Introduction to Pain
Two Types of Pain
Neuropathic Pain
Nociceptive Pain
Chronic Pain Treatment Alternatives

Neuropathic pain is described as a burning, tingling, shooting, electric-like, or lightning-like pain. This type of pain may exhibit opioid resistance or require higher opioid doses to achieve pain relief.

• Damage to the peripheral or central nervous system
• Pathologic changes in neuro-functional relationships within the peripheral or central nervous system

• Central sensitization or "wind-up"
• Abnormal sympathetic somatic nervous system interactions
• Abnormal activation of NMDA receptors

• Radiculopathies
• Neuralgias
• Failed back syndrome
• Complex regional pain syndrome
• Arachnoiditis
• Painful neuropathies

Nociceptive pain is described as dull, aching, throbbing pain that is sometimes sharp. This type of pain is often responsive to opioid therapies, whether delivered orally, transdermally, parenterally or spinally.

• Results from mechanical, thermal or chemical excitation or trauma to peripheral nerve fibers
• Is mediated at nociceptors widely distributed in cutaneous tissue, bone, muscle, connective tissue, vessels, and viscera

• Bone pain (e.g. from a fracture, bone metasteses, etc.)
• Pain elicited by tissue injury
• Pressure pain
• Cancer pain

Introduction to Pain
Two Types of Pain
Neuropathic Pain
Nociceptive Pain
Chronic Pain Treatment Alternatives