Types of Pain and the Body
Learn about the body’s pain pathways and the unique and different types of pain that may influence your arthritis.
Just as there are different types of arthritis, there are also different types of pain. The arthritis pain you experience can come from various areas of the musculoskeletal system and your brain can process this information in different ways. Here are the main mechanisms of pain.
This is the mechanism that the body uses to process pain, typically due to ongoing inflammation and damage of tissue from trauma. Nociceptive pain occurs when tiny nerves — nociceptors — that run on the surface of organs, muscles, joints and throughout the body are stimulated by signals from different areas of the body. These messages are carried by nerves to the brain. For example, when you bang your elbow or knee, you feel nociceptive pain.
Mechanical pain is a subset of nociceptive pain that occurs because of damage to, in or around the structure of joints. Severe inflammation often occurs with mechanical pain. Osteoarthritis, low back disorders and tendinitis are common examples of mechanical pain.
Inflammation is an essential process that helps the body respond to and heal an injury. But it also activates nerves and causes nociceptive pain. Inflammatory pain is another subset of nociceptive pain. When joints are inflamed, damage to bone, muscles and cartilage (the slick surface between bones of the joints) can occur. Examples of inflammatory arthritis are rheumatoid arthritis, psoriatic arthritis, lupus, gout and ankylosing spondylitis.
Neuropathic pain is caused by nerve damage and happens when there’s too much or persistent pressure on nerves or nerves are pinched. It’s often described as burning, tingling, shooting, stinging or as “pins and needles.” Some people may describe a stabbing, piercing, cutting or drilling pain. An example of this type of pain is sciatic pain due to irritation of the sciatic nerve by a disc or bone spur. This pain starts at an area of the spine in the lower back and can run across the hip and buttock and down the leg. Another example: carpal tunnel syndrome, where the median nerve that goes through the wrist is inflamed or pinched.
Centralized pain, also referred to as nociplastic pain by the international community of pain researchers, was first used to describe pain caused by a damaged central nervous system — the brain, brainstem and spinal cord. It is now used to describe any pain that happens when the central nervous system doesn’t work properly and amplifies or increases the volume of pain — in other words, multifocal pain that is more widespread and/or intense. Other terms used to describe this condition include “central sensitization,” “central amplification” and “central pain syndrome.” Centralized or nociplastic pain is common in rheumatoid arthritis, lupus and other autoimmune diseases, as well as fibromyalgia, irritable bowel syndrome and temporomandibular joint disorder. Long-lasting arthritis joint pain can also become centralized.
Pain Management Planning
Sometimes, people living with arthritis and related conditions can experience different types of pain at the same time. Rheumatoid arthritis and fibromyalgia are two examples. That’s why it’s important to work with your health care provider to develop the best pain management plan for you. This may include many different strategies to address the types and causes of pain. The type of pain you’re experiencing may dictate the type of treatment you receive.
Pain research is also evolving — and as a result, our understanding of pain is, too. For example, fibromyalgia was once believed to be simply psychogenic pain, or psychosomatic, an older term — that has since been debunked and vastly abandoned by pain researchers and health care providers — that referred to emotions that caused pain in the body or that made existing pain worse or last longer.
The more you learn about your pain pathways and pain mechanisms, the better you can manage your arthritis pain. Consider keeping a pain journal to record how, when, where and what type of pain you are experiencing. Tools like the Arthritis Foundation’s Vim app can help. Share the information with your health care providers so they can optimize your treatments.
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