • Ischemia pain (pain associated with circulatory disorders)

3.2. Visceral pain

Visceral pain (gut pain) occurs when internal organs are stimulated by pain receptors. This type of pain is often difficult to localize and often has a pressing or pulling character.

 

The intestinal pain includes, for example:

  • Stomach / intestinal pain
  • Pain with kidney or biliary colic
  • Inflammatory pain in the pancreas

Since the pain fibers of the internal organs and those of the skin in the spinal cord run in common pain paths, pain from internal organs is often also perceived in the so-called "head zones". These are sections of skin that are connected to certain internal organs. For example, some patients experience pain in the left arm after a heart attack or pain in the right shoulder area with gallbladder disease. This phenomenon is called "Transmitted pain" designated.

4. Nerve pain

Nerve pain (neuropathic pain) occurs as a result of nerve damage and can be violent, attack-like or permanently burning. Other typical signs are hypersensitivity to touch (allodynia), unpleasant, sometimes painful body sensations with tingling, numbness, cold and heat perception disorders (paresthesia) and sensory disorders.

 

Nerve pain includes, for example:

  • Nerve root pain in sciatica
  • Nerve pain in diabetic neuropathy
  • Facial pain in trigeminal neuralgia
  • Shingles pain (post-therapeutic neuralgia)
  • Phantom pain after amputations

5. Psychogenic pain

Psychogenic pain (also called functional pain) is caused by mental illness or stress and can be understood as an expression of unresolved mental and psychosocial problems. Common causes are e.g. chronic stress, somatoform disorders, anxiety disorders, depression or post-traumatic stress disorders.

Psychogenic pain often occurs in several places and manifests itself very differently from person to person. Examples are chronic headache, stomach ache or back pain for which no physical cause can be found.

6. Mixed forms ("mixed pain")

Many chronic pains cannot be clearly assigned to a single type of pain, but mixed forms of different types of pain occur at the same time in different forms.

 

Mixed pain includes, for example:

  • Tumor pain
  • Lumbar spine pain radiating into one leg (lumbar sciatica)
  • Lower back pain (low back pain)
  • Pain after a disc surgery

Mixed forms are not always easy to diagnose. In order to achieve therapeutic success, all types of pain must be treated accordingly.

7. Practical advice

Free download: Pain Guide as PDF with information on all of the above topics and the articles linked below.

8. Related links

Chronic pain

Chronic Pain> Treatment and Rehabilitation

Opiates and opioids

WHO level scheme

migraine