What Is Pain? Acute and Chronic

Ouch, that hurts! Pain – you know it all to well. When you’re bending over to pick up your 2 year old child, or when you cut yourself shaving. In minor instances it lets you know something isn’t quite right – and in major cases it lets you know something is seriously wrong. It’s a feeling triggered by your nervous system and, as defined by the IASP (International Association for the Study of Pain), is “an unpleasant sensory and emotional experience associated with actual or potential tissue damage, or described in terms of such damage”. We know it as a feeling that can rob you of comfort and limit your productivity.

There are two types of pain – acute and chronic.

  • Acute pain is exactly what the body intended – caused by injury, inflammation, infection, etc. It lets you know when there is a problem so you can do something about it. It’s commonly treated using painkillers (analgesics) such as NSAIDs, paracetamol (like Tylenol), narcodics (like morphine) or synthetic drugs with narcodic properties (like tramadol). These drugs are designed to control painful sensations until the injury has healed or the underlying cause of pain has been remedied.
  • Chronic pain, originally defined pain that lasts longer than 6 months, is now more accurately described as “the disease of pain.” Unlike acute pain, chronic pain may occur for no apparent reason or may attributed to an illness that may never heal – in such cases pain no longer becomes beneficial, rather a burden. Even worse, chronic pain can trigger dificult to diagnose psychological problems potentially leading to a feeling of hopelessness for those who suffer from it.

We’re going to focus alittle more attention on chronic pain and more specifically the 5 ways it can be categorized. Grouped according to the source and related nociceptors (pain-detecting nerve endings located outside of the spine), the main types of chronic pain include: cutaneous, somatic, visceral, phantom limb and nuropathic.

  • Cutaneous pain is caused by injury to the skin. Cutaneous nociceptors end just below there and, due to the extremely high concentration of nerve endings, sharp and well defined pain of short duration occurs. Examples include minor cuts, first degree burns and lacerations.
  • Somatic pain comes from damage to tendons, ligaments, blood vessels, bones and even nerves themselves. Detected by somatic nociceptors (of course), resulting pain often feels dull and is of longer duration than with cutaneous pain. Examples include sprains, strains and broken bones.
  • Visceral pain originates from the body’s organs, or in other words it’s viscera and is detected by visceral nociceptors. The even greater scarcity of nociceptors in these areas lead to an often aching, much longer duration pain than that of the somatic type. This kind of pain is often very difficult to localize and can even lead to pain in areas where injury doesn’t occur.
  • Phantom limb pain, as the name suggests, is a sensation of pain from a lost limb or from which physical signals are no longer being received. This is a type of “referred pain” and is an experience almost exclusivly reported by amputees and quadriplegics.
  • Neuropathic pain results from injury or disease to the nerve tissue itself. This type of pain disrupts sensory nerves from transmitting correct information to the thalamus whereby causing the brain to interpret painful stimuli even though there is no actual cause for the pain. This is clearly a chronic pain, or as stated earlier – “the disease of pain”.

Pain can also be classifed by strength. The World Health Organization has a “pain ladder” with 3 steps – including mild, moderate and severe.

  • Mild pain goes away, either without treatment or with the use of nonprescription medication such as acetaminophen (Tylenol), aspirin, or other nonsteroidal anti-inflammatory drugs (NSAIDs).
  • Moderate pain is, obviously, worse than mild pain in that it may interfere with normal daily activities. It will take longer to go away but, when treated, doesn’t come back. You may require stronger NSAIDs or prescription strength medicine.
  • Severe pain is, you guessed it, the worse kind to have. It’s defined as pain that interferes with some or all aspects of your daily life. The pain may be so great that you’re confined to a chair or given bed rest. This pain often doesn’t go away, with treatment needed for weeks or even years. Often drugs such as morphine, oxycodone, hydrocodone, hydromorphone, methadone, or fentanyl, as well as adjuvant therapies (secondary treatment to increase the chances of a cure) are needed.

Pain isn’t all bad though, remember that it’s part of your body’s natural defense system. It’s designed to be helpful, to encourage you to stop doing whatever it is that’s causing the pain. Without pain, you might seriously injur yourself without knowing it or you may not realize you have a medical problem in need of treatment.

October 31st, 2007 • mdvaldosta • Chronic Pain, Conditions and Diseases Comments Off


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