Pain can occur acutely, i.e. for a limited period of time, or chronically, over a longer period of time.
Chronic pain is one of the most common symptoms of all. According to figures from the “Austrian Pain Alliance”, 1.5 million people are affected in Austria alone. Half of these patients are impaired in their working lives by their chronic pain, and 11% are even unable to work due to their condition.1
Pain is classified not only according to its duration, but also according to its underlying triggering mechanisms into so-called nociceptive, neuropathic, mixed and dysfunctional pain.2,3 Therefore, the type of pain must be known for a drug-based pain therapy in order to be able to individually adapt a mechanism-oriented pain therapy to the patient.
Nociceptive pain is caused by acute tissue damage in the context of inflammatory, degenerative and malignant diseases or in the context of an acute injury. Depending on the localization, somatic pain (caused by diseases of the musculoskeletal system, skin, subcutaneous tissue and mucous membrane) can be distinguished from visceral pain (so-called “visceral pain” affecting internal organs, e.g. colic). Nociceptive pain is mediated by pain receptors (nociceptors) and tends to have a consistent character (e.g., stabbing, dull, or drilling). Neuropathic pain occurs after damage or disease to the nervous system (often referred to as “nerve pain”) and is often described as burning, tingling, stabbing, shooting in, radiating, “electrifying.” Neuropathic pain is subject to a different mechanism than nociceptive pain and, accordingly, requires different analgesics. Mixed pain has both nociceptive and neuropathic components.
These types of pain can vary in intensity from mild to severe and can occur in the context of different diseases (e.g. tumour diseases or non-malignant diseases). Therefore, especially in the context of chronic pain therapy, an exact diagnosis of both the mechanism and the intensity of pain is essential for the correct choice of analgesic.
1 Rudolf Likar. Opioids in chronic pain. Ärztemagazin 11, 2017: 16- 19.
2 Sabine Sator-Katzenschlager. Pain therapy update 2015. physician & practice volume 69, 2015: 89-94.
3 Gabriele Grögl. Type of pain determines type of drug. Physicians Crown Pain17, 2017: 14-16.