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What is Pain - Explained Simply

Updated: Mar 18

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

  1. Cramping, dull, aching, worse with movement (Muscle)

  2. Dull, aching, worse with passive movement (Ligament, joint capsule)

  3. Sharp, shooting, follow dermatome* supplied by the nerve (Nerve)

  4. 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:

  1. Persistent night pain

  2. Constant (24 hours) pain

  3. Unexplained weight loss

  4. Loss of appetite

  5. Unusual lumps or growths

  6. Sudden persistent fatigue


Cardiovascular

Signs and Symptoms:

  1. Shortness of breath

  2. Dizziness

  3. Pain/ feeling of heaviness in the chest

  4. Discolouration in the feet

  5. Persistent swelling with no history of injury


Gastrointestinal/Genitourinary

Signs and Symptoms:

  1. Frequent or severe abdominal pain

  2. Frequent heartburn/indigestion

  3. Frequent nausea or vomiting

  4. Change in bladder or bowel habits

  5. Unusual menstruation


Neurological

Signs and Symptoms:

  1. Changes in hearing

  2. Frequent or severe headache

  3. Problems in swallowing or changes in speech

  4. Gait disturbances, problems with balance/coordination

  5. 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

  1. From Nociceptors to Spinal Cord

  2. Within the Spinal Cord to Brainstem

  3. 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.

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