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What’s the Underlying Source of Your Pain?
Does your doctor look perplexed when you explain your symptoms? You’re in distress. but they can’t see why? Do you get the feeling they don’t believe you or they think you’re exaggerating?
In medical school, I was taught about two types of pain. But, a group of people I saw during this time had chronic pain that didn’t fit into either type.
Were these patients imagining their symptoms? Or did the medical profession not understand the complexity of pain? Spoiler: It’s the latter.
Pain Types
Injury.
The first pain type is called nociceptive pain, which is caused by inflammation and tissue damage. This is the type of pain you feel when you experience an injury, like spraining your ankle or breaking a bone. Nociceptive pain feels sharp, aching, or throbbing. Nociceptive pain sends the message that you’re hurt.
Nerve damage.
The second type of pain is called neuropathic pain and is more complicated than the pain from an injury. Neuropathic pain arises from damage to your nerves, which produces sensations of numbness, tingling, or burning. For example, numb fingers from carpal tunnel, or pins and needles from a pinched nerve in your back.
The tricky thing about nerve pain is that your symptoms may persist after your nerve damage has resolved. While an injury to your bones or muscles may heal, once your sensory nerves are injured, they may continue to emit abnormal sensations.
Confused nerves.
The third pain type is perplexing because it doesn’t appear on conventional tests, like X-rays and MRIs. Central sensitization pain or nociplastic pain stems from confused nerves that incorrectly process pain signals.
You feel intense pain, but there’s nothing in your medical tests to provide a clue, which leads to either incorrect treatment or none at all.
What are the signs of central sensitization pain?
- Symptoms persist long after the expected healing time. For example, your back injury that should’ve healed after 3 weeks still hurts 6 months later.
- Your symptoms spread beyond the injury area. A small area of pain in your back extends across your back and down into your thighs.
- A marked sensitivity to pain develops. Pain is felt more easily and intensely than usual. Basic movements, like bending forward and walking, cause you discomfort.
- Non-pain symptoms develop. Fatigue, poor sleep, and brain fog (thinking less clearly) can be signs of sensitization.
The people I saw during my medical training who didn’t fit into the two main pain types, nociceptive or neuropathic, are now understood to have the third type called nociplastic pain. This pain is the result of abnormal processing of pain signals in your brain.
Understanding the type of pain – what’s causing your suffering – is critical to receiving the correct treatment.
