Pain is something we’ve all experienced. For most people, it is a part of our sensory system – the same way we touch, smell, see and hear. We also experience pain as a response to both internal and external stimuli. This pain tells us something. Sharp pain, burning pain, dull pain, aching pain, throbbing pain, acute pain, chronic pain. Pain means something is wrong, whether a dangerous snake bite or a stubbed toe. Pain is information, and it is very often helpful information.
But pain does not always work in our favor. For one, it is inherently unpleasant. And in many ways, it can feel like a burden more than a blessing. We often cannot choose when or how we feel pain, nor can we determine the intensity with which we feel it. Some people are far more sensitive to pain than others, experiencing it even when it serves no purpose as a warning mechanism or means to protect ourselves. And because pain links to the receptors present throughout our nervous system, it too can malfunction, the same way our senses of touch, smell, hearing, or sight can.
Pain conditions are when the primary symptom is excessive, chronic, or misplaced pain. Menstrual cramps, or dysmenorrhea, are an example of a frequent pain that affects millions of women, some far more intensely than others. Some conditions are rarer, though. Conditions like chronic fatigue syndrome and fibromyalgia can involve lasting, chronic pain, in contrast to the passing, acute pain of an injury or physical trauma. Understanding how pain can present itself and how it differentiates itself can help you better understand your pain symptoms and seek better care.
How Does Pain Work?
Your nervous system governs pain, which includes the central and peripheral nervous systems. The central nervous system consists of the brain and spinal cord, feeding into the peripheral nervous system, which innervates the rest of the body. Our peripheral nerves include sensory nerves and motor nerves. While some nerves are under our control, others contribute to the autonomic nervous system, regulating things like heartbeat and body temperature. In a way, the central nervous system does not “feel” pain. It only processes it.
You cannot feel a doctor cutting into your brain to resolve an aneurysm or discover the cause of your seizures, nor can you feel it when your spinal cord is severed. Nociceptors are special interpreters of painful stimuli, forwarding the information of a sudden jolt of pain into your brain in a fraction of a second. While nociceptors are responsible for sending pain signals, not all pain is strictly nociceptive. Most nociceptors are in the rest of the body, which is why you can feel a pinprick on your skin but wouldn’t feel a neurosurgical instrument on your frontal lobe. Instead, nociceptors send all pain signals.
Nociceptive Pain vs. Neuropathic Pain
If you pinch yourself hard enough, you will feel nociceptive pain. But if your hands and feet begin to tremble, ache, and hurt because of your diabetes, or an arthritic condition, you will experience neuropathic pain. Neuropathic pain signals are still interpreted and forwarded by your body’s nociceptors. Still, the pain is entirely different—nociceptive pain results from a painful stimulus, such as damaged nerves causing neuropathic pain.
Many chronic pain conditions are ultimately neuropathic rather than nociceptive. This is because chronic pain is a sign of a malfunction in your nervous system rather than an ongoing noxious stimulus. Chronic pain due to terminal illness can be nociceptive, as your body breaks down. This is not always the case, of course. But understanding both forms of pain and their differences can help you identify and understand the root cause behind your symptoms.
Is Pain a Disease?
Pain is a natural sense but can also serve as a symptom. While it is good and healthy to feel pain due to hurting your knee, as opposed to damaging your knee and not feeling it, the pain is still an indicator that something may need to be treated, even if it isn’t the disease itself. Pain conditions, or pain diseases, do exist. These are conditions wherein the primary symptom is pain. This means the pain itself is the problem and not an effect of the actual problem (such as a tumor, heartburn, or a heart attack). Fibromyalgia is an example of a pain disorder. It is also an example of a chronic illness.
What Is Acute Pain?
Medically, all pain is acute pain until it lasts a specific period. In general, acute pain is all pain that goes away within three to six months or within the cause’s “normal healing” timeline. Acute pain is not better or worse than chronic pain. Acute pain can be much more severe than chronic pain, even if it is short-lived. If you break your leg and the doctor estimates that it will take about six months to recover fully, it’s normal to still feel pain after week three. On the other hand, a small cut might not even hurt anymore in a day or two.
What Is Chronic Pain?
Pain becomes chronic if recurring and does not dull after three to six months. When an acute injury – such as an aching shoulder and poor joint mobility after a bad fall – becomes chronic, it may be a sign that the wound did not heal well. Alternatively, chronic pain can occur suddenly, without any known cause. Chronic pain can be debilitating.
Even if it isn’t as painful as some acute pain, chronic pain lasts longer and can flare up in intensity unexpectedly. Identifying the cause of a person’s chronic pain is essential. Most causes of acute pain are immediately apparent – such as touching a hot pot or breaking a leg. On the contrary, most causes of chronic pain are less visible to the naked eye – such as an arthritic condition, migraine disorder, chronic fatigue syndrome, or fibromyalgia.
Pain Management and Anesthesiology
Pain management is a form of medicine that attempts to help patients minimize and manage pain, especially chronic pain. The goal isn’t to entirely dull a person’s senses but to help people with debilitating pain conditions, such as MS or terminal pain, and drastically improve their quality of life. Many pain specialists branched into treating pain conditions from other forms of medicine, and pain clinics often employ a wide range of experienced physicians who bring their knowledge and diagnostic expertise into the mix. Examples of pain management include:
- Non-opioid painkillers
- Prescription painkillers
- Physical therapy
- Nerve blocks
- Corticosteroid injections
- Nerve stimulation
- Radiofrequency ablation
- In some cases, surgical intervention
Pain is neither your friend nor your enemy. It is a part of life and serves its purpose. When it has no practical sense, pain can be treated and often minimized through pharmacology, therapy, and specific interventions. Understanding how pain works can help you better understand your condition and find the proper treatment.