Chronic pain - Definition & classification

11 important questions on Chronic pain - Definition & classification

Why is pain a subjective kind of problem?

The amount of pain experienced doesn't have to be in line with the actual or severity of the tissue damage or hindrance.

Which 6 categories exists for the classification of pain?

  1. Underlying cause
  2. Frequency
  3. Severity
  4. Duration
  5. Cancer related
  6. Functional consequences

How can pain be classified in relation to underlying cause?

  • Nociceptive pain
  • Neuropathic
  • Ideopathic
  • Mixed pain
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What is nociceptive pain?

Pain related to damage or pathology to the musculoskeletal system, it involves the activation of pain receptors in the spinal cord that signal to the brain (nociceptors). (burns, wounds, arthritis, broken bones)

What is neuropathic pain?

Pain as a consequence of damage or dysfunction of nerves. Which involves damage to peripheral or central nervous system. Which becomes permanent over time. Can also involve sensory changes (hyperalgesie, allodynia) 

For instance, in diabetes, spinal cord injury, HIV infection, limb amputation, due to chemotherapy/radiation, or infiltration of a tumour suppressing a nerve, MS

What is mixed pain? And what injuri is an example of mixed pain/

A combination of both nociceptive and neurophathic pain. For instance due to a herniated disk. In a herniated disk the nuclues pulpopus leaks out of the cavaty which then irritates the nerves.

What is ideopathic pain?

Pain in the absence of a physical injury or tissue damage

How can pain be classified in accordance to duration?

  • Chronic pain = lasting >3-6 months
  • Acute pain = lasting <3-6 months

What is the association between physical and mental deconditioning in chronic pain?

In the beginning acute pain is often a sign of harm/damage. As a reaction people can experience fear, worry, depression, and become less physical active to prevent more harm, more medication use etc. But in the end this could reinforce the experienced disability because non-use leads to muscle weaking, which causes more limitations/pain --> more worry etc.

How can pain be classified in accordance to frequency?

  • Constant: pain is always there, may or may not fluctuate in intensity
  • Intermittent: pain is present for some time, can be in a specific rhythm or not (migraine)
  • Transient or brief: only seconds or minutes (bumping knee)

What are the most important causes for cancer-related pain?

Tumor growth, bone metastasis, post-surgical or post-radiation pain, or chemotherapy induced neuropathy.

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