What are the main types of pain?
Doctors like to have different words to describe the various things that can go wrong with the human body. It is like a code they can use to speak to each other. When talking about pain, they start by talking about time. When the cause of the pain is going to pass quickly on its own or respond well to treatment, the pain is described as “acute”, i.e. you will heal and all you need is pain relief while you wait. But if the pain is going to set in for a long time, it is called “chronic”. When it comes to the physical causes, the distinction is between nociceptive and neuropathic pain.
Nociceptive pain
The nociceptors are the nerves that recognize damage to a part of the body and signal where that damage has been sustained. So, if you have a bruise, cut, sprain or fracture, the pain will tell you exactly where the injury is. This comes as a two-stage process. There is an anticipation system. For example, if you are about to get a burn, the nerves tell you are about to be damaged. Once the real injury arrives, the pain is localized and usually constant. Depending on the type of injury, the pain may be steady throbbing or an ache. Internal injuries are less localized.
Neuropathic pain
This pain is caused by a problem in the nervous system. It does not necessarily result from a specific injury. For example, as diabetes advances, it can cause damage to the nerve endings which triggers pain without a clear point of origin. The same can happen if nerves are trapped or pinched by growths, fail to heal properly following a wound, are damaged by vitamin deficiencies or some other poison, e.g. drugs or excess alcohol, and so on.
How to treat pain
The strategy is to start with the underlying cause of the pain. If there is a specific injury, disease or disorder, this must be addressed. Once resolved, the pain should disappear. Except, of course, some neuropathic pain can persist even though the healing is supposed complete. If there is doubt about the diagnosis, your doctor will put you through tests if the pain is sufficiently severe to justify the cost. The latest scanning and imaging technology allows doctors to make more precise identification of problems in the muscles and soft tissues. Surgery can then correct the problem.
But some diseases and disorders have no effective treatment. The best the doctors can do is stabilization. In these cases, the pain becomes the problem in its own right. There are two basic approaches, best taken in combination. The first is drug therapy. An opioid like Tramadol is the first choice to control moderate to severe pain. It provides effective relief over the medium to long term. The second is psychotherapy and counseling. Cognitive behavioral therapy and other forms of practical advice to make life bearable within new physical limitations gives the best long-term outlook.