The Basic Types of Pain
There are two well-recognized broad categories of pain: the common sensical sort (the pain of damage), and the somewhat more exotic kind that comes from damage to the system that reports and interprets damage, the nervous system. It’s the difference between engine trouble and trouble with that light on your dashboard that says there’s engine trouble. More specifically:
- Nociceptive pain arises from various kinds of trouble in tissues, reported to the brain by the nervous system.1 This is the type of pain everyone is most familiar with, everything from bee stings and burns and toe stubs to repetitive strain injury, nausea, tumours, and inflammatory arthritis. Nociceptive pain typically changes with movement, position, and load.
- Neuropathic pain arises from damage to the nervous system itself, central or peripheral, either from disease, injury, or pinching.2 The simplest neuropathies are mechanical insults, like hitting your funny bone or sciatica, but this is a big category: anything that damages neurons, from multiple sclerosis to chemotherapy to alcoholism to phantom limb pain. It’s often stabbing, electrical, or burning, but nearly any quality of pain is possible. Unfortunately, it’s also more likely to lead to chronic pain: nerves don’t heal well.3
Obviously these kinds of pain can overlap. Some medical problems, like injuries, can affect both nerves themselves and other tissues, causing both kinds of pain. However, it’s surprising how little overlap there is: look at any list of the most painful conditions [NHS] and they all fit pretty clearly into one category or the other.
