Introduction

Whether we like it or not pain is an part of our human life. We have felt it and chances are at some point we will feel it again. So it is useful for us to spend some time to try to understand it.

Essentially pain is a sensation coming from activating one of our deeply ingrained threat response systems. It's purpose is to inform of danger so we take action and return to safety. And this system has evolutionary developed to react automatically and in most instances beyond our control. After all it is there to protect us!

But as conscious being what action shall we take and under what criteria? That's where building our understanding of pain becomes important. Even more so for chronic pain where even doctors don't know what else to do.

This is all about empowering us, as human beings.

Exactly because we are conscious beings we have the ability to take decisions on different levels and adjust & calibrate our experience. Yes even pain! We do that by assigning meaning and thus putting things in context. And as a matter of fact we do that all the time, below the level of our conscious awareness

This is why categorising and interpreting pain can help us make meaning based decisions about what is going on and how we would like to respond to it. Since pain is an element that appears in our lives in various instances it is helpful to examine categories of pain and explore their interactions.

So here I want to let you know about different broad categories of pain and how they can inform our experience about pain.

About Ways of Slicing: Types & Categories

The way we slice a cake can completely change our perception of it!

Sure triangles and squares are fine. But what if we cut horizontally across the cakes layers so the top looks intact? What if we cut diagonally?

That would be a strange party indeed. Let's dive into it.

So if pain is like a cake the question we are trying to examine is what are some meaningful ways to slice this cake and what are these slices in each case :) Yum!

In that sense while different types of pain within a category are typically distinct, many of them can feed into the types of other categories. That is different ways of slicing.

So examining not only different types but also different categories is helping us figure out what is going on.

More than that the pain we actually feel at a specific moment can be more than one slice of the cake. Thus it can have different layers in it each belonging to a different types within the same category.

What Is This Cake About? - Decision Steps

If we wanted to schematically break down a simple sets of decisions our minds take into account when in pain (and in other cases too) this would be:

- What is happening?

- How do I interpret it?

- What will I do about it?

Most of the time these run unconsciously, however by bringing our attention to them we can create awareness and start the process of exercising conscious control. Knowing about different categories and types of pain, helps us do just that.

Some cake questions to ponder are:

What if a part of the cake has whipped cream?

What if part of it has strawberry toppings?

What am I tasting at the moment?

What are some of the combinations of materials present?

And how can I slice this cake in the future so it tastes for me better?

Broad Categories & Types of Pain

Anatomy Based: What's happening to the body

When it comes to pain this is where our mind most easily goes to. After all we are conditioned through life and culture to associate pain with physical damage. And while this is not always true it is indeed something we should check.

So anatomy based types of pain help us reflect on the body origin of the pain. And together with that we have to remember that signals coming from our body are only transformed into pain within our brains.

Two main types of signals that activate pain (because the signals themselves are not pain) are either nociceptive signals or neuropathic signals.

Nociceptive signals reflect an issue to the body's tissues (e.g. muscles, bones, organs) and neuropathic signals reflect an issue to the nerves or the nervous system.

A 3rd type is that of nociplastic aka functional pain.

This refers to pain coming from no obvious damage to the body and highlights how pain is a sensation created in the brain while it is felt on the body. This type of pain is typically considered part of chronic pain conditions.

So while this type is refers to pain of no clear anatomical origin it is still defined in terms of anatomy and in my humble opinion reflects our cultural obsession of examining things from the lens of the body even when they have to do with the mind.

Duration Based: Acute vs Chronic

This is another typical categorisation that comes by approaching pain in terms of it's longevity.

Acute Pain

Acute refers to pain of recent onset, typically (but not necessarily) associated with some recent issue in the body.

Chronic Long Term Pain

However when the pain of a specific issue lasts for more than 3 months, it is classified as chronic.

Unfortunately this is an unhelpful terminology that can trap people in the belief their pain will be lasting forever or they have no control over it. Long term pain is a much suitable term.

As someone with several orthopaedic issues, more than a few past surgeries and fibromyalgia I am speaking from experience. Chronic pain can in many cases completely go away or at least significantly reduce for extra long periods of time. So the term "long term pain" is much much better and hopeful.

Necessity Based: Useful vs Unnecessary

This is the JUICY stuff!

This is one of the most juicy categories as it takes us into the realm of adjusting pain through the mind.

This is what allows people to have tooth extractions, specific types of surgeries and even significantly reduce chronic long term pain for good.

Within a given situation our mind automatically gives us as much pain as it considers necessary. As a result all of the pain or any part of that becomes unnecessary can go away. Though sometimes our system gets stuck and we need to help it.

The interesting thing here is that within the appropriate context it doesn't matter if there is damage on the body or not. Pain can go away or not be felt at all. Sometimes it can transform to another sensation like heat or pressure. Neither it matters if the pain is acute or long term. What matters is how necessary our mind considers pain the particular situation we are in. Useful or unnecessary pain can contain any type of pain from the previous categories.

There is an element of safety to be taken into account here because absence of pain doesn't mean there is no damage to the body. Within safe contexts we can reduce pain or turn it off. So forming safe contexts is important when we turn pain from useful to unnecessary. Forming this safe context is part of the many methods which help reduce chronic pain through the mind.

This also feeds into the next good/bad pain category.

Good vs Bad vs Neutral

While this category is not often referred when we talk about pain as a problem (i.e. injury or chronic pain), it is still important as it adds a way to talk about pain that applies to other areas of our everyday experience.

It allows us to start painting the emotional palette of pain as it applies to our experience. After all pain is indeed recognised by modern neuroscience as an emotion!

This is something that can easily apply to pain coming desirable activities like working out, sports, sex and other erotic activities like kink.

For example the pain we have next day after going to the gym, may actually feel good because it reminded us we exercised. On the other hand if we overdid it and it limits us, even though there is no body damage present it can feel like a "bad" or unwanted pain.

Personally I like adding the neutral type as it increases the palette of options and can give us more accurate pain signal interpretations.

The words "good" and "bad" insert binary emotional evaluations which can affect how we read on our pain experience. Hence why I believe "neutral" is a good addition to this colour scheme.

So neutral pain can be a pain which doesn't worry us from a safety point of view (i.e. it's not bad), so we are still ok to have it because it is part of something else that is happening, but we don't inherently enjoy it or feel bad about it.

We can feel neutral about pain from sore muscles after last day's exercise, or we can feel neutral about a pain from an old injury which doesn't causes any new damage anymore. And chronic pain can indeed be placed in this category.

It may sound strange and even completely alien the fact that pain which causes us so much suffering can be a neutral thing. And indeed when we connect it with suffering pain is something really bad. Pain though by itself, although unpleasant, isn't suffering. Realising that can help us reduce the "badness" of long term pain an move it more in the neutral category.

Essentially neutral pain, when safety checks are in place, is pain that is ripe to become unnecessary. Thus it has the possibility to go away with the power of our mind.

In summary these types of pain can be classified like that:

- Good Pain: One that doesn't physically or emotionally alarm us and we enjoy

- Neutral Pain: One that doesn't physically or emotionally alarm us and we are ok with or simply don't mind it.

- Bad Pain: Pain that signifies potential damage that needs to be addressed, significant emotional distress and activity that needs to be stopped.

Please keep in mind the same element of safety that was mentioned in the useful vs unnecessary category applies here too. Pain is an approximate signal, similar body issues can hurt differently in different moments or not at all. Getting to know your mind, your body and establishing your own calibration is essential for interpreting your body signals and turning them into appropriate action.

More than all that I would love to know is: How do these categories inform you on your pain?

What are some terms, techniques, considerations you use to evaluate it, process it, manage it?

Press the chat bubble and let's talk!