What is Pain?

“Mental pain is less dramatic than physical pain, but it is more common and also more hard to bear. The frequent attempt to conceal mental pain increases the burden: it is easier to say “My tooth is aching” than to say “My heart is broken.” -C.S. Lewis The Problem of Pain

Everyone feels pain. Whether for a stubbed toe, fractured wrist, or deep cut, you can always count on pain to be there. Pain is the way your body gets your mind’s attention. It is the most common reason that people seek medical aid. But what is pain exactly? What makes it come and go? Below we will explore what pain is, the various types of pain (including chronic pain), and how to manage it.

Table of Contents

The International Association for the Study of Pain (IASP) defines pain as the “unpleasant sensory and emotional experience associated with actual or potential tissue damage, or described in terms of such damage.” Pain is a feeling that is triggered in the nervous system that can be felt in one concentrated place or in several places throughout your body simultaneously. Receptor nerve cells in and beneath your skin sense heat, cold, light, touch, pressure, and pain. You have thousands of these receptor cells. Most sense pain. When there is an injury to your body, these tiny cells send messages along nerves into your spinal cord and then up to your brain. Your body sends messages through the form of pain to your brain telling it that something is wrong. Your brain informs you whether or not you are experiencing pain. These warning messages travel in an electric pulse from receptors called nociceptors (which are sensitive to heat, electrical, mechanical, chemical, and painful stimuli) through nerves to your spinal cord and up to your brain. Once there, your brain interprets these messages. Pain can be a powerful defense mechanism that our bodies use to encourage us to get help. When we receive the medical attention that we need, oftentimes the pain goes away. But sometimes it doesn’t, as with Chronic pain.

Diagnosing It

There is no way to truly tell how much pain a person has. Pain is a subjective experience. There are no tests available that can measure pain intensity or show what pain looks like or locate its precise location. For this reason, doctors rely closely on how and where the patient describes his or her pain. Over time and through experience, doctors have been able to identify medical issues based off of pain histories they take where they include descriptions like “dull,” “sharp,” and “constant.”

Two Main Types of Pain

There are two main types of pain:

Acute
Chronic

Acute Pain

Acute pain is the more common everyday kind of pain. Generally it is sharper and more concentrated than Chronic pain and mostly results from disease, inflammation, or injury to tissues. This type of pain generally comes on suddenly, for example, after trauma or surgery, and may be accompanied by anxiety or emotional distress.

Chronic Pain

Chronic pain lasts longer than acute pain. This type of pain is most often caused by an illness or injury. Generally, pain is considered Chronic when it lasts for at least six months. Chronic pain can come in one of two forms:

Nociceptive – sharp, aching, or throbbing pain that is caused by damage to body tissue. Can be caused by cancer cells or tumors
Neuropathic – burning, heavy, or numb-like pain that occurs when there is actual nerve damage. While this type of pain can also be caused by cancer, it can be affected by nutritional balance, alcoholism, toxins, infections, and auto-immune diseases.

Pain Management

Pain can be treated in many ways. Doctors use medications, surgery, alternative procedures, or a combination of these.

Medications

Non-opioid analgesics (aspirin, acetaminophen (Tylenol), ibuprofen (Advil), and naproxen (Aleve)) treat pain at the site. After damaged tissue releases enzymes that stimulate local pain receptors, non-opioid analgesics interfere with the enzymes and reduce inflammation and pain.
Opioid analgesics Opioid analgesics are used for higher levels of pain relief — they include morphine, meripidine (Demerol), propoxyphene (Darvon), fentanyl, oxycodone (OxyContin), and codeine. They can be easily overdosed on and become addictive.
Adjuvant analgesics (co-analgesics) are primarily used for treating some other condition, but they also relieve pain. These compounds are useful in treating neuropathic pain (chronic pain that comes from injury to the central nervous system).

Surgery

In extreme, “last resort” cases, surgeons may have to sever pain pathways. Examples of such surgeries include:

Rhizotomy – destroying portions of peripheral nerves. This procedure is used most often relieve symptoms of neuromuscular conditions (i.e. spastic cerebral palsy).
Cordotomy – disables pain conducting areas in the spinal cord. This procedure is typically saved only for advanced cancer patients and extreme pain.

Surgical interventions can be aimed at eradicating the source of the pain. For example, many people suffer back pain from herniated disks between the vertebrae. An inflamed disc can compress a nerve and cause neuropathic pain. If the patient does not respond to medication, a surgeon might try to remove at least part of the disc and relieve pressure on the nerve.

Alternative Therapy

These approaches do not involve drugs or surgery.

Chiropracty manipulates joints to relieve compression of nerves.
Massage stimulates blood flow and relieves spasms
Hot and cold applications
Stimulation of the skin with small electrodes can close the gate to pain.
Acupuncture
Mental control techniques (hypnosis)

Pain-management plans involve the participation of doctors, patients, family members, and other caregivers. As with any medical treatment, the source of pain, pain tolerance, and the potential benefits and risks of treatment must be considered.

Sources: NINDS, MedTronic, HowPainWorks