Somatic Pain

There are two primary types of pain, somatic pain and neuropathic pain. Somatic pain, also known as Nociceptive pain, is typically due to an injury or degenerative condition that affects the bones, muscles, and soft tissues of the musculoskeletal system. The soft tissues of the musculoskeletal system that cause somatic pain include ligaments, tendons, and fascia. The somatic pain that we feel is typically appropriate to the injury to the tissues that have been injured or changes. In a typical tissue injury involving somatic pain, the level of pain that we feel is proportional to the amount of damage to the tissues, and the pain often lessens and goes away as the injury heals. The nociceptors - sensory receptors in the form of nerve endings - near the damaged tissues react to signs of changes in body chemistry or function by sending signals to the brain that something is wrong.

We would then experience pain or discomfort as a result of the messages sent to the brain from these nociceptors. The nociceptors near the site of injury may react to mechanical, thermal, or chemical changes that are occurring. There are nociceptors in nearly every muscle, joint, and body part, but they are more concentrated towards the structures closer to the body's surface. For this reason, injuries to the muscles and tissues in the deeper part of the body tend to cause somatic pain that tend to be a diffuse, dull, aching pain. Somatic pain may be involved with acute or chronic back pain. Somatic pain may be a response to either an acute injury, such as a muscle strain or sprained ligaments, or a pain response to a joint injury to a degenerative condition, such as osteoarthritis. Somatic pain is often associated with the inflammatory healing response. When cells are tissues become injuries, blood flow is increased to these areas, there is a buildup of fluid in these areas from the blood and lymphatic vessels, and the cells themselves release chemicals called prostaglandins, signaling the nerve receptors of an injury in that area. This release of chemicals triggers the inflammatory response by the body. This is why anti-inflammatories, or NSAIDs, are often effective in treating or reducing pain and inflammation involved with somatic pain injuries.

Neuropathic pain is nerve pain. This type of pain involves certain nerves sending pain signals to the brain that is not appropriate to the severity of the injury, or even when there is no injury at all. Nerve pain usually does involve an original injury, but for some reason, the pain continues even after the injury has healed. With Neuropathic pain, the nerves continue to send messages to the brain, alerting it of tissue damage, even though after the tissues have healed. These misfiring nerves may send false signals to the pain centers of the brain as well as other nerves in nearby tissues and body structures. Injuries involving neuropathic pain may be difficult to treat because they may often involve a diagnosis that is only found after eliminating several other causes of back pain. Therefore, patients may undergo many months of examinations, diagnostic tests, and physical therapy before doctors even suspect neuropathic pain.