How To Know Key Features of Pain Types and Syndromes

Acute Pain Feature


• Pain usually concordant with degree of tissue damage, which remits with resolution of the injury

• Reflects activation of nociceptors and/or sensitized central neurons

• Often associated with autonomic nervous system and other protective reflex responses (e.g., muscle spasm, “splinting”)



Chronic Pain Feature


• Low levels of identified underlying pathology that do not explain the presence and/or extent of the pain

• Perpetuated by factors remote from the cause.

• Continuous or intermittent with or without acute exacerbation.

• Symptoms of autonomic nervous system hyperactivity less common.

• Irritability, social withdrawal, depressed mood and vegetative symptoms (e.g., changes in sleep, appetite , libido), disruption of work, and social relationships

Cancer Pain


• Strong relationship between tissue pathology and levels of pain

• Limited time frame that permits aggressive pain management

• Rarely involves medical-legal or disability issues.

Chronic Non-cancer Pain


• Weak relationship between tissue pathology and pain levels

• Prolonged, potentially life-long, pain

• May involve medical, legal, disability issues/conflicts, work or relationship problems, physical de-conditioning, psychological symptoms (see chronic pain above)

• May progress to chronic pain syndrome


Chronic Pain Syndrome


• Preoccupation with somatic functioning

• Lifestyle centered on seeking immediate pain relief, with excessive, nonproductive, and often harmful use of health care

• services

• Repeated attempts to obtain pain-related financial compensation (e.g., Social Security,. Veterans’ benefits)

• Numerous symptoms and signs of psycho-social dysfunction that the patient attributes to the pain (e.g., anger, depression, anxiety, substance abuse, disrupted work or personal relationships)

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