There are two types of long-term pain:
- musculoskeletal pain
- neuropathic pain.
You may experience these at the same time, but the symptoms of each need to be treated in different ways because medications designed for musculoskeletal pain sometimes aren’t effective in neuropathic pain and vice versa.
Musculoskeletal pain comes from structures involved with your skeleton or its movement, for example muscles, tendons and ligaments. This type of pain is often experienced by people who have arthritis.
You may experience flare-ups, which can cause stiffness and a feeling of warmth in the affected part when the arthritis is active.
Neuropathic pain is caused by damage or disease of your nervous system. You may experience burning and other sensations such as a persistent itch, pins and needles or shooting pains. This type of pain is particularly difficult to treat.
When a nerve is cut or becomes altered by disease, it tends to ‘fire’ more easily, and sometimes for no reason, so a constant sensation is experienced. Sometimes, the opposite happens and the nerve becomes less sensitive so an area can feel ‘dead’ or numb.
Quite often, over-sensitivity and reduced feeling can be present together.
Neuropathic pain can happen alongside changes in skin colour and temperature over the affected area. These changes can occur over the course of a day or even within the hour.
In conditions which typically include long-term widespread pain, such as fibromyalgia, or ongoing pain in a single limb, such as complex regional pain syndrome (CRPS), the quality of the pain experienced can be very much like that experienced in neuropathic and/or musculoskeletal pain but there’s no evidence of damage to the body.
This type of pain is no less ‘real’, but it’s usually caused by a disruption in the communication systems within the body rather than an physical cause. It can help to think of this type of pain as similar to a fault on the hard drive of a computer – it causes a wide range of ongoing problems, but trying to find the cause and fix the problem is very difficult.