Motion Stability

Pain Sciences

Pain Sciences

Most patients do not realize that there are different types and categories of pain. Based on what types of pain you present with should determine the treatments you receive. This includes:

Peripheral Nociceptive:

This pain is what we are accustomed to. Peripheral nociceptive pain occurs as a reaction to injury in the periphery including skin, muscle, tendon, ligaments, joint and cartilage. For example, if you were to sprain an ankle - the pain fibers around the ankle send a signal to your brain to tell you are in pain. Once the ankle heals, the signals are no longer sent and the perception of pain subsides. Treatments are focused on reducing pain, swelling, spasms, limitations in mobility, and correction in movement patterns and strength.

Peripheral Neurogenic:

Pain or symptoms such as numbness or tingling that comes from the peripheral nerves is known as 'peripheral neurogenic'. Sciatica or a pinched nerve in the neck are classic examples. The nerve itself becomes injured or inflamed causing symptoms from the spine and down your legs or arms. Treatments are directed at taking pressure off the nerve, reduce its irritation and restore it to its normal mobility.

Central Processing:

When diagnosed, this type of pain is often 'inconclusive' or given a general diagnosis like 'fibromyalgia' or 'myofascial pain syndrome'. Central pain occurs in the central nervous system from your spinal cord to the brain. The central nervous system processes pain differently than the peripheral nervous system. The spinal cord is a center that receives all your sensory feedback from the periphery. When the central nervous system becomes irritated – unexpected things like light touch or heat / cold can become painful. Diffuse pain or pain that occurs away from your primary injury can occur as well. Treatments target the ability for the central nervous system to process sensory feedback properly – for the central pain symptoms to normalize.

Autonomic:

Pain associated with ongoing swelling, redness, sweating, or nausea may involve the autonomic nervous system. This system involves your 'flight and fight' response or the feelings you get when you are in perceived danger. Diagnoses such as complex regional pain syndrome (formerly reflex sympathetic dystrophy) usually involves the autonomic nervous system. Treatments seek to calm the sympathetic nervous system down as well as address the tissues that are involved with the reaction the patient is experiencing.

Affective:

Pain is very subjective. A patient's own perception of their pain and how it affects them gauges the intensity of pain they are experiencing. Previous experiences of pain, cultural/family influences, or other traumatic experiences all contribute to a patient's pain complaints. This partly explains why two people with the same exact injury can have dramatically different responses. Treatment is focused on educating the patient on their perspectives of pain and how to take ownership of their activities that may affect their symptoms.