There are many types of pain we experience throughout our lives: acute pain (also known as nociceptive pain), visceral pain, somatic pain, nociplastic pain, neuropathic pain, and radicular pain.
ACUTE PAIN / NOCICEPTIVE PAIN
Acute pain happens suddenly, starts out sharp or intense, and serves as a warning sign of disease or threat to the body.
It is caused by injury, surgery, illness, trauma, or painful medical procedures and generally lasts from a few minutes to less than three months. Acute pain usually disappears whenever the underlying cause is treated or healed.
The most common signs and symptoms of acute pain include:
- sharp pain
- throbbing
- burning
- stabbing pain
- tingling
- weakness
- numbness
Common causes of acute pain include:
- blunt trauma
- broken bones
- surgery
- dental work
- childbirth
- cuts and infections
- burns
- pulled or strained muscle
- sprains of body part
This includes pain from physical injury or trauma, but could also include something such as chronic pain from arthritis or cancer.
Acute or Nociceptive Pain is the most common type of pain.
VISCERAL PAIN
Visceral pain originates from damage to internal organs.
Visceral pain is described as dull and diffuse and often poorly localized. It is frequently mediated by the slower, small unmyelinated C-fibers. Visceral pain is often perceived as more unpleasant than somatic pain.
Examples for visceral nociceptive pain:
- Tumor invasion
- Obstructions (bowel, ureter, bile duct)
- Colic
- Angina
- Pancreatitis
- gallstones
- apendicitis
- irritable bowel syndrome (IBS)
SOMATIC PAIN
Somatic pain is due to stimulation of peripheral nociceptors in your tissues capable of responding to stimuli such as mechanical (pressure), thermal, chemical and other stimulation.
It most most commonly described as sharp, localized pain that is predominately being carried by fast, myelinated Aδ-fibers.
This includes skin, muscles, joints, connective tissues and bones. It is often seay to pinpoint the source and location of somatic pain.
Examples of somatic nociceptive pain:
- Burn
- Fractures
- Incisions, Wounds
- Cellulitis
- Shingles
- Arthritis
- Gout
- connective tissue disorders
- joint pain
- Musculoskeletal Pain
It can feel like a constant ache, sharpness, or gnawing and can be either deep or superficial.
NEUROPATHIC PAIN
Neuropathic pain results from dysfunction of the nervous system. It is an issue with the nerve signaling mechanism itself. Whereas nociceptive pain is a pain sensation from tissue damage, neuropathic pain is a pain sensation from nerve
damage.
Nervous system disorders results in damaged or dysfunctional nerves misfiring pain signals. This pain seems to come out of nowhere, rather than in response to any specific injury.
You may also feel pain in response to things that aren’t usually painful, such as cold air or clothing against your skin.
Neuropathic pain is described as:
- burning
- freezing
- numbness
- tingling
- shooting
- stabbing
- electric shocks
NOCIPLASTIC PAIN
Nociplastic pain is mechanistically different from nociceptive pain and neuropathic pain.
It can be defined as chronic pain and results in increased sensitivity from a chronically altered function of pain-related sensory pathways in the periphery and central nervous system.
It consists of multifactorial processes from different inputs, which could be either a bottom-up response to a peripheral nociceptive, a
neuropathic stimulus (known as central sensitisation), or a top-down CNS-driven response.
Nociplastic pain is a descriptor of the type of pain experienced. It encompasses pain from stereotypical terms such as dysfunctional pain or medically unexplained somatic syndromes.
Nociplastic pain usually is the result of disorders such as fibromyalgia, osteoarthritis, electrical injury, multiple sclerosis, complex regional pain syndrome, spinal cord disorders, and chronic headaches.
This typically persists longer than 3 months. It arises from altered nociception and can cause significant emotional distress and disability over time.
There are three categories of nociplastic pain:
Supraspinal - resulting in hyperresponsiveness to pain stimuli, hyperactivity, disordered signaling pathways between the brain and nervous system, inhibition of GABAergic transmission.
Spinal mechanism - clustering narrowing of signals from different spinal nervous system signalling.
Peripheral mechanism - proliferation of sodium channels and sympatho-afferent coupling mechanisms that signal pain leading to increased sensitivity to pain.
Nociplastic pain indicates malfunction of the pain signalling pathways that need to be retrained.
RADICULAR PAIN
Radicular pain also known as radiculopathy is pain where a spinal nerve gets inflamed, compressed, or irritated in some way.
The resulting pain can traverse the length of the nerve fibers and be numbing, tingling, radiating back or leg pain, or present as muscular weakness. It can signal as burning sensation, stabbing pain, or pulsating pain.
Radicular pain can make it hard to stay mobile and can cause significant depression, frustration and despair.
Though there are different types of nerve pains, radicular pain is physical damage to spinal nerves, whereas neuropathic pain is a term that includes radicular pain as well as other forms of nerve pain, such as: diabetic nerve pain, alcohol-related, chemotherapy induced, etc.
Both are different from nociplastic pain because its not due to misguided signalling pathways but directly linked to a pinched or inflamed nerve.