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The Different Types of Pain

Pain is so complicated that doctors and scientists still can’t precisely define it. Kathryn Weiner, director of the American Academy of Pain Management says, “Pain is far more than neural transmission and sensory transduction.  Pain is a complex mixture of emotions, culture, experience, spirit and sensation." Talk about being vague and all encompassing! The best American Academy of Pain Management can do is to describe pain as, “an unpleasant sensation and emotional response to that sensation." So let’s settle on defining pain as physical discomfort causing emotional and mental distress.

Different Types of Pain

Acute Pain

This type usually results when someone is violently struck (hit your thumb with a hammer), injured (sprained ankle, strained muscle) or ill (sore throat, stomachache).

Chronic Pain

Involves in long-term, continuous discomfort from physical injury (lower back pain), damage to nerves (neuropathy), infection (swelling and inflammation), or arthritic pain (damage to joints).

Exceptions

While acute pain usually comes from direct injury, chronic pain can be the spontaneous variety for which there’s no apparent cause (burning pain, intermittent sharp, stabbing discomfort or shooting pain). On the other hand, while nerves function to protect and warn us about danger, sometimes nerve pain can actually come from undamaged nerves.

New Discoveries About Chronic Pain

Chronic pain is one of the most widespread and irreversible medical conditions in the U.S. One in five Americans is afflicted and this disability costs our nation’s industry $61 billion in lost productivity and much more in medical fees.

In recent years, much more has been learned about this affliction. In healthy people, neurons cease firing once the original wound is healed. However with chronic pain, the pain-sensitive neurons keep firing long after the injury has gone. Why? Scientists don’t understand why some people develop chronic problems with their injuries yet others heal normally with no pain at all and attempting to analyze and account for all the variables involved is, for now, a scientific impossibility.

Chronic can begin with scraping the skin of the elbow. While the skin surface heals, the nervous system, for some reason, doesn’t. Within a couple of years, the elbow now feels like it’s on fire, while nothing on the skin surface appears to be wrong. Many Americans with aching backs and sore knees find themselves disabled by the accumulated strain put on joints, bones and muscles every day.

Scientists now recognize that the brain and spinal cord mysteriously rewire themselves into “pain pathways” that, in some people, become torturously overactive years later. Simply put, pathologically hyperactive neurons make life intolerable.

Source of Chronic Pain

New research (at the University of Bristol in the UK.) published in the Jan. 25 issue of the journal Neuroscience have found an explanation of how certain types of ongoing pain (those connected to nerve injury and inflammation), can be caused by healthy nerve fibers. It turns out that pain is relayed from its source through large fibers, which send electrical signals more rapidly and are believed to communicate sharp, pricking pain.

On the other hand, fine fibers transmit ongoing, burning pain, which appear to have no source and don’t respond to the standard painkillers. In examining the fine fibers, researchers discovered that the faster these fibers fire pain sensations, the worse the pain grows. The research physiologists concluded that the source of this increased firing appears to come from “…inflammation within the nerves or tissues, caused by dying or degeneration of the injured nerve fibers within the same nerve."

Chronic Pain Shrink’s People’s Brains

Research done at Northwestern University have discovered that the brains of chronic back pain suffers were up to 11% smaller than those of healthy individuals. The findings indicate that people with constant pain are losing an over-sized pea of gray matter for every year of chronic pain. (Grey matter is the brain’s outer layer of nerve cells that handles information and memory processing).

Chronic Back Pain is Correlated to Changes in the Brain

At a meeting of the Radiological Society of North America, researchers using specialized imaging techniques presented evidence that patients with chronic low back pain also had microstructural changes in their brains. Using a new technique called diffusion tensor imaging (DTI), researchers were able to track the movement of water molecules in the brain's gray and white matter.

Dr. Jurgen Lutz, M.D., a radiology resident at Ludwig-Maximilians University Hospital in Munich, Germany, conducting the research explained that “a major problem for patients with chronic pain is making their condition believable to doctors,” [and with DTI producing] “objective and reproducible correlates in brain imaging” [for pain diagnosis and treatment] …”chronic pain may no longer be a subjective experience.”

While the findings do not show why the brain shrinks, scientists speculate it might be due to the degradation of neurons. And even more significant, they speculate that this degradation could be due to the high level of stress in living with the condition, which is causing the neurons to become exhausted with the over-activity.

How Women Feel More Pain

New research, published in the October issue of the journal Plastic and Reconstructive Surgery, has shown that women have more nerve receptors; therefore they feel pain more intensely than men. For example, facial skin differs greatly in women and men – with women possessing 34 nerve fibers per square centimeter, while men have only 17.

Endorphins – Our Natural Opiate-like Painkillers

The human brain is also capable of synthesizing chemicals very similar to opiates. Endorphins are our body’s own pain relievers which are more powerful than the ones you buy in the drugstore. Recent discoveries have identified distinct receptor cells in the brain for receiving these endorphins. Opiates like morphine perform their painkilling effect on the body by binding to the brain’s same receptor cells. The fact that these receptors have evolved indicates there is natural use for them. Endorphins are produced in the paraquaductile grey in the brain and healing relaxation modalities stimulate the release of these natural painkillers.

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