What Are the 4 Types of Pain?

• Central Pain Syndrome
  • What is central pain syndrome?
• Psychogenic Pain
  • What is psychogenic pain?

Pain is one way your body tells you that something is wrong. But in addition to being unpleasant, it is also difficult to describe sometimes, since we all feel pain differently. Understanding the different types of pain can help you better explain to your doctor what you are experiencing.

1. Acute vs. chronic pain

Pain is clinically classified as acute or chronic depending on its duration:

• Acute pain is usually severe, short-lived, and has a specific cause. Causes include cuts, scrapes, burns, sprains, broken bones, etc.
• Chronic pain ranges from mild to severe, lasts for more than 6 months, and sometimes has no apparent cause. Examples include lower back pain, arthritis pain, nerve damage pain, frequent headaches, etc. 

2. Somatic pain

Somatic pain often results from the stimulation of pain receptors in tissues such as your skin, joints, muscles, and bones. This type of pain is usually localized and described as aching, gnawing, or throbbing.

Causes of somatic pain may include:

• Fractures
• Sprains
• Burns, scrapes, or cuts
• Arthritis 
• Osteoporosis
• Cancer affecting skin or bones

Somatic pain responds to painkillers (NSAIDs) such as ibuprofen, paracetamol, diclofenac, and other opioid painkillers.

3. Visceral pain

Visceral pain often results from the stimulation of pain receptors in your internal organs and is felt around your chest, abdomen, or pelvis. This type of pain is usually vague and described as pressure, cramping, squeezing, or aching. Symptoms may be accompanied by changes in blood pressure, heart rate, or temperature.

Causes of visceral pain may include:

• Appendicitis
• Indigestion or constipation
• Gallstones
• Irritable bowel syndrome

This type of pain responds well to a wide variety of pain management approaches including decompression (procedures that relieve pressure over the organs), NSAIDs (especially opioids), anesthetics injected into the organs, and neurosurgical procedures.

4. Neuropathic pain

Neuropathic pain often results from nervous system damage, where nerve fibers are damaged. This type of pain is described as burning, tingling, shooting, stabbing, or freezing.

Causes of neuropathic pain may include:

• Nerve inflammation and compression
• Infections
• Tumors
• Shingles
• Diabetes

Neuropathic pain responds well to tricyclic antidepressants (TCA), selective serotonin reuptake inhibitors (SSRIs), anticonvulsants, opioids, and local anesthetic injections.

Central pain syndrome (CPS) is chronic pain that stems from central nervous system damage, affecting part of the brain called the thymus. The pain can often be debilitating, and may be accompanied by itching and loss of sensation in the face, arms, or legs. In some cases, individuals become hyperresponsive to normal stimuli; for example, feeling pain due to a breeze or the weight of a blanket. 

Causes of CPS may include:

• Stroke (altered blood supply) 
• Tumors
• Multiple sclerosis
• Spinal cord injury

Most conventional pain modalities do not work for CPS. The only FDA-approved treatments for CPS are ziconotide, methods that use virtual-reality-assisted hypnosis, supportive care, rehabilitation, and psychotherapy.