Every person may experience pain at different periods of their lives due to different reasons. Determining the causes of the pain experienced is of great importance for the development of the right treatment methods. As a result of all known pains and researches on these pains, some classifications have emerged and pain types have been identified. Thus, diagnosis and treatment can be planned much more easily.
How Many Types Of Pain Classification Are There?
Although there have been different classifications of pain to date, it is possible to say that they are largely close to each other. For example, some pain is classified as anatomical and etiological. In fact, the determinant here is the area where the pain occurs or the factors that cause the pain. For example, anatomical classifications are evaluated as low back pain or headache, while etiological pain is defined as cancer pain, lumbar disc herniation and so on. The most common classification of pain is the classification according to the temporal background, mechanism and the region of origin. Although there are different forms of classification, we can classify pain in 3 groups: temporal, according to the mechanism and according to the region of origin.
Classification Of Pain And Types Of Pain
Pains classified according to their temporal, mechanisms and origin are also divided into different groups within themselves. For example, temporal pain is classified as acute and chronic, pain according to its mechanisms, also called physiopathological pain, is classified as nociceptive, neuropathic, deafferentation pain and psychosomatic pain, and pain according to its site of origin is classified as somatic, visceral and sympathetic pain. In order to categorise pain, it is necessary to have a thorough knowledge of the types of pain in question.
Temporal (Duration-Related) Pain
When classifying temporal pains, the person’s pain duration is taken into account. Acute pains occur suddenly and usually resolve within a short period of time. Chronic pains, on the other hand, are longer lasting and can cause other problems. The details of acute and chronic pains are as follows:
The cause of acute pain is often a structural damage that occurs. Therefore, the pain disappears as the structural damage disappears. Structural damage to bones, muscles, or organs can also lead to problems such as anxiety or emotional restlessness. Acute pain usually resolves within 3 to 6 months, but it can sometimes be shorter. Any injury or trauma can cause acute pain.
Chronic pain, which usually lasts longer than 3 to 6 months, often does not respond to medication. Tissue sensitisation can cause chronic pain to become persistent and unbearable. It can occur due to many different causes, including fibromyalgia and arthritis. Since it is long-term and persistent, chronic pain can also be accompanied by various psychological problems. Chronic pain is categorised as follows:
- Pain caused by a disease that has not been diagnosed in a clinical setting,
- Pain associated with diseases of the peripheral or central nervous system, also called neurogenic or neuropathic pain,
- Pain caused by psychiatric illnesses,
- Pain of unknown origin.
Both acute and chronic pain can be debilitating and have a negative impact on the patient’s mood. While acute pain can usually be controlled with medication, the underlying causes must be identified and a treatment method must be developed for the treatment of chronic pain.
According To Mechanisms (Physiopathological) Pain
According to their mechanisms, physiological or physiopathological pain is examined in 4 groups: neuropathic pain, nociceptive pain, deafferentation pain and psychosomatic pain.
Neuropathic pain is usually caused by problems in the structures of the peripheral or central nervous system. As the nerves become hypersensitive, pathophysiological changes occur in nerve function. Neuropathic pain that manifests itself as stinging, tingling or burning can be caused by conditions such as nerve end inflammation and nerve compression. Neuropathic pain, which can also be caused by nerve injury, may be accompanied by symptoms such as loss of sensation or loss of strength. In cases where the nerves are pressed or stretched, there may be an increase in pain. It is possible for the pain to suddenly subside or suddenly intensify. When the pain is severe, sleep problems or various psychological problems may occur.
A problem on the skin, muscle, or connective tissue can cause nociceptive pain. Nociceptive pain develops when peripheral nerve endings respond to inflammatory, mechanical, or oxygen deprivation-induced stimuli. Nociceptive pain can be caused by joint arthritis, infection, or circulatory disorders. Simple pain relievers are effective in relieving this type of pain. Changing posture and movements can help reduce pain. In addition, there are no symptoms such as changes in reflexes and loss of sensation or muscle strength.
It occurs with peripheral nerve cuts and spinal, medullary, thalamic or pontine problems. Thalamic haemorrhages and thalamic pain syndrome, also called Dejerine-Roussy syndrome, are examples of this type of pain.
Pains that people feel physically but have no medical counterpart are called psychogenic pains. These types of pain often occur as a result of emotions such as stress, anxiety, or sadness. Examples of psychogenic pains include abdominal pain, migraine and headache, menstrual pain, arm and leg pain, and neck and shoulder pain.
Apart from all these, reactive pains are also included in the physiopathological pain group. Pains, also known as earache among the people, are called reactive pains.
Pain According To The Region Of Origin
According to the region of origin, pain is analysed according to the nervous and organ systems. They are analysed in 3 groups as somatic, visceral and sympathetic pains.
Somatic pain is transmitted by nerve fibres. This type of pain, which can be stinging, aching or throbbing, starts suddenly and is usually sharp. It is perceived more clearly in areas where the nerves begin to spread. In cases that develop due to trauma or fractures and dislocations, the pain that occurs is called somatic pain.
Visceral pain is usually caused by internal organs. For example, if the intestines are stretched, this can affect the nerves in the lining of the intestines, resulting in pain. This type of pain, which cannot be easily localised, usually radiates to other areas. For example, pancreatic pain radiates to the shoulder, heart pain to the arm and appendicitis pain to the navel.
Sympathetic pain originating from the sympathetic nervous system can manifest itself long after the illness has passed. These burning pains increase in intensity especially in cold weather and at night. It is possible to see deformation of the skin in pain occurring in the arms or legs.
Regardless of the type of pain, a doctor’s control is required to determine the causes and to apply the correct treatment methods.