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Chronic pain
Centralized pain is caused when pain centers in the brain amplify the pain response.
What Causes Chronic Pain?
Describing your pain accurately to your doctor is important. Based on the description, your doctor will be able to determine what type of pain you have and how to treat it.1 There are three types of pain and below are the descriptions on how they might feel.2
Nociceptive pain2,3
Nociceptive pain can feel
Nociceptive pain is caused by tissue damage from injury or inflammation.
This results in pain receptors (called nociceptors) sending persistent pain signals to the brain.
Examples of this type of pain include osteoarthritis, rheumatoid arthritis, tendonitis, gout, neck or back pain, tumor-related pain, sickle cell disease, inflammatory bowel disease.
Neuropathic pain2,4
Neuropathic pain can feel
Neuropathic pain is caused by damaged nerves that send pain signals to the brain.
The pain signals are sent to the brain even when there is nothing to trigger the pain.
Examples of this type of pain include neuropathy due to diabetes, pain after having shingles, spinal cord injury, post- stroke pain, pain caused by tumor or chemotherapy.
Centralized pain2
Centralized pain is accompanied by
Centralized pain is caused when pain centers in the brain amplify the pain response. In this, ordinary touch or pressure may also cause pain.
Often there is no identifiable tissue or nerve damage, which makes centralized pain difficult to diagnose.
Examples of these type of pain include fibromyalgia, irritable bowel syndrome, tension headaches, neck or back pain without any structural damage, chronic fatigue syndrome.
Chronic pain may be caused by more than one type of pain. For example, people with conditions such as osteoarthritis, rheumatoid arthritis and cancer, can have a combination of the pain types mentioned above—i.e., mixed pain types.2
Pain Management Plan
Knowing what type or types of pain you have can help your healthcare provider tailor a pain management plan according to your needs. You must describe your pain with as many details to your healthcare team to help them make an accurate diagnosis.2,5 Below are some questions that can help you record the details of your pain:5
Do you experience pain on most days?
How long does your pain last?
What is the intensity of the pain? (e.g., mild, moderate, severe, very severe)
Where do you feel the pain? (e.g., only joints)
What is the type of pain you feel? (e.g., pins/needles, hot/burning, numb, electrical
shocks)
To what extent does the pain interfere with your regular activities?
Are you facing trouble remembering things or concentrating?
Does the pain make you sensitive to bright lights, loud noise, or smells?
If you are considering complimentary approaches for managing chronic pain, keep in mind:6
Do not use an unproven product or practice to delay seeing your healthcare provider.
Talk with your healthcare provider to learn about safety, use, and likely effectiveness of the product or practice that you are considering.
If you are considering a practitioner-provided complementary health approach such as spinal manipulation, massage, or acupuncture, ask your health care provider or a nearby hospital to recommend a practitioner. Find out if the practitioner has training and experience with your pain condition.
If you are considering the use of dietary supplements, keep in mind that they can cause health problems if not used correctly or may interact with other medications or dietary supplements.
Stanos S, Brodsky M, Argoff C, Clauw DJ, D'Arcy Y, Donevan S, Gebke KB, Jensen MP, Lewis Clark E, McCarberg B, Park PW, Turk DC, Watt S. Rethinking chronic pain in a primary care setting. Postgrad Med. 2016;128(5):502-15.
Chronic Pain: In Depth. | National Center for Complementary and Integrative Health website. [Internet]. 2018 [Cited 27 June 2019]. Available at https://nccih.nih.gov/health/pain/chronic.htm