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Types of Pain
There are three types of pain, based on where in the body the pain is felt: somatic, visceral, and neuropathic. Pain of all three types can be either acute or chronic. Somatic, visceral, and neuropathic pain can all be felt at the same time or singly and at different times. Most cancer patients experience both somatic and visceral pain. Only about 15-20% of all cancer patients report neuropathic pain. The different types of pain respond differently to the various pain management therapies. Somatic and visceral pain are both easier to manage than neuropathic pain.
Somatic Pain
Somatic pain is caused by the activation of pain receptors in either the cutaneous (body surface) or deep tissues (musculoskeletal tissues). When it occurs in the musculoskeletal tissues, it is called deep somatic pain. Common causes of somatic cancer pain include metastasis in the bone (an example of deep somatic pain) and postsurgical pain from a surgical incision (an example of surface pain). Deep somatic pain is usually described as dull or aching but localized. Surface somatic pain is usually sharper and may have a burning or pricking quality.
Visceral Pain
"Viscera" refers to the internal areas of the body that are enclosed within a cavity. Visceral pain is caused by activation of pain receptors resulting from infiltration, compression, extension, or stretching of the thoracic (chest), abdominal, or pelvic viscera. Common causes of visceral pain include pancreatic cancer and metastases in the abdomen. Visceral pain is not well localized and is usually described as pressure-like, deep squeezing.
Neuropathic Pain
Neuropathic pain is caused by injury to the nervous system either as a result of a tumor compressing nerves or the spinal cord, or cancer actually infiltrating the nerves or spinal cord. It also results from chemical damage to the nervous system that may be caused by cancer treatment (chemotherapy, radiation, surgery). This type of pain is severe and usually described as burning or tingling. Tumors that lie close to neural structures are believed to cause the most severe pain that cancer patients feel.
Acute Pain
Acute pain is short lasting and usually manifests in ways that can be easily described and observed. It may, for example, cause sweating or increased heart rate. It can last for several days, increasing in intensity over time (subacute pain), or it can occur intermittently (episodic or intermittent pain).
Chronic Pain
Chronic pain is defined as pain lasting for more than 3 months. It is much more subjective and not as easily described as acute pain. Effectively treating chronic pain poses a great challenge for physicians. This kind of pain usually affects a person's life in many ways. It can change someone’s personality, ability to function, and quality of life.
Signs and Symptoms of Osteoarthritis
The signs and symptoms of osteoarthritis vary, depending on the joint. But the main symptom associated with osteoarthritis is stiff and painful joints. Typically, stiffness is worse in the morning—lasting less than 30 minutes—and after resting: moving the joint for a few minutes can help shake off the stiffness often associated with osteoarthritis. Joint pain also may be severe after exercising and at the end of the day.
Another sign of osteoarthritis is the creaking or grinding sounds that occur when the affected joint is moved. Moreover, moving the joint through the full normal range of motion may not be possible.
In more advanced osteoarthritis, muscles may become weaker because of insufficient use. Joints also may appear swollen, mostly caused by new bony growths called osteophytes or, sometimes, by extra synovial fluid.
The severity of symptoms in osteoarthritis is greatly influenced by a person's attitudes, anxiety, depression, or daily activities.
The Definition of Rheumatoid Arthritis
Rheumatoid arthritis, known as Still's disease when it affects children, is a condition that causes inflammation of joints and associated pain, swelling, and stiffness. The body's own immune system attacks joint tissue, breaking down collagen, cartilage, and sometimes bone or other organs. This chronic disease varies between people and fluctuates over time, often marked by symptoms that improve only to re-emerge later. In some cases rheumatoid arthritis is mild and lasts only a few months (this kind of rheumatoid arthritis is called type 1), while in others the disease becomes progressively complicated by disability and other health problems, lasting many years (this is called type 2 rheumatoid arthritis).
Rheumatoid arthritis most often affects the wrist and finger joints closest to the hand, but can also affect joints in the feet and throughout the body. Anyone can be affected by rheumatoid arthritis, but women are more likely to develop symptoms, which most often begin between the ages of 20 and 30. The causes of rheumatoid arthritis are not yet understood, but many effective strategies have been developed to manage its symptoms.
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