Pain The Ultimate Decider

Editor's Note: When you see these three dots surrounded by a gray rectangle — 1 — you can click on it to get further information about the topic. Click a second time, and the message goes away.

This article was edited and updated on December 23, 2021.

Pain Defined

All of us experience pain — there are many levels. It can be as simple as our stomach growling to tell us we're hungry to excruciating pain in our kidneys when our body tries to pass a kidney stone.

There are two broad categories of pain 2. They are:

Quite simply, the difference in what type of pain you have is in what part of your body is being affected: tissues (nociceptive) or nerves (neuropathic). You can have both, of course, particularly with injuries.

Are there Other Types of Pain?

We might also include a third category of pain which we will just call "other."

Neurological dysfunctions can also be painful in conditions such as fibromyalgia, irritable bowel syndrome, and some low back pain. These conditions sometimes can and do change — both in symptoms and in treatment. As research continues, as well, these dysfunctions are becoming better understood.

For instance:

"Fibromyalgia is probably a pain system dysfunction, a poorly understood multi-system failure causing widespread body pain (and more), but 'dysfunction' of the nervous system is specifically excluded from neuropathic pain, by decree with the International Association for the Study of Pain (IASP), as of 2011 3. Dysfunction means that fibromyalgia isn’t caused by any (known) damage to the nervous system, but by its misbehaviour, and so it’s not welcome at the neuropathy club." (from The Basic Types of Pain by Paul Ingraham) 4

Sensitization of Pain: What is it?

Sometimes our bodies over-react to a normal process. For example, our immune system over-reacts in allergic situations, and our nervous system sometimes overestimates a danger to the body. A certain amount of sensitization is good: if we're about to have a medical test, and we know that some pain may be involved, our bodies do a bit of preparing for that.

Sensitization only becomes dysfunctional when it is chronic and disproportionate to what is actually happening in the body. There will always be a grey area between what we call "normal" and what we call "dysfunctional".

When you see a massage therapist or a physiotherapist, you might be asked to measure your pain between 1 and 10 with 10 being the worst. But everyone feels pain differently, and it is impossible to know if a "10" for Person A really does feel the same for Person B. That's why they ask you to identify the pain, based on your own experience. None of us can truly understand how much pain someone else is in.

"Sometimes we just don’t understand a problem well enough to classify it. The best example of this is the sensitive spots in soft tissue that so many people have — often referred to as 'trigger points'.... There is a popular hypothesis that they are caused by a problem with muscle tissue, which would make it a clear case of nociceptive pain from a fairly subtle lesion… but it’s just an hypothesis, and some experts have suggested that trigger points are caused by a problem with nerves themselves, which would make them neuropathic. No one actually knows, and it’s not likely to be settled for a long time." 5

Coping with Chronic Pain

Most of us cope with pains that come and go. Whether it be a headache, an injured ankle, or post-surgery discomfort, we know that it will end and we try to find ways of dealing with the temporary pain — everything from taking medication to mindfulness exercises and deep breathing.

Chronic pain is another thing altogether and much more challenging for us to cope with. Here are a few suggestions for ways to cope with chronic pain: 6

The Final Word: Myths about Pain

If you suffer from chronic pain, there are probably several myths which have been repeated to you about it — either from so-called friends and even by your doctor. Here are some of the most common:

There are no easy answers. The critical issue is that each person must monitor their own pain, find solutions, and learn to understand their pain as much as possible. It is your body, and it makes sense to understand it as much as possible. Be pro-active and work with your doctor on solutions.

Other related articles:

I am a BCRPA-certified fitness instructor in Vancouver, BC. I teach four classes at the West End Community Centre in Vancouver, BC, mostly designed for the older adult. The Inevitable Disclaimer: Everything published here expresses only my opinion, based on my training and research. What you do with the information is entirely your own responsibility. I am not liable for any injury you suffer that seems to be related to anything you read here. Always consult your doctor before beginning an exercise program. For other articles, return to the table of contents.

★ ★ ★

  1. These three dots behave exactly like a footnote. Click on them and you will get more information about the topic. ↩︎

  2. Thanks to Paul Ingraham's article, The Basic Types of Pain ↩︎

  3. The IASP (International Association for the Study of Pain) keeps a list of the painful conditions and what type of pain they are. Have a look at their website: IASP ↩︎

  4. Paul Ingraham's website discusses many painful conditions. ↩︎

  5. Thanks to Paul Ingraham's article, The Basic Types of Pain ↩︎

  6. Thanks for some of the ideas from 11 Tips for Living with Chronic Pain ↩︎