Types of Pain

Non-nociceptive pain (NO tissue damage but pain is present)
Pain comes from within the nervous system.
A. Neuropathic
B. Neuroplastic

A. Neuropathic Pain
Examples: RSD, MS, CRPS, Carpal Tunnel Syndrome, Neuroma, Tumor, or Herniated Disc

Neuropathic pain results from damage to or dysfunction of the peripheral or central nervous system, rather than stimulation of pain receptors. With neuropathic pain, the nerve fibers themselves may be damaged, dysfunctional or injured. Originating from either the peripheral nervous system (the nerves in the area between the tissue and the spinal cord) or the central nervous system (the nerve connecting the spinal cord to the brain).

Neuropathic pain can be caused by a multitude of reasons, such as nerve inflammation, nerve degeneration (examples include stokes and multiple sclerosis), nerve pressure, and nerve infection. If ignored, neuropathy can lead to numbness, pain, weakness and incoordination. There are more than 100 known types of peripheral neuropathy, each with its own characteristic symptoms, pattern of development, and prognosis. Approximately 30% of neuropathy cases are linked to diabetes. Other common causes of neuropathy include autoimmune disorders, tumors, hereditary conditions, nutritional imbalances, infections or toxins. Another 30% of neuropathies are termed “idiopathic” when the cause is unknown.These damaged nerve fibers send incorrect signals to other pain centers.

B. Neuroplastic Pain
Changes occur within the nervous system that result in pain with little or no tissue damage. This type of pain is neurologically progressive and can become independent of the original pathology that caused pain.

Your pain warning system is not just a system for the con­duction of pain impulses from the periphery to the brain. Scientists now know that changes can take place in the receptors, nerves, the spinal cord and in the higher brain cen­ters following injury, inflammation, continued use of the pain system, disuse of inhibiting factors and learned behaviors. These changes can increase the likelihood that pain is perceived and may contribute to the development of "chronic pain". Therefore, "chronic pain" can in some cases be considered a separate disease, independent of the pathology that initially set off the pain warning system.

The nociceptive (pain) system is not just a system for the conduction of pain impulses from the periphery to the brain. We now know that plastic changes can take place in the periphery, the spinal cord and also in higher brain centers following injury or inflammation. These changes may increase the magnitude of the perceived pain and may contribute to the development of chronic pain syndromes. SWISS MED WKLY 2002;132:273– 278

There is good evidence that chronic pain is associated with changes in brain function. It is possi­ble that these brain changes compound chronic pain and future agents may be able to prevent such complica­tions. German J Psychiatry 2003; 6: 8-15