Types of Pain

Pain is a complicated and complex feeling. Pain can be acute or chronic, intense or dull, life threatening or a nuance, physical or emotional, expected or unpredictable, and even self-induced or external. I feel different pain when I run hard during races and workouts, when someone says something that hurts me, and when I burn myself cooking pizza (that was last week!). Other people may feel chest pain when they are having a heart attack, head pain due to a migraine, phantom limb pain after an amputation, abdominal pain from a stomach bug, or low back pain that has been persistent or reoccurring for years. Sometimes pain is easy to figure out and solve; however, often pain is difficult to understand and treat.

Today I am going to discuss types of pain that are caused by physical factors. As a physical therapist, most of the pain I treat is due to musculoskeletal (muscle/ligament/tendon/bone) or neurological (nerve) issues. We use a 0-10 scale with 0 representing no pain and 10 representing the worst pain ever imaginable for our patients. This is very subjective, but it gives clinicians a ballpark number to track progress. Below I have outlined how to interpret various pain sensations, the timing of pain, and a few general treatment options for these types of pain.

Pain Sensations

  • Dull/achy/tender: These words typically describe musculoskeletal pain. The pain sensation is usually felt right in the area of the problem and can include anything from tight muscles to arthritis to overuse injuries.

  • Burning/Tingling/Shooting: These words typically describe nerve pain and can radiate down the leg(s) or arm(s). Irritation to nerves can be from damage at the level of the spinal cord in the neck or back. Irritation can be also from a nerve in a limb being compressed due to swelling or external pressure such as in the wrist with carpal tunnel syndrome.

  • Sharp/Stabbing: These words also usually describe nerve pain (such as hitting your funny bone which is actually cause by hitting a nerve!); however, they can also be due to a new injury in the musculoskeletal system such as a fall or other trauma (i.e. muscle tear or broken bone).

Timing of Pain

  • With movement: Pain during certain movements usually indicates musculoskeletal pain. For example, pain in your arm when putting your coat on or when reaching to the top cabinet is often from ligament or tendon or muscle problems in the shoulder.

  • At rest: Pain without movement is often from neurological issues. Being in one position for a long time can cause nerves to be compressed or irritated, especially if someone has poor posture or there is pressure from tight clothing or shoes. 

  • Inconsistent: Irregular pain can be either caused by either musculoskeletal or nerve problems. For example, often pain from arthritis feels better after some gentle exercise, and sometimes a change in position can fix nerve pain.  

General Treatments for Pain

  • Musculoskeletal: Ice works best for a new injury and heat for a chronic injury.  Massage, posture correction, alteration of movement patterns and exercises to correct any muscle imbalances are very important to fixing the cause of the problem. If there is severe damage to the area, surgery may be needed.

  • Neurological: Ice usually works best for nerve pain because you don’t want to heat an already irritated and inflamed nerve. However, neurological pain can often be a result of a musculoskeletal problem such as poor posture causing the nerves in your neck to be compressed or weak abdominal muscles causing the nerves in your low back to be compressed. In this case, you have to treat the underlying musculoskeletal problem through posture correction, alteration of movement patterns, and exercises to strengthen muscles allowing pressure to be taken off the irritated nerve(s).

Some people have a hard time describing their pain or they cannot remember exactly what their pain feels like. It is so important to be in tune with your body and learn from the messages it is sending you. Pain overtakes the lives of many people, but early treatment and education to help individuals understand pain can make a huge difference.

What pain sensations have you felt during an injury?

The pain of racing vs. the pain of almost cutting your fingers off - quite different!!