THE NATURE OF PAIN
Inpatient and outpatient pain management options differ, as does the nature of each individual’s pain.
Somatic pain: Dull, achy, throbbing and sore. It is usually well localized — for example in fractures, arthritis or injury — to deep musculoskeletal structures or superficial cutaneous tissues, or in bone and spine metastases.
Visceral pain: Squeezing pressure, cramping, deep, distension, stretching, bloated and diffuse. It originates deep in an organ and is often referred to dermatomes innervated by the same fibers and is often seen in post abdominal or thoracic surgery, bowel obstruction, venous occlusion, ischemia, liver metastasis, ascites or pancreatitis.
Neuropathic pain: Burning, shooting, numb, tingling, radiating “like a fire” or electrical shock like pins and needles. It is caused by nerve damage by tumor or injury, spinal cord compression, postherpetic neuralgia, diabetic neuropathy or neuropathies from tumor chemotherapy or radiation. Neuropathic pain can be related to dysesthesia — sensations of pain from non-painful stimuli.
Acute vs. Chronic:
Acute pain: Can be seen after surgery and teams may use opioid medications during procedures and postoperatively to keep patients comfortable.
Chronic pain: Specialists, like rheumatologists, are especially challenged to help patients suffering from chronic, long-term pain due to rheumatic and autoimmune diseases and may often rely on opioid medications when other treatments may not be considered as effective.