Different Types of Pain, Explained

Buckets of pain

What kind of pain do you have? Sorting out different types of pain can be helpful when considering how to relieve it. How long pain lasts, where it arises and how it feels are some of the ways pain is classified. Acute pain and chronic pain are the two major pain "buckets." Chronic pain, which is more complex, includes several categories involving a variety of causes and treatments. Here are some of the ways that people may experience pain.

Acute pain

Acute pain actually has some positive aspects. It's short-term by definition -- resolved within 30 days but often much sooner -- and it tends to respond well to treatment. Anything from everyday aches and pains to intense pain following a dental extraction or surgical procedure are examples of acute pain. "That's the sort of pain people probably have the most experience with, and it's the pain our medicines work best for," says Dr. Tonya Palermo, a professor of anesthesiology and pain medicine at University of Washington School of Medicine and a researcher in pediatric chronic pain at Seattle Children's Hospital. Compared to chronic pain, acute pain is a simpler process, she says: "You have an injury, you have local inflammation and then an analgesic relieves it."

Chronic pain

Chronic pain makes life miserable for a lot of people. About 100 million Americans suffer from chronic pain, according to the Institute of Medicine. A simple definition of chronic pain is that it's any pain lasting more than 12 weeks. But duration is only part of what sets chronic pain apart. "I would almost consider chronic pain as a disease state itself," says Dr. Asokumar Buvanendran, president of the American Society of Regional Anesthesia and Pain Medicine. "Arthritis pain is not just in one hand or one knee," says Buvanendran, who is an anesthesiologist at the Rush University Medical Center in Chicago. "It affects the whole body and so there are whole systems that are also affected." Hormonal and metabolic changes arising from pain can cause significant consequences and lasting damage, he says.

Nerve pain

It's not surprising that nerve damage can lead to pain: Nerve pain, or neuropathic pain, can result from conditions such as diabetes, shingles and HIV; trauma and certain treatments, notably cancer chemotherapy. "The main difference with neuropathic pain is really the quality of the pain," Palermo says. "It's a burning, stinging kind of pain." People with diabetes may develop diabetic neuropathies, when high blood sugar, or high blood glucose, affects the nerves, primarily in the legs and feet but also in the hands. Certain medications used for other conditions may also improve diabetes-related nerve pain, including anti-seizure drugs such as gabapentin (Neurontin or Gralise), or specific antidepressants like duloxetine (Cymbalta). A device called a spinal cord stimulator may help control neuropathic pain.

Back pain

Chronic back pain is so pervasive that it merits its own category. First comes back pain itself, followed by the agony of back surgery -- which can then lead to a sequel of long-lasting pain if things don't go well, Buvanendran warns. Advanced brain scans called functional magnetic resonance imaging, or fMRI, have identified changes in the brain stemming from chronic low back pain, according to a March 2018 evidence review in the Clinical Journal of Pain. If you live with low back pain, you may have to go through a gamut of treatments and lifestyle changes to find a method that works.

Visceral, somatic and referred pain

"I feel it in my gut." Abdominal pain arising from your internal organs, or viscera, is sometimes called visceral pain. Appendicitis pain, pelvic pain and gallstone pain are common examples of visceral pain, which patients describe as a deep, dull sensation. Pain you can feel directly at its source is known as somatic pain. Localized types of pain include facial pain and cancer-related bone pain. Gnawing, cramping, throbbing or aching sensations are characteristic of somatic pain. Referred pain means pain in one area of the body causes pain in another. "For example, someone has a nerve impingement in their neck, but they have pain down in their butt," Palermo says. That obviously can be confusing for patients trying to figure out what's going on.

Phantom pain

After an amputation, some people can still feel pain where the limb or organ used to be. Phantom pain is not just psychologically based, as was previously believed, but a physical feeling arising from the brain and spinal cord. Phantom pain and phantom limb sensation are two different things. Shooting, throbbing, squeezing or burning phantom pain can develop soon after an amputation. Treatments including physical therapy, mirror therapy and peripheral nerve stimulation devices help ease phantom pain in some patients.

Cancer pain

Unfortunately, cancer pain may come from several simultaneous sources. Bone pain from cancer can be particularly severe, according to the American Society of Regional Anesthesia and Pain Medicine website. Tumors can be painful in and of themselves as well as by spreading and injuring surrounding bodily tissues. Neuropathic and other pain can result from radiation, chemotherapy and surgery, among other treatment hazards, and from cancer progression. Pain management specialists are often part of the treatment team for cancer patients experiencing increasing pain. These clinicians help make adjustments in opioid medications like morphine, deal with breakthrough pain and offer interventions like spinal pain pumps if indicated.

Children's pain

Although pain types are similar for adults and children, some differences exist. Children don't have as much back pain as adults, Palermo says, perhaps because kids haven't experienced years of wear and tear on their backs. "When children have musculoskeletal pain, it's more likely to be in other parts of their bodies," she says. Children may suffer from sports overuse injuries, for example. "Children have less experience with pain, and that can be both an advantage and disadvantage," she says. Kids can be more resilient, she says, with the ability to work on self-management strategies. "They can actually have complete resolution of pain, sometimes, in a way that's unusual for adults to have," she adds. "But we know that kids who have pain are at risk for having pain later in life."

Pain management

Effective pain management requires a multifaceted, team approach. "Certainly, for chronic pain, you need to involve everything: physical therapy, psychology, medications and all components of conventional pain therapy," Buvanendran says. "That's what most multidisciplinary centers do. You have everybody involved in this discussion." The population of people with chronic pain vastly outnumbers the availability of pain management specialists. In most cases, pain management starts with your primary care provider, who can make referrals as needed. And ongoing pain management centers on you. Exercise, relaxation, pacing yourself and complementary and cognitive techniques can be highly effective. Medication isn't necessarily the first or best resort. "There is a larger range of strategies that can help you with any pain that you're experiencing," Palermo says. "All pain is not harmful. It can be managed."

Lisa Esposito is a Patient Advice reporter at U.S. News. She covers health conditions, drawing on experience as an RN in oncology and other areas and as a research coordinator at the National Institutes of Health. Esposito previously reported on health care with Gannett, and she received her journalism master's degree at Georgetown University. You can follow her on Twitter, connect with her on LinkedIn or email her at lesposito@usnews.com.