Physical pain is divided into nociceptive & neuropathic pain.
Nociceptive pain from direct activation of pain nerve fibers, d/t chemical, inflammatory or
mechanical mediators. Most common type of pain occurs when pain
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Physical pain is divided into nociceptive & neuropathic pain.
Nociceptive pain from direct activation of pain nerve fibers, d/t chemical, inflammatory or
mechanical mediators. Most common type of pain occurs when pain receptors, called
nociceptors, respond to stimuli that are potentially damaging, ( noxious thermal, chemical,
or mechanical stimuli),may occur as a result of trauma, surgery, or inflammation, mostly
described as aching. 2 types of nociceptive pain: Visceral pain (internal organs) caused by
stimulation of deep internal pain receptors, most often in the abdominal cavity, cranium, or
thorax. Visceral pain may vary from local, achy discomfort to more widespread,
intermittent, pain. Menstrual cramps, labor pain, GI infections, bowel disorders, organ
cancers all produce visceral pain. Description of quality & extent of pain often serves as a
strong clue to the cause. Deep somatic pain (skin, muscles, bones, connective tissue)
originates in ligaments, tendons, nerves, blood vessels, & bones. Deep somatic pain is more
diffuse than cutaneous pain & tends to last longer. A fracture or sprain, arthritis, bone
cancer cause deep somatic pain. Arthritis is a type of chronic somatic pain.
Neuropathic pain generated by nervous system, complex, often chronic pain arising when
injury to one or more nerves results in repeated transmission of pain signals even in
absence of painful stimuli. Nerve injury may come from many conditions, poorly controlled
diabetes, tumor, viral infection, some meds, chemo can trigger nerve injuries, may cause
neuropathic pain even after d/c. Described as burning, numbness, itching, pins & needles,
prickling pain. Cutaneous / superficial pain in the skin or subcutaneous tissue. If you’ve
touched a hot object or paper cut, that’s superficial pain. Radiating pain starts at origin
but extends to other locations pain of sore throat may extend to ears. Referred pain occurs
in an area that is distant from original site Pain from heart attack may be experienced
down left arm. Psychogenic pain believed to arise from the mind, pt perceives pain despite
fact no physical cause identified, can be just as severe as pain from a physical cause. Acute
pain has short duration, rapid onset, varies in intensity, last up to 6 mo, mostly associated
w/ injury or surgery. It’s protective in that it indicates potential or actual tissue damage &
may absorb pt’s physical & emotional energy for a short time, helpful for pt to know pain
usually ends as tissues heal. Chronic pain lasts 6 mo. or more, often interferes w/ daily
activities, may have periods of remission & exacerbation, can be progressive even if there’s
no current tissue injury, as in neuropathic pain. May be viewed as insignificant by family &
Dr. & lead to pt w/drawal, depression, anger, frustration, & dependence. Next to
incurability, chronic pain is a feared aspect of contracting cancer or other diseases.
Intractable pain is both chronic & highly resistant to relief.
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