It's important to have a general understanding of the major different types of back pain, because the type of pain dictates the treatment options.
Nociceptive Pain and Neuropathy
The medical community usually classifies pain in one of two general categories: neuropathic pain and nociceptive (somatic) pain.
- Nociceptive pain is pain that is sensed by the “nociceptor” sensory fibers after an injury to a muscle, soft tissue (ligaments, tendons), bones, joints, or skin (or other organs). Nociceptive pain is often characterized as a deep aching, throbbing, gnawing, or sore sensation. Common examples of nociceptive pain related to back pain include: pain after trauma (e.g. back pain after a car accident or a fall), pain after back surgery, and arthritis pain. Nociceptive pain is usually localized and gets better with healing.
- Neuropathy or neuropathic pain is pain caused by damage to nerve tissue. Neuropathy is often characterized as burning, severe shooting pains, and/or persistent numbness or tingling. Common examples of neuropathic pain related to back pain include sciatica, pain that travels from the spine down the arm, pain that persists after back surgery.
It is thought that in some cases prolonged nociceptive pain may progress to neuropathy, and a patient may have both nociceptive pain and neuropathy at the same time.
Acute Pain and Chronic Pain
It's also important to distinguish between acute pain and chronic pain, as the two types of pain are very different in form and function.
- Acute pain- With acute pain, the severity of pain directly correlates to the level of tissue damage. This provides us with a protective reflex, such as the reflex to move your hand immediately if you touch a sharp object. This type of pain is a symptom of injured or diseased tissue, so that when the underlying problem is cured the pain goes away.
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Acute pain is a form of nociceptive pain.
- Chronic pain - In chronic pain, the pain does not have the same meaning as with acute pain - it does not serve a protective or other biological function. Rather, the nerves continue to send pain messages to the brain even though there is no continuing tissue damage.