Mild Pain
A rating of one on the scale is effectively no pain at all. Anything between one and four is considered mild pain and can be ignored or easily treated.
Moderate Pain
Moderate pain is a five or six on the scale; it hurts, and you know it hurts, but it’s not blotting out rational thought or your basic functionality.
Severe Pain
Severe pain is anything from a seven to a ten on the scale. If one is no pain at all, ten is the worst pain you have ever experienced. A ten on the scale is mind-numbing, searing, extreme pain that blocks basic functions such as walking or even breathing.
Note that, although we have split the pain scale up here to illustrate the range of severity, these are not different types of pain—just different levels. A pain of intensity one on the scale may behave exactly like a pain of intensity ten; it’s just that the effect on you is different.
Pain Inventory
Many clinics now use a more sophisticated methodology than the simple one-to-ten pain scale. While helpful in acute situations (like in a hospital’s emergency room), the one-to-ten scale doesn’t reflect the changing nature and effects of chronic pain. Almost all chronic pain clinics use some form of pain inventory, pain interference, or pain functionality system to measure pain’s severity and effect, as well as the effectiveness of treatments.
These systems may vary slightly by clinic and region, but, essentially, they record the pain at its high and its low, and the level of disruption the pain causes in key areas of life, such as sleep, work, mood, etc. This gives a better overall illustration of pain and how it impacts daily life on an ongoing basis, and doctors can use these systems to find ways to reduce the impact of the pain (even when they can’t change the pain itself).
Cause
Pain is often classified by the damage that causes it, and there are layers of classification, depending on how in-depth you want to get. Let’s look at them, starting with the broadest terms:
Nocioceptive Pain
Nocioceptive pain is a fancy way of saying pain from any of the physical structures of your body. This can include organs, muscles, skin, joints, and tissues.
Neuropathic Pain
This is the type of pain caused by damage to or a disease of the nervous system itself; it can affect any area of the body and can come in many forms: a stabbing pain, an ache, a shock, tingling or numbness, a burning sensation, a spasm. It can be continuous or episodic. Neuropathic pain is notoriously hard to treat and often is the most persistent, least understood of all types of pain.
Algopathic or Central Sensitization Pain
This is pain caused by the brain’s perception of the sensations reaching it. It is not a function of the physical body, the tissues, joints, muscles, organs, or even the central nervous system, but rather is caused by neurological disorders that affect the way the brain interprets information.
These three basic types of pain are the main classifications.1 But we can go down a level into different types of pain:
Visceral Pain
Visceral pain is associated with injury to the internal organs and is usually acute until the underlying illness is treated.
Somatic Pain
This is the most common form of everyday pain, affecting sensory receptors within the muscles, soft tissues, or skin. Examples of somatic pain are mild burns, muscular inflammation, an insect bite.
Psychogenic Pain
Psychogenic pain refers to physical pain that is caused by psychological factors only, with no physical cause component. This is extremely rare. Mood can magnify pain in many ways, but very rarely does it cause pain all on its own.
And going further still into specific types of pain within the body:
Joint Pain, Bone Pain, Muscular Pain, Nerve Pain
Rather obviously, these labels refer to a specific type of body part that is affected by pain. If you pull a muscle, you have muscular pain. If you have arthritis or another illness affecting the joints, you have joint pain. If you have a broken bone or a form of bone disease, this is bone pain. Or, if you have nerve damage, this causes nerve pain. These are simple classifications, but you probably already know the feel of each one—most of us have pulled a muscle in our time or overdone it and had a sore back.
Sensations
There are a lot of different ways that pain can feel. No two people experience pain identically, and you are the only person who is feeling the pain that you’re feeling. No one else can tell you how it feels. It is important that you can name your pain, describe it, and distance yourself from it. Not only will this help you to understand it, describe it to your doctor, identify what is happening in your body, and analyze your possible responses, but it will also help distance you from it emotionally. You are not your pain, and your pain does not define you. Try imaging your pain as a really unwelcome, disliked family member you simply cannot get rid of.
Here are some helpful words that you can use to describe the feel of your pain(s):
| spasmachingdullsharpacutestabbingpoundingrasping | tinglingnumbitchingburningcoldshockradiatinggrinding | episodicpersistentirritantticklingpricklingthrobbingboringswollen | stingingsearingtwingecramptendernessinflamedpinchinglacerating | rawthumpingtightpressure/vise-likemildintensepulsingnagging |
Common Causes
of Chronic Pain
Chronic pain can be anything that lasts longer than three months, but some chronic pain ailments are permanent and others are, ultimately, temporary. There are many different illnesses that can cause chronic pain; below are just some of the most common. Even these can come with complications, comorbidities and unusual presentations, so this is not intended to be an exhaustive or prescriptive list—just a rough guide to the most widely diagnosed chronic pain ailments at present.
Arthritis
Arthritis is the most common cause of pain, affecting almost one in every two adults over the age of sixty-five. Arthritis is not simply a disease of the elderly, however, with over a third of working-age adults experiencing it in some form at some point in their lives. Arthritis affects the joints through inflammation and can make movement painful.
Chronic Back Pain
According to research, almost 85 percent of adults will experience chronic back pain at some point. This may be due to injury, accident, arthritis, or through normal wear and tear, but anyone who has suffered this particular issue knows it can be immobilizing and very difficult to treat. It is rare for chronic back pain to become permanent.
Fibromyalgia
Fibromyalgia affects the nervous system and is associated with widespread pain in the muscles and bones without apparent cause. It can cause severe fatigue and general bodily tenderness, as well as cognitive impairment. It is the second most common condition affecting bones and muscles but, because of its amorphous symptoms, is often misdiagnosed.
Psychogenic Pain Disorder
Pain problems associated with psychological factors only, without physical cause, are known as psychogenic disorders. They can be caused by stress, anxiety, depression, or mood disorders and can present as headaches, migraines, back pain, stomach pain, or muscular pain. Given the wide range of possible affected areas, psychogenic pain is usually diagnosed when all potential physiological causes have been ruled out.
Chronic Headaches
Headaches are commonplace, but some people suffer from headaches which last at least fifteen days per month, for consecutive months, thereby becoming officially chronic. These can be tension headaches, migraines, cluster headaches,