the most fundamental techniques you need to master, as a starting point for everything else, is understanding your pain. Know it, label it. This is not a one-step process. Your pain may well change over time. You need to be able to bring your awareness to whatever hurts, objectively assess it, and respond appropriately. You have to be able to depersonalize it, every time.
So what’s your pain like? Let’s break it down into some simple components and descriptors.
Classifying Pain
Duration
Acute Pain
Acute pain is typically sudden, intense, and short-lived. It is an immediate reaction to stimuli and is usually solved (or greatly ameliorated) by medical intervention.
Chronic Pain (Non-Cancer)
Chronic non-cancer pain is longer-lasting, often duller, and resistant to medical treatment. It can be linked to a physical or mental illness (other than cancer) but is not necessarily defined by it and can far outlast the original illness. The official definition of chronic pain is pain that lasts more than three months, and this definition can therefore encompass anything from prolonged recovery from injury to long-term illness.
Chronic Pain (Cancer)
Chronic cancer pain is long-term pain caused directly by cancer. Most cancer pain is caused by a tumor pressing on a nerve, bone, or organ. It can also be a result of cancer treatment—for example, pain experienced due to chemotherapy.
Breakthrough Pain
Breakthrough pain isn’t technically its own category, as it’s a form of pain that occurs when an ongoing chronic pain problem suddenly becomes acute—but we’ve kept it separate here because it does behave differently than chronic or acute pain. Breakthrough pain is often caused by a change or failure in medications, and although it is a function of the chronic pain, it acts and feels acute. This is most common among patients who are under treatment and have bouts of severe pain that break through their medication at intervals.
Location
Localized Pain
Most pain stays where it was caused; you break a leg, your leg hurts. You get stung by a bee on your finger, your finger hurts. Localized pain stays at its origin site.
Referred Pain
Referred pain is when pain from one part of your body is felt somewhere else.
Phantom Pain
Phantom pain is where there is pain in a part of the body that has been removed.
Intensity
Traditionally, pain is rated on a simple scale, from one to ten, depending on how it feels to you.
Mild Pain
A rating of one on the scale is effectively no pain at all. Anything between one and four is considered mild pain and can be ignored or easily treated.
Moderate Pain
Moderate pain is a five or six on the scale; it hurts, and you know it hurts, but it’s not blotting out rational thought or your basic functionality.
Severe Pain
Severe pain is anything from a seven to a ten on the scale. If one is no pain at all, ten is the worst pain you have ever experienced. A ten on the scale is mind-numbing, searing, extreme pain that blocks basic functions such as walking or even breathing.
Note that, although we have split the pain scale up here to illustrate the range of severity, these are not different types of pain—just different levels. A pain of intensity one on the scale may behave exactly like a pain of intensity ten; it’s just that the effect on you is different.
Pain Inventory
Many clinics now use a more sophisticated methodology than the simple one-to-ten pain scale. While helpful in acute situations (like in a hospital’s emergency room), the one-to-ten scale doesn’t reflect the changing nature and effects of chronic pain. Almost all chronic pain clinics use some form of pain inventory, pain interference, or pain functionality system to measure pain’s severity and effect, as well as the effectiveness of treatments.
These systems may vary slightly by clinic and region, but, essentially, they record the pain at its high and its low, and the level of disruption the pain causes in key areas of life, such as sleep, work, mood, etc. This gives a better overall illustration of pain and how it impacts daily life on an ongoing basis, and doctors can use these systems to find ways to reduce the impact of the pain (even when they can’t change the pain itself).
Cause
Pain is often classified by the damage that causes it, and there are layers of classification, depending on how in-depth you want to get. Let’s look at them, starting with the broadest terms:
Nocioceptive Pain
Nocioceptive pain is a fancy way of saying pain from any of the physical structures of your body. This can include organs, muscles, skin, joints, and tissues.
Neuropathic Pain
This is the type of pain caused by damage to or a disease of the nervous system itself; it can affect any area of the body and can come in many forms: a stabbing pain, an ache, a shock, tingling or numbness, a burning sensation, a spasm. It can be continuous or episodic. Neuropathic pain is notoriously hard to treat and often is the most persistent, least understood of all types of pain.
Algopathic or Central Sensitization Pain
This is pain caused by the brain’s perception of the sensations reaching it. It is not a function of the physical body, the tissues, joints, muscles, organs, or even the central nervous system, but rather is caused by neurological disorders that affect the way the brain interprets information.
These three basic types of pain are the main classifications.1 But we can go down a level into different types of pain:
Visceral Pain
Visceral pain is associated with injury to the internal organs and is usually acute until the underlying illness is treated.
Somatic Pain
This is the most common form of everyday pain, affecting sensory receptors within the muscles, soft tissues, or skin. Examples of somatic pain are mild burns, muscular inflammation, an insect bite.
Psychogenic Pain
Psychogenic pain refers to physical pain that is caused by psychological factors only, with no physical cause component. This is extremely rare. Mood can magnify pain in many ways, but very rarely does it cause pain all on its own.
And going further still into specific types of pain within the body:
Joint Pain, Bone Pain, Muscular Pain, Nerve Pain
Rather obviously, these labels refer to a specific type of body part that is affected by pain. If you pull a muscle, you have muscular pain. If you have arthritis or another illness affecting the joints, you have joint
