Types of Pain

Whether you have ongoing chronic pain or a short period of serious pain, what you are feeling is real and help is available. Pain management specialists can evaluate your pain and develop a personalized plan to help you manage it. Types of pain include:

Head and neck pain

The most common origins of head and neck pain include:

• Neurogenic: Nerve root compression, peripheral neuropathy and herpetic neuralgia
• Soft tissue pain: Cervical strain and myofascial pain
• Musculoskeletal pain: Degenerative joint disease, fracture, neoplasm and degenerative disk disease
• Sympathetic pain
• Trigeminal neuralgia: Trigeminal nerve pain, or shooting, intermittent pain in the face, considered one of the most painful conditions in medicine

Depending on pain origin, there are different treatment options.

Lower back pain

Lower back pain originates from any of four major structures:

• Bone: Degenerative joint disease, spinal stenosis, facet arthropathy, metastatic malignancy
• Lumbar disk: Herniated nucleus pulposus, degenerated ruptured disk
• Musculoskeletal system: Muscles and ligaments strain, muscular spasm
• Nerves: Neuropathic pain

The cause of low back pain can be difficult to identify by diagnostic testing.

Upper back and thoracic pain

Although upper back pain and thoracic pain are not very common spinal disorders, they can result in significant discomfort and pain. Thoracic pain may be caused by:

• Internal organ pathology: Lung cancer, esophageal disorders and heart disorders
• Referred pain: Cardiac angina and cholecystitis
• Muscular irritation: Myofascial pain
• Joint dysfunction of thoracic cage and upper back
• Pain from herniated or degenerated disk
• Nerve pain: Intercostal neuralgia and herpes zoster
• Pain from osteoporotic vertebral body collapse

Abdominal pain

Abdominal pain is usually caused by disease of internal organs of the abdominal cavity and is often treated by a gastroenterologist or surgeon. Interventional pain management can be offered to patients who suffer from advanced cancer of internal organs (especially pancreatic cancer) or other chronic conditions such as chronic pancreatitis and abdominal angina.

Chronic pelvic pain

Chronic pelvic pain may occur in the presence of known or suspected organ pathology, or without any evidence of any underlying physical cause. Pelvic pain is more common in women, with most common causes being endometriosis, pelvic inflammatory disease, pelvic adhesions, neoplasm, and myofascial pain of the pelvic floor muscles. Specific exercises can alleviate symptoms in many women. Often times an interventional pain procedure can be performed with good improvement in patient’s pain.

Central pain

Central pain is produced by lesions of the central nervous system which includes the spinal cord, brain and brainstem. Examples of central pain are multiple sclerosis, neoplasm and stroke.

Peripheral nervous system pain

Peripheral nervous system pain (peripheral neuropathy) results from peripheral nerve lesions. Peripheral nerve lesions may be caused by:

• Herpes Zoster (postherpetic neuropathy)
• Diabetes (diabetic neuropathy)
• Entrapment neuropathy (pain after inguinal hernia repair)
• Chronic alcoholism (alcoholic neuropathy)

Specific pain medications are available that can substantially improve pain in these patients.

Reflex Sympathetic Dystrophy

Reflex Sympathetic Dystrophy (RSD) or Complex Regional Pain Syndrome (CRPS I), applies to a variety of seemingly unrelated disorders having similar clinical feature and manifesting the same fundamental disturbed physiology. Causalgia or Complex Regional Pain Syndrome (CRPS II) is a historical term describing a RSD that follows partial or complete injury to a peripheral nerve. Pain is characterized by constant, spontaneous or severe burning pain. If persistent, it results in changes to the skin, hair and bone.