What is pain?
You might feel pain in various parts of your body, but did you know that pain is actually produced in the brain, and not in the body part that hurts? Body parts can only send messages that something is wrong (known as nociception). The brain must interpret the message sent by body parts, and sometimes it creates the experience of pain.
There are different types of pain. How long it lasts and treatments options depend on the type of pain you have. Pain that lasts more than 3 months is considered chronic pain.
The 3 types of pain:
- Nociceptive pain
- This is a healthy type of pain.
- Nociceptive pain acts as a protective mechanism.
- Usually only lasts for a short duration.
- Example: a broken leg hurts to remind you not to use it so it can heal.
- Neuropathic pain
- Neuropathic pain comes from damaged nerves.
- Often lasts longer than nociceptive pain.
- Nociplastic pain
- Nociplastic pain is mostly created in the nervous system.
Please watch the videos below to learn about types of pain.
Dr. Dan Clauw explains how pain is produced in the brain
The Mechanisms of Pain
Understanding the different types of pain mechanisms
Below is a description of the 3 types of pain.
Types of Pain
- Nociceptive pain is an example of the body's pain mechanism working properly.
- It warns you of threat and danger.
- Examples include pain from a recent injury, pain after surgery, and pain associated with tumors.
- Short-term inflammatory (swelling) pain is an example of adaptive pain, where the immune system warns of danger by causing inflammation.
- The brain can interpret this as being painful.
- Most forms of nociceptive pain are short lived and are the body's way of trying to keep you safe.
- For example, the pain after a broken bone helps remind us to let that bone rest so it can heal.
Neuropathic pain is pain associated with damage to either the central or peripheral nervous system.
- The central nervous system includes the brain and spinal cord.
- The peripheral nervous system is what connects your brain and spinal cord to the rest of your body.
How does neuropathic pain work?
- These nervous systems help take nociceptive messages from a site of injury to the brain.
- If the nerves carrying messages to the brain get damaged, they may fire too much or in abnormal patterns.
- These patterns can be interpreted by the brain as sharp or burning pain.
What is it?
- Neuropathic pain is a pain disorder that has lost its adaptive function- it no longer serves the purpose of protecting you.
- Examples include diabetic neuropathy, severed nerves, and nerve damage to the brain or spinal cord.
- Nociplastic pain or "centrally augmented pain" is a disorder of how the brain processes types of pain signals.
- When this happens, the brain misinterprets signals from the body, creating a painful experience when the body was not signaling pain.
Note: pain feels the same when it comes from an injury as it does when caused by central augmentation. Both are "real" forms of pain that can lead to the same level of suffering.
What causes nociplastic pain?
- genetics, infections, hormonal abnormalities, physical and/or psychological trauma, repetitive injuries, and sustained physical/psychological stress.
Some conditions associated with augmented pain processing include:
- fibromyalgia
- some forms of low back pain
- some forms of headache.
Treating to the Mechanism
How treatment approaches differ based on pain type
Approaches to Pain Management
Doctors and other professionals can use procedures, medications, and devices to help you change how the brain processes pain; but the person with the best access to your brain is you.
- The best approach for managing chronic pain is a partnership between what your doctor can do (professional care) and what you can do (self-care).
- Current approaches to chronic pain management follow a step-by-step algorithm that personalizes treatment to the type of pain you are experiencing at any given time.
Steps to Pain Management
Chronic pain management starts with determining what type or types of pain you feel. Understanding your specific pain type helps guide the most effective treatment approach.
Self-management is the foundation of optimal pain care because it can directly impact how your brain produces the experience of pain.
- There are many different self-management techniques.
- The techniques described in the self-care section of the website have been demonstrated to influence how the brain forms the experience of pain.
In addition to self-management, your doctor may want to include professional care such as medications, professional therapies, devices, and procedures. These approaches can also work to influence the perception of pain. Understanding various professional care options helps you have an informed conversation with your health care provider to determine what combinations of self-care and professional care are right for you.