Assessing Pain

It is important to understand the characteristics of different types of pain so that you can explain it to a healthcare professional. Nociceptive pain can result from a tissue injury (such as a cut or a burn) where you can pinpoint the location on the skin or joint, but it may also be from internal tissue/organ injury or inflammation, called visceral pain.1 This type of pain may be sharp, burning, stabbing, throbbing, or cramping.1

Neuropathic pain can be categorized in three ways: hypersensitivity (called allodynia), excessive pain (called hyperalgesia), and abnormal sensation of the skin (called paresthesia). Sensations associated with paresthesia can include pins and needles, burning, tingling, itching, or partial or full loss of sensitivity.2

Nociplastic pain can cause widespread body pain or pain in multiple regions, along with other symptoms such as fatigue, and sleep disturbances. It can also occur with one or both of the other types of pain.3 For descriptions of how each pain type can occur, please visit the What is Pain? portal page.

Substance and opioid use disorders

When assessing your pain, your doctor might ask about previous pain management therapies and opioid use. This is important to discuss because Substance Use Disorder (SUD) is a serious problem, which affected around 40 million people in 2020 in the United States.6 SUD is defined as a “treatable, chronic disease characterized by a cluster of cognitive, behavioral, and physiological symptoms indicating that the individual continues using the substance despite significant substance-related problems”.7 Even though a person with an SUD knows the harm around addiction, there are changes in the brain that occur that lead to intense cravings and a cycle of continued use.7 Risk factors for SUD can include a family history of mental illness, SUD, or addiction, or a personal history of mental illness or prior misuse or overdose episode.8 Risk factors specific to opioid use disorder (OUD) can be biological and genetic factors, socioeconomic situations, poor social support, a history of legal problems, trauma, stress, and unclear etiology of pain.8

It is important to discuss with your doctor all signs and symptoms associated with the pain. The more detailed information they have, the better they are able to figure out what is causing the pain and determine if and what treatment may be needed.

References

  1. Cleveland Clinic. Nociceptive Pain. Last reviewed July 8, 2024. https://my.clevelandclinic.org/health/symptoms/nociceptive-pain
  2. Cavalli E, et al. The neuropathic pain: An overview of the current treatment and future therapeutic approaches. Int J Immunopathol Pharmacol. 2019;33:2058738419838383.
  3. Fitzcharles MA, et al. Nociplastic pain: Towards an understanding of prevalent pain conditions. Lancet. 2021;397:2098-2110.
  4. US Department of Health and Human Services. How can I describe my pain to my health care provider? Last Reviewed January 31, 2017. https://www.nichd.nih.gov/health/topics/pelvicpain/conditioninfo/describe
  5. Public Radio (NPR). Neighmond P. Words matter when talking about pain with your doctor. July 23, 2018. https://www.npr.org/sections/health-shots/2018/07/23/626202281/words-matter-when-talking-about-pain-with-your-doctor
  6. Centers for Disease Control and Prevention (CDC). Travelers’ Health. Substance Use & Substance Use Disorders. Last reviewed May 1, 2023. https://wwwnc.cdc.gov/travel/yellowbook/2024/additional-considerations/substance-use
  7. Centers for Disease Control and Prevention (CDC). Treatment of Substance Use Disorders. April 15, 2024. https://www.cdc.gov/overdose-prevention/treatment/index.html
  8. Webster LR. Risk factors for opioid-use disorder and overdose. Anesth Analg. 2017;125:1741-1748.

All URLs accessed August 23, 2024.

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