Clinical Classification of Pain

Pain can be divided into nociceptive and neuropathic types of pain, and can be a mixture of these two types.

It is of clinical importance to try and distinguish the types or components of a patient’s pain since this assessment has clinical management implications in the use of analgesics, adjuvant drugs and other analgesic modalities.

Nociceptive pain:
Caused by invasion and destruction of or pressure on superficial somatic structures like skin, deeper skeletal structures such as bone and muscle and visceral structures and organs.

• Types: superficial, deep, visceral
• Superficial and deep nociceptive pain is usually localized and non-radiating
• Visceral pain is more diffuse over the viscera involved

Neuropathic pain:
Caused by pressure on or destruction of peripheral, autonomic or central nervous system structures.

• Radiation of pain along dermatomal or peripheral nerve distributions
• Often described as burning and/or deep aching
• May be associated with dysesthesia, hypoesthesia, hyperesthesia and allodynia
• May also be accompanied by lightning-like jabs of brief sharp pain  (lancinating pain)