Pain

types of pain

1. Types of Pain By Dr Parneet Singh

2. "Pain is an unpleasant sensory and emotional experience associated with actual or potential tissue damage” Pain derived from latin word ‘ poena ’ which means penalty or punishment Pain is a symptom Definition Indian association for study of pain

3. Visual Analogue Scale(VAS)

4. Superficial Pain Segmental Pain Deep Pain Psychogenic Pain Types of Pain

5. Due to direct irritation of peripheral nerve endings It can be chemical/mechanical/thermal /electrical Pain is sharp Can be pointed with finger tip Superficial Pain

6. Due to irritation of a sensory nerve trunk or root Located in particular dermatone of body supplied by affected sensory nerve trunk or root Segmental Pain

7. Due irritation of deep structures like deep fascia, muscles, bones, joints or viscera Vague pain Can be referred to other part of body due to common area of representation in spinal cord Deep Pain

8. Pain arises from the brain Can be functional pain due to emotions or hysteria Psychogenic Pain

9. Protective mechanism that alerts the individual to a condition or experience that is immediately harmful to the body Sudden onset This type of pain mobilises the individual to prompt action to relieve it Psychological and behavioural response to acute pain Fear - General sense of unpleasantness o r unease - Anxiety Acute Pain

10. Chronic pain is persistent or intermittent usually defined as lasting at least 6 months The main behaviour changes are: - Depression - Attempt to keep pain - related behaviour to a minimum - Sleeping disorders - Preoccupation with the pain Chronic Pain

11. Vague aching pain -Mild continuous pain with no specific features Burning Pain -like burning sensation when in contact with hot object. Seen in peptic ulcer or reflux oesophagitis Throbbing Pain -Throbbing sensation seen in pyogenic abscesses Scalding Pain -type of burning sensation like felt during micturation in cystitis or urethritis On Basis of Nature of Pain

12. Pins and Needles Sensation -injury to peripheral nerve Shooting Pain -like in case of Sciatica Stabbing Pain - sudden, severe, sharp and short lived pain as in acute perforation of peptic ulcer Constricting Pain -like something s encircling and compressing the part like in angina pectoris Distension -Experienced in diseases encircled or restricted by wall eg hollow viscus

13. 10. Colic -Occurs when the muscular wall of a hollow tube is attempting to force certain content out of the tube Pain appears and goes off suddenly Pain is gripping Four types- Ureteric colic, Biliary colic, Intestinal colic and Appendicular colic

14. Twisting Pain -sensation as if something is twisting in the body like in volvolus of intestine or torsion of testis ‘Just A Pain’- sometimes the patient does not describe nature of the pain and says it as “JUST A PAIN” Radicular pain - caused by compression, inflammation and/or injury to a spinal nerve root arising from common conditions including herniated disc, foraminal stenosis and peridural fibrosis.

15. Radiation of Pain Referred Pain Shifting or Migration Pain On the Basis of Movement of Pain

16. Extension of pain to another site while pain at original site persists The radiating pain has almost the same character Eg Duodenal ulcer pain penetrates posteriorly Pain in epigastrium remains but at the same time radiates to the back Radiation of Pain

17. Pain is felt at a distance from the source while no pain at site of disease Eg - Inflamation of diaphragm causes pain at tip of the shoulder Pain in hip joint can be referred to knee joint Referred Pain

18. Pain is felt at one site in the beginning then pain shifts to another site and pain at original site disappears When abdominal organ becomes diseased original pain occurs at site of distribution of somatic segment As parietal peritoneum is involved the pain is experienced at site of organ Eg -Acute appendicitis pain is experienced at umbilical region(T9-T10) but later on goes to right iliac fossa Shifting or Migration of Pain

19. Thank You

20. The Nervous System and Pain

21. The Neurochemicals of Pain