Pain types

Nociceptive pain arises from activation of nociceptors due to actual or threatened tissue damage. Nociceptive pain is more than nociception because the brain is also involved; the brain receives nociceptive signals, integrates them with other available information (eg from other senses, expectations, previous experience), and the output is pain perception. Tissue damage, which causes nociceptive pain, is often subsequently accompanied by local inflammation that induces peripheral sensitisation. See #agg7-c01-s6__tagg7-c01-tbl2 for features of nociceptive pain and see Pain types most commonly associated with painful conditions  for painful conditions commonly associated with nociceptive pain.

Neuropathic pain arises as a direct consequence of a lesion or disease affecting the somatosensory nervous system. Pain is perceived in the innervation territory of the damaged or diseased neural structure. Neuropathic pain may be peripheral (peripheral nerve) or central (spinal cord or brain) depending on the location of the lesion in the nervous system. See #agg7-c01-s6__tagg7-c01-tbl2 for features of neuropathic pain and see Pain types most commonly associated with painful conditions  for painful conditions commonly associated with neuropathic pain.

Nociplastic pain is a diagnosis of exclusion. It is characterised by altered or abnormal function of the nociceptive pathways or cerebral cortex in the absence of a nociceptive stimulus or neuropathic lesion. Central sensitisation is the key contributor to nociplastic pain, rather than ongoing pathology. See #agg7-c01-s6__tagg7-c01-tbl2 for features of nociplastic pain and see Pain types most commonly associated with painful conditions for painful conditions commonly associated with nociplastic pain.

Pain is rarely attributable to a single pain type (nociceptive, neuropathic or nociplastic); often more than one pain type contributes (ie mixed pain). Although it may not be possible to definitively categorise a patient’s pain, an attempt should be made, because therapy is tailored to pain type. See Pain types most commonly associated with painful conditions  for examples of pain types most commonly associated with painful conditions.