How many types of Pain?

1. SUPERFICIAL PAIN.

This occurs due to direct irritation of the peripheral nerve endings in superficial tissue. Such irritation may be by chemical mechanical thermal or electrical.
The superficial pain is sharp and can be pointed with a fingertip.

2. SEGMENTAL PAIN

This occurs due to irritations of a sensory nerve trunk or root. This is located in a particular dermatome of  body supplied by the affected sensory nerve trunk or root.

3. DEEP PAIN

This pain occurs due to irritation of deep structures of body e.g. the deep fascia, the muscles, the tendons, the bones, the joints, and viscera. The pain sensation from the affected structure is conveyed to the brain. Either by somatic nerve or by autonomic nervous system. The deep pain is vague compared to the superficial pain and may be one of the various types which are described below. The deep pain is vaguely localized in comparison to the superficial pain. 

The deep pain may be referred to as some other area of the body due to a common area of representation in the spinal cord (supplied by the same segment). The deep pain may cause involuntary spasms of the skeletal muscles supplied by the same spinal cord segment.

4. PSYCHOGENIC PAIN

In this condition pain arises from the brain, which may be a functional pain either emotional or hysterical or due to lesions in the thalamus or spinothalamic tract or due to causalgia.

What is the Nature of the pain?

(i) VAGUE ACHING PAIN

This is a mild continuous pain that has no other specific features

(ii) BURNING PAIN

It is almost like burning sensation caused by contact with a hot object. Burning pain is typically experienced in the case of peptic ulcer or reflux esophagitis.

(iii) THROBBING PAIN

It is type of throbbing sensation which is typically felt in case of pyogenic abscesses.

(iv) SCALDING PAIN

It is also a type of burning sensation that is particularly felt during micturition in the presence of cystitis, acute pyelonephritis, or urethritis.

(v) PINS AND NEEDLES SENSATION 

It is typically felt in case of injury to the peripheral sensory nerve. As if pins and needles are being pricked in that area of skin supplied by the affected sensory nerve.

(vi) SHOOTING PAIN

It is typically felt in the case of sciatica when pain shoots along the course of the sciatic nerve.

(vii) STABBING PAIN 

A sudden, severe, sharp, and short-lived pain. This is typically felt in the acute perforation of peptic ulcer.

(viii) CONSTRICTING PAIN –

This means as if something is encircling and compressing from all directions the relevant part. The pain is often expressed as an iron band tightening around chest. It is typical of angina pectoris.

(ix) DISTENSION

This type of pain is experienced in diseases of any structure encircled or restricted by wall e.g. a hollow viscus. When tension increases inside such hollow viscus it causes pain which is typically described by the patient as a feeling of distension or ‘ tightness’.

(x) COLIC

A colicky pain occurs when muscular wall of a hollow tube is attempting to force certain content of tube out of it.

(xi) TWISTING PAIN 

A type of sensation as if something is twisting inside body. Such sensation is often felt in the case of volvulus of the intestine, torsion of the testis, or ovarian cyst.

(xii) ‘JUST A PAIN’

Often a patient may not describe his pain. He often says that ‘it is just a pain’ and cannot describe nature of the pain.

What is the pain which travel?

There is pain that travels from one part of the body to another part of the body. Pain may move from one place to the other and 3 types of such movements are noticed – (i) radiation, (ii) referred, and (iii) shifting or migration of pain.

RADIATION O F PAIN.

This means an extension of the pain to another site whilst the original pain persists at its original site. The radiation of pain has almost same character. A typical example is when a duodenal ulcer penetrates posteriorly. The pain in the epigastrium remains but at the same time, the pain spreads or radiates to the back.

REFERRED PAIN

When pain is felt at a distance from its source and there is no pain at the site of the disease, it is called a referred pain. Irritation or inflammation of the diaphragm causes pain at tip of the shoulder. Referred pain occurs when central nervous system fails to differentiate between visceral and somatic sensory impulses from same segment. In this case diaphragm is supplied by the phrenic nerve (C3, 4, and 5) and the cutaneous supply of the shoulder is also C4 and CS.

SHIFTING OR MIGRATION OF PAIN

In this condition, pain is felt at one site in beginning and then the pain is shifted to another site original pain disappears.