The 5 Differences Between Nociceptive Pain And Neuropathic Pain
Among the advances and scientific knowledge that the 20th century brought is the detailed description of the physiological mechanisms that allow us to experience pain From there, the latter has been defined taking into account different elements.
For example, depending on its cause and specific course, Pain has been divided into three main types: neuropathic, nociceptive and psychogenic In this article we will see what the main characteristics of these types are, as well as the differences between neuropathic pain and nociceptive pain.
According to the International Association for Pain Studies, “pain is an unpleasant sensory and emotional experience with actual or potential tissue damage or described in terms of such damage” (1994).
Depending on its functions and location, this sensory and emotional experience can be classified in the following ways: nociceptive pain, neuropathic pain or psychogenic pain.
1. Nociceptive pain
Also known as somatic pain, nociceptive pain is defined as a normal response of the body to an offensive stimulus, and its goal is to prevent further damage. It is an adaptive pain, which is called nociceptive precisely because its main function is to perceive, alert and protect the body from a harmful stimulus. An example would be removing our hand when we begin to feel a hot object.
This kind of pain It is understood as a warning mechanism, an alarm signal or as an adaptive reaction to real or apparent harmful stimuli. The latter, harmful stimuli, are transmitted through messages that are also known as “nociceptive messages.” They begin in the periphery and advance towards the dorsal horn of the spinal cord, and then towards different structures that allow them to reach the thalamus and the cortex (considered the higher pain centers).
In the same sense, nociceptive pain receptors can be found in the skin, muscles, joints or vices. For this reason, it is a well-localized pain and the person can write without much difficulty. A persistent experience of nociceptive pain can also cause a series of local sympathetic effects, muscle contractions and postural changes
2. Neuropathic pain
For its part, neuropathic pain is pain that is no longer considered an adaptive response, and is characterized by changes in the physiology of the response. This type of pain results from injuries or chronic alterations in peripheral or central nerve pathways. It develops when faced with a harmful stimulus, but can also do without it. To describe it, people often use unusual terms, while It represents a new experience that is difficult to describe
It can occur in the following forms, which at the same time are part of a hypersensitivity to pain known as hyperpathy:
Furthermore, neuropathic pain can be divided into the following types depending on the specific location:
2.1.Pain of central origin
This may be the case, for example, of a cardiovascular accident or multiple sclerosis. Its location is in the central nervous system and It is usually a pain that is more resistant to treatment
In this case it is a pain that has a generally favorable response to treatment and that originates in areas of the peripheral nervous system. Over time, this type of neuropathic pain can develop not only as peripheral but also as central pain, through a process called precisely “centralization” and It is characterized by plastic changes in the posterior horn of the spinal cord
3. Psychogenic pain
Psychogenic pain is the psychological experience (e.g. anxiety or depression) described in terms of tissue damage. This description can be made in both verbal and behavioral terms, regardless of whether tissue damage has existed or not. It is an experience of pain that has its genesis in a psychological state and which cannot be located in the organic structures of the nervous system.
Differences between neuropathic pain and nociceptive pain
Once the general characteristics of the different types of pain have been described, we can explain and summarize some differences between nociceptive and neuropathic pain. We follow Dagnino (1994) in the following five points.
1. The stimulus
In the case of nociceptive pain, the stimulus that causes the pain is obvious and easily located both by the person who experiences it and by the specialist. In the case of neuropathic pain, there is no obvious stimulus.
2. The location
Related to the above, the place where the pain occurs is easily located by the person experiencing it, which is why they easily describe it. For its part, Neuropathic pain is generally diffuse in location
The experience reported by people with nociceptive pain is often similar. For its part, the experience reported by people with neuropathic pain is difficult to report; it seems to be an unusual and different pain, so it’s harder to explain and it can vary between each person.
4. The response to the narcotic
The differences in responses to pharmacological treatment in both cases are also different. While an effective effect has been reported in nociceptive pain, in the case of neuropathic pain partial relief has been reported
5. The response to placebos
Contrary to the above, neuropathic pain usually responds better to placebo treatments, and nociceptive pain responds practically ineffectively. According to Dagnino (1994) the figures are 60% effective in the first case, and 20-30% in the second.
