Monday, July 23, 2012


The are several ways to classify pain.  Two ways of describing pain are generally used to define low back pain.  The first is centered around acuity.  Acute pain is pain less than 6 weeks in duration.  Subacute pain lasts from 6-12 weeks.  And chronic pain is defined as lasting more than 12 weeks.  These divisions are arbitrary, but they help the physician decide what the chances are your pain will diminish on its own.

Another clssification has to do with the way your brain perceives pain.  If you are receiving pain from pain receptors within your body, then that is called nocioceptic pain.  Non-nocioceptic pain information is sent by nerve fibers not attached to pain receptors.

Nocioceptic pain can be visceral (from organs) or somatic (from the rest of the body).  Non-nocioceptic pain can be neuropathic (peripheral nervous system) or sympathetic (from the parasympathetic nervous system).

Most back pain  is sent by pain receptors: it is somatic and nocioceptic.  Some back pain is neuropathic (sent by compressed nerves).  That pain is non-nocioceptic.

Each type of pain has a characteristic pain pattern.  The patterns are not 100% reliable, but they help the physician decide where the pain originates.

To help delineate patterns, the doctor will also ask you to describe the pain: sharp, dull, squeezing, buring, itching, etc.; if the pain is steady, intermittent, or occasional; how long it lasts; and how long periods without pain last.  In addition, he will want to know how severe the pain is and if it radiates (travels) to different places, what makes it better or worse, and what triggered the initial occurrence.

The difficulty in diagnosis usually occurs when there are multiple sources of pain, or the patient is unable to describe the pain.  It's not easy to tease out the information sometimes.

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