Chronic pain is typically divided into three broad types by mechanism. Describe each of the mechanisms.
Chronic pain is typically divided into three broad types by mechanism: somatic, neuropathic, and psychologic
1. Somatic- arising from injury, ischemia, infection, or inflammation of the musculoskeletal, connective tissue skin i.e., arthritis, scleroderma, lupus erythematosis, whiplash, temporomandibular joint dysfunction (TMJD), posttraumatic headaches, endometriosis, and sickle cell crisis.
- Central- arising from injury to the central nervous system (spinal nerve root entry zones, spinal cord and brain), i.e., painful paraplegia or Hemiplegia, post-thalamic stroke pain (Dejerine-Roussy Syndrome), phantom limb pain or complex regional pain syndrome (CRPS)- type I (reflex sympathetic dystrophy).
- Peripheral- arising from nerve injury, nerve destruction (deafferentation) or autonomic nervous system dysfunction, i.e., post-herpetic neuralgia, trigeminal neuralgia, ischemic or diabetic peripheral neuropathy, complex regional pain syndrome (CRPS)- type 2 (causalgia), Charcot-Marie- Tooth Syndrome, compressive spinal nerve root syndromes, entrapment neuropathies (i.e. Carpal Tunnel Syndrome), intercoastal neuralgia, post-irradiation neuralgia.
3. Psychological- arising from emotional stress expressed somatically- i.e. non-specific vaginismus, many myofascial syndromes, factitious disorder, conversion disorder, Munchausen’s syndrome.
See Online Reading Assignment: “Introduction to Chronic Pain” Written by J.K. Lilly and Carol Walker.
Lilly and Walker. “Introduction to Chronic Pain.” In P. Deutsch and H. Sawyer (Ed.) A Guide to Rehabilitation. White Plains, NY: AHAB Press.