Pain is a result of tissue damage causing both Sensory and Emotional experiences. Pain serves as a warning, warning our body that we are injured, which may cause us to withdraw from the painful stimulus to protect the injury. It is associated with issues such as muscle spasm, atrophy, habitual postures, guarding and psychological factors
Categories of pains
1. Somatic
- Acute (Sudden onset, less than 6 weeks)
- Chronic (Last longer than 6 weeks)
Somatic pain is physical pains that include skin pain, tissue pain or muscle pain, for example, a sports injury
2. Neurogenic
Neurogenic pains are pain that is caused by a problem with the central nervous system such as nerve damages that could be resulted from trauma.
3. Psychogenic
Psychogenic pain is actual physical that happens due to your mental, emotional or behavioural state. For example, headaches, stomach pains etc. that could be caused by anxiety.
Different types of pain that you feel can help you understand which part of your body is injured, for instance, is it your muscle, ligament, bone or nerve.
Type of pain
Cramping, dull, aching, worse with movement (Muscle)
Dull, aching, worse with passive movement (Ligament, joint capsule)
Sharp, shooting, follow dermatome* supplied by the nerve (Nerve)
Sharp, severe, unable to weight bear (Fracture of bone)
Red flags of Pain
Pain and other symptoms may suggest serious pathology which requires medical investigation.
Patients have persistent pain, generally unwell.
Changes in bladder and bowel habits.
Alterations in vision.
Gross changes in gait.
Body system and possible Pathology (How to identify the issue in your body)
Cancer
Signs and Symptoms:
Persistent night pain
Constant (24 hours) pain
Unexplained weight loss
Loss of appetite
Unusual lumps or growths
Sudden persistent fatigue
Cardiovascular
Signs and Symptoms:
Shortness of breath
Dizziness
Pain/ feeling of heaviness in the chest
Discolouration in the feet
Persistent swelling with no history of injury
Gastrointestinal/Genitourinary
Signs and Symptoms:
Frequent or severe abdominal pain
Frequent heartburn/indigestion
Frequent nausea or vomiting
Change in bladder or bowel habits
Unusual menstruation
Neurological
Signs and Symptoms:
Changes in hearing
Frequent or severe headache
Problems in swallowing or changes in speech
Gait disturbances, problems with balance/coordination
Drop attacks/sudden weakness
Additional information on Pain production - How is pain produced?
The free nerve endings, or rather, the nociceptors in our body respond to the painful stimuli
The pathway of the pain goes from
From Nociceptors to Spinal Cord
Within the Spinal Cord to Brainstem
From Brainstem to the cerebral cortex
When it reaches the cerebral cortex, that is when your brain will register the pain and you will feel it at the injured area.
Also, there are 2 types of pain fibres
C fibres (slow pain) – poorly localised; emotional response to pain, registered in the prefrontal region.
A delta fibre (fast pain) – registered in the parietal lobe.
Usually, an acute sports injury will cause stabbing pain first, followed by a dull aching pain, then an emotional response.
