What types of pain are there?
Author: SCIRE Community Team | Reviewer: Patricia Mills | Published: 12 April 2017 | Updated: 18 October 2017, 10 October 2024
Wrist injuries are a common source of pain after SCI.1
Muscle, joint, and bone pain
Pain from the muscles, joints, and bones is called musculoskeletal pain. This type of pain is felt in areas where there is normal sensation, such as above the level of SCI in an individual who has a complete injury, and also below the level of SCI in an individual with an incomplete injury and preservation of sensation below the level of injury. Musculoskeletal pain may feel ‘dull’, ‘achy’, or ‘sharp’ and usually happens during certain movements or positions. After SCI, musculoskeletal pain often comes from shoulder and wrist injuries, neck and back strain, or muscle spasms.
Visceral pain may be felt in certain areas of the body based on the organ involved.2
Internal organ pain
Pain from the internal organs (like the stomach, bladder, or heart) is called visceral pain (pronounced ‘VISS-err-el’). This type of pain can also be felt after SCI from areas with normal sensation. Visceral pain is usually felt in the abdomen, pelvis, or back but it is often hard to pinpoint exactly where it is coming from. This type of pain often feels ‘dull’, ‘tender’, or like ‘cramping’. Visceral pain is often caused by problems like constipation, bladder overfilling, or bladder infections.
Nerve pain (Neuropathic pain)
Pain from the nerves is called neuropathic pain. Neuropathic pain can be felt anywhere in the body, including below the level of SCI, even when there is no other feeling in the area. Neuropathic pain often has unique and unusual qualities compared to other types of pain:
It may feel like it is ‘hot’, ‘burning’, ‘tingling’, ‘pricking’, ‘sharp’, ‘shooting’, ‘squeezing’, or like ‘painful cold’, ‘pins and needles’, or ‘an electric shock’
It may happen spontaneously (‘out of the blue’)
It may happen in response to things that do not normally cause pain (like the brush of clothing on the skin)
It may be felt in areas far away from where the damaged nerve is (such as pain in the hand from a nerve injury in the neck)
Areas for nerve pain after SCI: below the level of injury (left), at the level of injury (centre), and other neuropathic pain (above the level of injury) (right).3
There are three main types of nerve pain after spinal cord injury:
At-level SCI pain is nerve pain felt at or near the level of SCI, usually as a band of pain around the torso or neck, or along the arms or legs.
Below-level SCI pain is nerve pain felt in any area below the SCI (including areas without other sensation).
Other neuropathic pain is nerve pain that is unrelated to the SCI and is felt above the level of the SCI. For example, an injury to nerves outside of the spine like nerve compression at the level of the wrist (i.e., carpal tunnel syndrome).
What is chronic pain?
Chronic pain, or persistent pain, is pain that is present for a long time (usually 6 months or more). Chronic pain is very different from pain experienced right after an injury (called acute pain). Long term or unrelieved pain can change how pain is experienced in the nervous system. This can lead to pain that is very complex and often challenging to treat. Chronic pain requires a very different approach to how it is understood and managed.
