Defining Pain - Pharmacology

Pain is whatever the patient who is experiencing pain says it is. Healthcare providers describe pain in terms of intensity, duration, frequency, and type of pain. However, these terms are subjective and characterized by the patient.

Pain is classified in six ways.

  1. Acute pain is the presence of severe discomfort or an uncomfortable sensation that has a sudden onset and subsides with treatment. For example, a fractured bone causes acute pain since the uncomfortable sensation occurs suddenly when the bone is broken and subsides when the bone is immobilized in a cast. Pain associated with myocardial infarction (heart attack), appendicitis, and kidney stones are also examples of acute pain. Acute pain can be treated with NSAIDs or opioid analgesics.
  2. Chronic pain is a persistent or recurring pain that continues for six months or more. This is the pain from cancer and rheumatoid arthritis and other chronic conditions. Chronic pain is treated with combinations of NSAIDs and opioid analgesics as well as medications to reduce swelling and anxiety.
  3. Visceral pain is the dull and aching pain caused by stimulating nerve endings in smooth muscle or sympathetically innervated organs. Visceral pain is referred pain. This makes it difficult to localize the source of the pain. Pain of a myocardial infarction (MI) is an example of visceral pain. MI can be described as crushing chest pain and also described as pain in the left arm or hand and even the shoulder, left back, or the left ear. Visceral pain is best treated with opioid analgesics.
  4. Somatic pain is pain occurring from skeletal muscles, fascia, ligaments, vessels and joint. Somatic pain is an aching, throbbing pain over the affected area. Somatic pain is best treated with nonsteroidal anti-inflammatory agents.
  5. Neuropathic pain is a burning, shooting, and sometimes tingling pain that is caused by peripheral nerve injury. This is caused by the invasion of a cancerous tumor or nerve damage. Neuropathic pain is treated with a combination of medications such as anticonvulsants, tricyclic antidepressants, and opioid analgesics.
  6. Psychogenic pain is pain caused by psychiatric illness or psychosocial stimuli such as anxiety, depression, and fear. Drug therapy alone may bring brief relief. Psychotherapy may bring long-lasting relief from psychogenic pain.

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